New federal data interoperability legislation good start but more needed

Reintroduced federal legislation supporting the interoperability of electronic health data is an urgently needed step but more is needed to properly advance this initiative, according to Canada’s leading national medical organizations.The second report from the Digital Health Interoperability Task Force has been framed as a submission to Health Canada on interoperability legislation and regulations. On Feb. 5 the federal government introduced Bill S-5, the Connected Care for Canadians Act. An earlier version of the act failed to advance when the last federal election was called.The task force has representation from the Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada and the College of Physicians and Surgeons of Canada, with backing from Canada Health Infoway. It issued a report in 2024 and this most recent document builds on many of the issues raised in that report as well as providing specific advice on how the federal legislation should be crafted.“Although interoperability legislation is urgently needed, it is only a first step,” the report states. “Mandating standards alone will not make information flow seamlessly. It is incumbent on legislators to ensure that clinicians are not crushed under systems and technologies that disrupt clinical workflows or add to the administrative, cognitive and financial burdens of an already overstretched workforce.…”The report notes that the new legislation appropriately assigns the primary responsibility for interoperability to health technology vendors. The task force adds that “to ensure success, it is essential that all health technology solutions sold in or developed for Canada be mandated to meet interoperability standards and requirements and that they do so in a way that creates no additional burden or digital burnout for the clinician users.”The report goes on to say, the federal government should “establish minimal national interoperability targets with a clear timeline for compliance.” The medical groups say the new legislation must have a precise definition and transparent criteria to ensure all provinces and territories are compliant or there is the risk “silos will continue to develop, and interoperability will be unequal across the country.”“Ambiguity could further entrench fragmented digital health systems, where data exchange is possible in some jurisdictions but impeded in others, undermining the very goal of national interoperability,” the report continues. “It may also create confusion for vendors, clinicians and patients navigating multiple healthcare systems.”The task force adds that most community physicians and other healthcare providers currently operate “outside” of provincial or territorial electronic data systems and the federal government must enable their participation.Building on comments and recommendations made in their previous report the task force notes community practitioners, unlike those working in hospitals, must bear the whole burden of implementing digital solutions. The new report calls on the federal government to institute “targeted, predictable and sustainable funding programs or subsidies for the acquisition, implementation and maintenance of interoperable health technologies in primary care.”“If health information is to serve as a public asset, then its creation, management, storage and exchange must be publicly funded across care settings, including primary care—ensuring equity, sustainability and a system that serves both patients and providers.” The report calls on the federal government to work with the provinces and territories to “invest in health data repositories and unified patient portals so that data exchange can flow unhindered, with the consent of patients and in line with patients’ desires.”The task force once again tackles issues of patient privacy and confidentiality when sharing health data and notes “patient consent cannot be assumed, and obtaining consent should not be the clinician’s responsibility.”This most recent report also touches on the role of AI in healthcare. “AI cannot solve the fundamental structural fragmentation of Canada’s health systems, EMR isolation or the crushing administrative burden this causes clinicians,” the report states. “Believing otherwise risks diverting resources and attention from building the foundational infrastructure that makes AI viable.”The task force report concludes that “the passing of interoperability legislation and regulations will provide the legislative framework, but success will rest on thoughtful implementation, calibrated to risk, supportive of a strong Canadian digital health industry and focused on improving the user experience of patients and clinicians.”Pat Rich is a Canadian health journalist and former editor of the Medical Post. This item originally appeared on his blog site.

New federal data interoperability legislation good start but more needed

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