We respond to Falk’s (2022) recent recommendations around interoperability. Although we applaud the notion that the health data of Canadians be usable – that is, machine interpretable – and widely clinically available, Falk’s (2022) recommendations must be extended. Specifically, interoperability must centre on the person and people’s rights to hold and control a usable copy of their health information for their own purposes. Also, we must acknowledge that Canada is a small global market and avoid internal fragmentation with competing jurisdictional standards. Our national strategy must align with major trading partners. To do otherwise will disenfranchise Canadians and our digital health innovators.

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