To begin with, I think it is important to fully understand the three items.
There is the computerized clinical file, which is used in hospitals by doctors who work there. In clinics, they use the EMR or the electronic medical record.
We have talked at length about the patient's personal record and about patients, regular people, keeping their records. Patients then have some control. They can decide who has access to their personal file. The exchange of information often takes place in a service corridor. Some service corridors develop naturally. In the Montreal area, Montreal, Laval and the south shore represent a service corridor. People will go to primary clinics and then to hospitals. In the Quebec City area, the same types of service corridors exist.
In all those cases, the exchange of information takes place with the patient's consent only. If patients do not give their consent to have their information sent electronically, it will not be done. I am in a good position to talk about this.
Furthermore, I think it all depends on how you ask the question. If patients in the emergency room are asked whether they want the doctor to have access to their information, the answer is always positive. In other situations, the answer is likely to be different.