A minor comment about the footnote: "It is important to note that in American terms, EMR refers equally to an in-patient hospital or outpatient ambulatory environment. In Canadian terms, EMR refers most often to the ambulatory environment of physician offices, health centres or outpatient clinics; while electronic patient record (EPR) refers – as for provincial RHA, DHAs or Health Regions – to the in-patient hospital environment."

It seems the author is saying that there is a difference in usage between the U.S. and Canada. I doubt this is found in the scientific literature, since the vast majority of scientific literature is found in American publications and Canadian authors would want to be understood by the Americans.
Perhaps the author notices a usage difference in how local authorities refer to different technologies? Is the Canadian usage uniform across 10 provinces?