Project AMPLIFI model connects acute care centres and LTC facilities

Project AMPLIFI, led by St. Joseph’s Healthcare Hamilton (St. Joe’s), has helped overcome vendor fragmentation barriers to Ontario’s vision of a single, cross-sector digital patient chart by connecting 106 hospital systems with 586 long-term care (LTC) facilities.

The network enables real-time sharing of discrete data and searchable continuity of care documents, supporting more than 165,000 bidirectional patient transfers thus far.

The technical architecture required to bridge this divide was a significant milestone. PointClickCare (PCC), used by almost 90 percent of Ontario’s LTC facilities at the project start in 2021, won the competitive RFP as the core data integration solution provider.

Using its Post Acute Care Network Management solution, PCC partnered with AMPLIFI to create three technical pathways across hospital networks dominated by Epic, Oracle Health, and Meditech.

Because only Epic had inherent exchange functionality through Care Everywhere, AMPLIFI created two new Health Information Exchanges, the Ontario eHub and Traverse Exchange Canada, that now also enable bidirectional hospital-to-hospital record exchange.

Still, the province-wide expansion was driven not by technology alone, but by cross-sector governance, trust engineering, and benefits realization.

Engineering trust: At e-Health 2026, AMPLIFI leaders explained that trust was explicitly engineered through a neutral convening authority under a public mandate, reducing concerns about vendor bias or product dominance.

Open communication about constraints and funding enabled co-design. Carina Andreatta, director of digital solutions at SJHH, stated: “From an operational perspective, it was not about control but about the speed of decisions at a provincial scale,” with executive sponsorship, implementation oversight, and functional working groups resolving issues at the right level.”

Cheryl Dieterle of PointClickCare noted that the framework “anchored the cross-sector relationship in shared healthcare outcomes rather than static contracts.”

To ensure clinical legitimacy, clinicians were embedded in advisory committees. Dr. Dan Perri, CMIO at SJHH, emphasized: “From a clinical perspective, the governance was designed to ensure interoperability served care, not the other way around, meaning clinical representation at multiple governance levels ensured decisions weren’t abstract but were grounded in how care is delivered, allowing connectivity to move to meaningful use.”

Dr. Perri added, “When hospital sites make unilateral, institution-specific decisions that do not include clinicians, such as limited functionality (view-only or unidirectional data), small pilot rollouts, and trust barriers regarding data sources, it compromises the solution’s utility.”

Change management and training (CMAT) lead, Raneel Dhillon, noted that “Training completion scores directly correlate with adoption; inconsistent training caused poor utilization.”
Disjointed rollouts, minimal CMAT activities, and restricted access (by unit or role), were all very impactful. This experience echoes current evidence that infrastructure alone is insufficient without thoughtful implementation and widespread use.

A living blueprint: AMPLIFI serves as a real-world pilot for Canada’s Connected Care Trust Framework (CCTF), a national federated approach to standardized health data exchange led by Canada Health Infoway.

A major bottleneck in large-scale health IT is the friction created when sites perform independent legal, security, and procurement assessments.

AMPLIFI addressed this through standardized Interoperability Agreements that reflect the CCTF philosophy: replacing fragmented local compliance work with a unified federated trust foundation.

To date, AMPLIFI has streamlined more than 70 hospital system agreements and more than 250 LTC home agreements.

Balancing efficiency and systemic effectiveness: This governance groundwork helped unlock measurable returns. Clinical end-user survey responses indicate that the integrated workflow recovers 60 minutes of clinical time per transfer.

Weighted by salary scales and actual use, this yields more than $3.7 million in annual cost avoidance and human resources capacity release across Ontario.

However, AMPLIFI leaders cautioned that evaluating provincial infrastructure solely through workflow time savings can understate value because sustainment and vendor software costs remain ongoing.

By applying a conservative, literature-based 2 percent reduction in hospital readmissions when eliminating critical point-of-transfer data gaps, the connected AMPLIFI network could unlock as much as $5.1 million in additional systemic cost avoidance annually.

A coded data analysis is underway to quantify AMPLIFI’s specific impact on readmission rates, length of stay, and mortality.

By moving the lens to a combined model that values both workflow speed and patient outcomes, the entire financial profile of connected care is transformed.

Under this broader model, AMPLIFI moves from appearing cost-heavy to delivering a positive combined return on investment of 48 percent across the five-year implementation timeline.

The last mile: AMPLIFI has built the foundational highway for connected care across Ontario, turning a technology expense into an active healthcare asset. However, as senior project manager Robert Steele noted, the final last mile is code set and data standardization.

Varying vendor-based code sets still create workflow friction when data fields do not map discretely between hospital systems and community electronic records. Resolving this variation will support automated clinical record reconciliation without extra clicks or manual transcription.

Sarah Culgin, MSc, is Research Manager, Research Institute of St. Joseph’s Healthcare, Hamilton, Ont.