2026-05-04 from cmaj.ca

Background: Canada has achieved near-universal adoption of electronic health records (EHRs) and yet interoperability, the secure exchange and use of health data across different systems and settings, remains limited. We aimed to describe the current state of EHRs in 10 provincial and 3 territorial jurisdictions in Canada and evaluate the maturity of their interoperability using a structured interoperability assessment model.

Methods: We conducted an environmental scan of EHR use and interoperability across all provinces and territories using Canada Health Infoway documents and structured interviews with 23 subject matter experts. Using a rigorously designed interoperability maturity model, we evaluated jurisdictions across 4 enabler dimensions (governance, legislation and standards, incentives and capacity-building, and technical infrastructure) and 4 interoperability status dimensions (community EHRs, hospital EHRs, patient portals, and system analytics).

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