A recent snapshot by research firm IDC Canada Ltd. of the e-health landscape in Canada reveals a market that is still very much fragmented and immature.
Although there exist several federal and provincial programs and funding initiatives designed to drive mass adoption of EMR (electronic medical record) and EHR (electronic health record), the lack of standardization at a national level has created a splintered landscape, said Alison Brooks, research director public sector with the Toronto-based firm.
“It’s fragmented to the extent that it’s so intricate and nuanced and specialized,” said Brooks.
The IDC Canada study looked at national and emerging EMR vendors and their ability to dominate and innovate.
Alan Brookstone, physician & founder of CanadianEMR, a Vancouver-based information Web site to help physicians select and adopt EMR systems, agrees that the country’s provincial approach toward EMR funding has splintered the market. “We don’t see a maturity level that is relatively consistent across the country,” said Brookstone.
While some provinces are just getting into EMR, other more mature provinces like Ontario and Alberta already have three or four potential user groups each with varying requirements, said Brookstone. Moreover, products are sold according to provincial procurement processes that could lead to one vendor supplying three provinces and another vendor supplying just one, he added.
As a result of different functional and procurement requirements across the country, vendors are tasked with supporting multiple versions of their products depending on where they’re selling it to, said Brookstone.
Just last year, the public questioned whether investments in an e-health system had been put to good use when an auditor’s report uncovered reckless spending at eHealth Ontario.
The Canadian EMR market is a crowded one where vendors must apply creative strategies to survive, said Brooks. The IDC Canada study found that vendors are turning to mergers & acquisitions and partnerships with other players in the market to deal with the fragmentation. “It’s causing there to be a movement to amalgamation to be able to devote resources,” said Brooks. “I expect the market to consolidate further because there needs to be some amalgamation and some sort of co-ordination across these services.”
Some Canadian vendors are even targeting the U.S. market where government funding and product certification is more standardized, said Brooks. She notes that U.S. vendors are also turning to the Canadian market.
Brookstone said that although he has observed some Canadian vendors targeting south of the border, there aren’t many who can devote the resources given that dealing with the Canadian landscape is already complex enough.
That complex market, he added, is also due to bilingual requirements that products must meet. New Brunswick, for instance, is home to 1,500 potential clients of a bilingual product, but vendors prefer to go after bigger markets, said Brookstone.
Other survival strategies that Brookstone has observed include a movement towards a centralized application service provider model.
Although there is some consolidation across the country, Brookstone said only a mere 30 per cent of physicians in Canada have adopted EMR thus far and some provinces like Quebec don’t even have an EMR strategy.
Brooks thinks improving Canada’s EHR system needs more standardization of requirements and more doctors to migrate away from paper-based processes. “It all comes down to patient safety at the end of the day is the main argument for these systems,” said Brooks.