The fax machine is still the principal means of communication in Canadian health care.
In the age of AI, our health infrastructure remains firmly rooted somewhere between the 19th and 20th centuries, with a mix of paper records, facsimiles (some still using paper, others encrypted digital versions), and databases that operate in splendid isolation.
Currently, while 95 per cent of health care providers have some form of electronic records, only 29 per cent of them are able to share electronic information securely and seamlessly outside of their offices.
If a patient goes to the ER, their family doctor (if they have one) is unlikely to know; if a patient fills a prescription (or doesn’t), their specialist will be none the wiser. Many patients still carry around file folders full of paper records from appointment to appointment. Tests get repeated over and over because providers can’t find the results.
For patients, the data dysfunction is even worse. The 2025 OurCare survey found that only about one-third of patients can access information like their vaccination or medication history, and fewer than 10 per cent are able to access info on a hospital stay or ER visit.
In short, our health data is unwell, as Globe and Mail reporter Chris Hannay said in an article last year.
All this because systems don’t speak to each other. We spend billions on computer systems, but they are marred by a stunning lack of interoperability between different providers, something Health Minister Marjorie Michel called “unnecessary silos.”
So, the federal government is promising – yet again – that this is finally going to change.
Last week, Bill S-5, the Connected Care for Canadians Act, was tabled in the Senate. The proposed legislation is almost identical to Bill C-72, which was introduced in 2024, and which subsequently died when a federal election was called.
Under the proposed law, health technology companies would be forced to adopt common standards that would make it easier to transfer info between systems. It would also prohibit companies from blocking transfer of data when a provider changes software providers.
Finally, the legislation would make it easier for patients to access their own health information, something that is long overdue.
Proper data-sharing saves time, money, and even lives. So this is a good start. However, the legislation still has some big holes.
In this day and age, patients need to be guaranteed unfettered access to their data. Vague promises are not enough. Similarly, data should be available to research, without excessive privacy barriers.
The key to the Connected Care Act is having standards that ensure data is shareable. But the law doesn’t reference any standards. Those details matter.
While the proposed legislation has provisions for financial penalties, they have to be meaningful. A toothless law is no law at all.
There is also a clause that allows provinces to opt out if they introduce their own legislation. The principal impediment to data-sharing now is that there are 10 different privacy and data handling standards across the country.
There needs to be a single standard, and provincial autonomy be damned.
The problem here is not technology – it’s culture.
Interoperability between systems is a technical challenge that can be resolved easily enough. Many countries have done it, long ago.
But there has to be willingness to change, and there needs to be standards and oversight.
Let’s not forget that, way back in 2001, Canada Health Infoway was tasked with creating a standard for electronic medical records. Despite the $500-million budget, that never happened and, to this day, our EMRs are a hot mess.
In an era where artificial intelligence – which, at its core, is about scraping data – is becoming mainstream, we can’t afford to be mired in the Stone Age (or Fax Age).
This is not just about cost-saving, patient safety, and data sovereignty.
There is also a tremendous opportunity here. As Anderson Chuck, president and CEO of the Canadian Institute for Health Information, says, Canada’s single-payer medicare system, with more than 40 million multicultural participants, means “we have one of the most valuable data sets on Earth.”
Having clear standards is not only important for better patient care, it’s foundational for enabling data access for research, innovation, and scaling AI across the country, he added.
More than ever, health data is a precious resource, individually and collectively. We have to start treating it as one.