ontario primary-care medical records system should be canadian-made, expert says
3 minute read
dr. kumanan wilson among the voices that have been calling for sovereignty and security of canadian health data — meaning that electronic health data should be kept in canada.
julie oliver
/
postmedia
the ontario government’s plan to create a new electronic medical records system for primary care is being met with cautious optimism by some who have long called for better health records in the province to support seamless patient care and track immunizations, among other things.
health minister sylvia jones announced a plan to replace the current fragmented and disconnected system with a primary-care medical records system that would be connected and accessible from across the province. the new records system, announced earlier this past week, is part of the province’s plan to connect every ontario resident with primary care by 2029.
an integrated health records system would mean faster access to patient records for health providers and reduce the need for patients to repeat their histories when moving between health-care providers. i could also help prevent unnecessary medical testing.
it could also go a long way toward closing a gap that leaves ontario with unreliable data about vaccination rates at a time when vaccine-preventable diseases are on the rise, said dr. kumanan wilson, who is ceo and chief scientific officer of the bruyère health research institute.
getting it right will be challenging, though, as a previous provincial government learned, and it is crucial that the health data remain in canada, wilson said.
“in theory it is a good idea, but the devil is going to be in the details,” he said, adding, “they have tried this before.”
david caplan, who was the health minister in liberal premier dalton mcguinty’s government, was forced to resign in 2009 amid an ehealth agency spending scandal. a damning report from ontario’s auditor general said the agency had spent $1 billion with little to show for it. a later report put a figure of $8 billion on various electronic health record initiatives by provincial governments.
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today, the vast majority of ontario family physicians use electronic medical records, but most systems are not fully integrated, making it difficult for doctors and hospitals to easily share records. and parents are still required to transfer information about their children’s immunizations by hand to schools and public health agencies because electronic records systems can’t.
among the challenges will be the difficulty of building a system centrally and convincing doctors who are already using other systems to switch.
but wilson sees even greater challenges, especially now.
he is among the voices that have been calling for sovereignty and security of canadian health data — meaning that electronic health data should be kept in canada.
in an article published in 2025 in the canadian medical association journal, wilson, michael geist, canada research chair in internet and e-commerce law at the university of ottawa, and mari teitelbaum, chief innovation officer at cheo, warned that canadian health data could be at risk from foreign surveillance and monetization without adequate protections.
specifically, u.s. law allows that country’s government to access data held by american companies for national security reasons. more recent legislation allows u.s. law enforcement to access data held by u.s. companies on foreign soil.
in addition to being potentially used for security reasons, canadian data could be monetized by foreign companies without appropriate consent.
the authors wrote that canada had to take steps to ensure health data were secure by requiring encryption by default and that federal and provincial privacy laws should require that data be stored in the region from which they come.
electronic medical records are often stored on cloud servers managed by u.s. providers owned by american tech giants.
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wilson said sovereignty and security had to be key considerations for ontario in creating a connected primary-care medical records system.
“i think it needs to be a canadian company. i am not comfortable with u.s. companies hosting canadian data,” he said. “we can’t give more of our health-care data to u.s. companies.”
data sovereignty is becoming a big issue globally. europe is taking steps to ensure its health data remains under the control of european citizens and institutions.
it should also be a priority for ontario when it is talking to potential vendors for the project, wilson said.
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