Health Committee on April 21st, 2026

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you for that.

I must say that, on the face of it, to replace a fax system with a digital system seems like an incredibly expensive proposition, which, to be honest, puzzles me.

Perhaps you could give us, from an on-the-ground perspective, what you heard was the actual experience of implementation and uptake amongst providers. Also, what do you see as the main reasons the program ultimately came to an end?

We heard about some 57 change orders. Could you maybe describe some of the more important changes that were required? Was it because there were so many changes required that the board of Canada Health Infoway terminated Telus's involvement?

[Michael Green]

As I mentioned in my opening statement, the system provided a technical foundation for e-prescribing. Over time, we really looked at how the program was progressing. As I mentioned, we have 95% uptake by pharmacies and technology vendors. On review, the system's future has a brighter path as an open standard.

As you are aware, Canada has a diverse health system. Different provinces and territories have different priorities, so with the new approach—which is a transition, not a curtailment of the system—I think we have built some very good assets for the country that are going to be utilized in the open standard approach going forward, which we believe will attract a higher level of adoption.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Why did physicians not adopt this? You've talked about the pharmacies at 95%. Were you actively promoting PrescribeIT to physicians across the country? How did that work, or how didn't it work?

[Michael Green]

Canada Health Infoway works in collaboration with our partners, principally in the provinces and the territories, which operate the health systems, and in the federal government. We work with the technology providers, and we work with the pharmacies. We worked with clinicians. It wasn't at the individual clinician office level, but we would have meetings with groups and associations to ensure that the clinical side of the program was addressed.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

How much time do I have?

[The Chair, Liberal, Hedy Fry]

You have one minute and three seconds.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you.

Mr. Green, you talked about moving towards standard setting, rather than reliance on a single delivery model, as a more effective way to encourage more vendors to enter the space and better meet the needs of providers and patients. Could you elaborate a bit on what is meant by “standard setting”?

[Michael Green]

Yes.

What we mean is this: Rather than having a single system operating that has to be adopted, we can come up with standards, which is a very common practice with other health solutions these days. Systems have the ability to connect to a variety of different IT systems within the health structure without having the need to do a lot of reprogramming. It's a simpler approach, going forward, that has developed over the last few years.

When PrescribeIT was initiated 10 years ago, the kind of technical excellence that we'd seen was a national, single type of approach. Now it's a more flexible, standards-related approach going forward.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you.

I'll now go to Mr. Blanchette-Joncas for six minutes, please.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Thank you, Madam Chair.

Mr. Green, over $250 million has been invested. How do you explain the fact that, in 2026, less than 5% of prescriptions are transmitted electronically?

[Michael Green]

Thank you for your question.

As I mentioned, we were really responsible for the design and collaboration with our partners through this process. We have established the technical foundation for e-prescribing, and we had readiness of 95% across pharmacies and vendors. Now we are going to be moving to an open standards approach, to take account of individual differences between the different health systems in Canada and improve flexibility.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Why are only 5% of prescriptions transmitted electronically? That's what I want to know.

[Michael Green]

Basically, when we reviewed the program with our board of directors, we had a couple of different pathways for continuing. We could continue with the existing model, or we could look for an open standards approach and a cost-sharing approach with the provinces. When we looked at them and presented the evidence and the progress we had made so far to the board of directors, the decision was made that the best path forward was to go for an open standards approach for the continued adoption of the program going forward.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Has no one wondered why only 5% of prescriptions are transmitted electronically? Haven't you found the answer to that question?

[Michael Green]

Our mandate is to work with the jurisdictions, the health systems and the technology vendors on the implementation of the technology. With a review of the pros and cons of the approach, we decided, and the board decided, that an open standards approach would be more effective going forward.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

Well, that doesn't really answer the questions, but we'll move on anyway to try to get some other answers.

You say that it was in November 2025 that you concluded that PrescribeIT was not viable.

Is that correct?

[Michael Green]

No. In December 2025, when we presented all the information to the board of directors, which includes representatives from the provinces and territories, they decided that the preferred option going forward would be to migrate to an open standard rather than continue with the existing approach.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

I'm trying to understand. When did you realize, based on internal assessments, that it was not viable?

[Michael Green]

The board meets on a regular basis, and we would at least have a quarterly review, a major review of performance. We started to look at the options going forward in 2023.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

What is the date?

[Michael Green]

Sorry, I didn't hear the question.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

What is the date?

Today is April 21, 2026. That's an answer, a date. I want to know when you realized it wasn't viable.

[Michael Green]

The board of directors met in November and December of last year and decided to pursue the path of an open standards approach.

[Maxime Blanchette-Joncas, Bloc, Rimouski—La Matapédia, QC]

I don't know how to be any clearer. I want to know at what point you realized that the program wasn't viable.

Did you continue to invest in the program after realizing that it wasn't viable?