Canadian Journey to a National Electronic Health Record

Report detailing Canada's journey towards its national EHR. Canada has chosen to utilise hub-and-spoke repositories over point-to-point information exchange systems. Estonia's system is a decentralised point-to-point information exchange system, where each provider maintains its own database and shares elements of information as requested. The hub-andspoke repository systems collect and store copies of critical health information in jurisdictionally coordinated repositories, enabling the care giver to view and access consolidated, timely information easy via a computer. Similar approaches are used by Vista, Epic (Kaiser Permanente) and in UK. The nationwide approach to EHR aims to ensure that consistent standards are used in building EHR elements, thus enabling future interoperability within and across jurisdictions. A shared approach also guarantees that movement of knowledge and people across jurisdiction is simple, that platform quality nationwide is equal, and that cooperation between different parts of the system is possible in terms of systems design and vendor negotiations. All this will reduce long-term costs and implementation time by leveraging care and cross-jurisdictional knowledge. (Infoway 2015) The most unique element of the Canada's approach is the strategic investor role of Infoway adopted to administer the allocation of the federal investment funds. It also uses a collaborative, jointly funded, and shared governance model with members including the deputy ministers of health from across the country.