2026-10-16 from cdhowe.org

The reality of digital healthcare in Canada has long been that three largest hospital EMR vendors have almost no Canadian presence. 

Epic and MEDITECH have zero Canadian employees, and the Cerner part of Oracle only a handful, even as we spend more than $1 billion on these systems every year. In 2026, living on the shores of Lake America, are we still okay with this? 

Meanwhile, physician EMRs belong to Canadian healthcare giants and represent a $300 to $450 million market, headquartered in Toronto, Kelowna and Vancouver inside larger healthcare companies. 

The hospital EMR market is three to five times that size. My bottom-up estimate for total costs – licences, hosting, implementation – is $1.5 billion to $2.2 billion a year. Ontario’s Auditor General found that province alone spent an average of more than $500 million annually over 13 years.  

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