Med records are digital, but sadly unconnected: study

CALGARY – A new study out of the University of Calgary, published in the Canadian Medical Association Journal , found that nearly all Canadian physicians use electronic health records, but those records are often disconnected. That often leaves clinicians without access to the information they need from clinics and hospitals.

The regular use of EHRs by physicians rose from 36 percent in 2009 to 95 percent in 2024. Researchers found that widespread adoption has unfortunately not translated into connected care.

“Because jurisdictions didn’t take a long-range planning perspective, nearly all have major deficits in connectivity between their EHRs”, said Dr. Braden Manns (pictured left), MD, senior author of the paper.

“That means patient’s health information is siloed in different software programs, each designed by different vendors with different standards. It leaves patients’ health records fragmented across separate systems, and it’s leaving clinicians without access to the information they need. It’s all harming patients.”

Over the course of two years, the researchers investigated EHRs across every Canadian province and territory, focusing on how well connected they are, the term for which is interoperability. Interoperability is the secure, accurate and meaningful exchange of information between different systems and organizations.

They found that nearly all jurisdictions lack interoperability between hospitals, community specialists and primary care. In practice, that means that information entered in a family doctor’s office cannot be viewed by other clinicians in the hospital or community caring for the same patient.

A more detailed look at each province and territory’s performance can be viewed on the Connected Care Scorecard.

“As a patient, health data matters because it guides how a healthcare system cares for you,” said Sunand Kannappan (pictured right), BHSc’21, a medical student and first author of the study. “When records are disconnected, clinicians do not have the full picture. That can really harm patients.”

Connected records would allow emergency departments, clinics, family doctors and specialists to access up-to-date information about the patient in front of them. This information helps clinicians order the right tests and offer safe treatments.

But, when records are disconnected, clinicians are forced to rely on faxed letters, mailed documents or patients remembering their own medical history. The study also found gaps in patient access to their own records and the ability for health systems to use data for planning and improvement.

The researchers identified eight key barriers that need to be addressed including the lack of interoperability legislation, vendor data-blocking behaviours and data-privacy concerns.

“It is possible to overcome these barriers,” said Manns. “The problems are clear. Better-connected health data would benefit patients, clinicians and the overall health system.”

Earlier this year, the federal government reintroduced the Connected Care for Canadians Act, which aims to prevent vendors from data blocking and requires common standards for sharing health information across systems.

The authors say the legislation is an important first step, but provinces and territories also need to build the governance, standards and infrastructure needed to make connected records a reality.

“Canada has made major progress moving from paper to digital records,” said Kannappan. “The next challenge is making sure those records can follow patients wherever they receive care. We need to see provincial standards, clear implementation requirements and the technology infrastructure needed to support effective use of electronic health records. This cannot be solved by individual clinics or hospitals alone. It requires system-level leadership.”

Source: Kristen Fong, Cumming School of Medicine