Pushing Back on Oligopoly: the need for EMR interoperability in Canada


In Canada's healthcare system, a quiet crisis mirrors the familiar frustrations of the telecom sector: the dominance of a few corporations over essential services.

Approximately 48,000 primary care physicians in Canada are caught in the web of a billion-dollar Electronic Medical Records (EMR) industry. Dominated by Telus, Well Health, and Loblaws, these corporations have not only captured the market but have also inadvertently shackled patient data. Once a physician chooses an EMR system, transitioning patient data to a different system becomes a Herculean task, thanks to the lack of interoperability and substantial 'data export' fees charged by an ever-dwindling number of software vendors.

The problem is that once a physician decides upon an EMR system, patient data becomes locked within that system. Vendors have no financial incentive to facilitate the transition of patient data from one system to another. With a combined $1.5B spent on the capture of market share, why should they make it easy for paying customers to take their business elsewhere?

On the occasion that physicians do migrate between EMRs and receive exported data, it doesn’t adhere to a standardized format. So, then, every EMR vendor must create data import capabilities for every other EMR vendor's idiosyncratic format. Not only is this wildly inefficient and wasteful, it’s a cost which is passed down to physicians via exorbitant subscription or licensing fees.

Yet, the problem isn’t insurmountable. At Cybermedex, we've tackled EMR interoperability head-on for the past 7 years, successfully migrating data across various systems. Our approach simplifies the migration process by directly mapping basic patient data and converting complex and unstructured clinical data into organized PDF files. While this method currently limits direct searchability, AI is going to change that in the very near future.

The consolidation of the EMR market over the past decade has stifled innovation and competition within an already stagnant space. We are therefore left with a healthcare system in which corporate profits have been placed above the interests of Canadian patients. Ultimately, Canadian taxpayers will foot the bill for the billions of dollars spent on the achievement of market dominance as well as a bad case of déjà vu—high costs and limited choice, much like with our telecom woes.

My goal is to create data connectors for major EMR systems in Canada, adhering to standard formats like OntarioMD, and place this technology under the stewardship of a non-profit organization funded by provincial health bodies and the physician community. By doing this, we can democratize patient data access.

Technology is currently available that can significantly reduce the administrative burden placed upon primary care physicians, but it is largely inaccessible—and will remain so—as a result of family practices being locked into outdated software. Emerging AI technology has the potential to dramatically improve the use of digital tools which we increasingly use to mediate patient care, if we let it.

With family physician burnout seemingly at an all-time-high, it’s essential to deliver these technologies to physicians as soon as possible. The healthcare system simply can’t afford to wait for a few corporations to solve an interoperability problem that they have no incentive to. Failure to act here will result in physicians shouldering the burden of a cumbersome oligopoly of EMR vendors who are well-positioned to charge premium fees in a manner that every Canadian with a cellphone is familiar with.

The good news is that we still have time to solve this problem, but we must act now before it’s too late. We can't afford to wait for profit-driven corporations to solve this issue. It’s time for us to reclaim control of our healthcare system. To support this initiative, I urge you to sign up for my mailing list and join the call for a fairer, more efficient, and more innovative healthcare future.

 

Brad Lawther Is the Founder and CEO of Cybermedex Inc.
 

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