Working prospectus — draft for discussion

Canada rents its patient records from three American companies. This is the case for owning the stack.

A modular, open-source clinical information system for every province and territory — built once, owned collectively, and never subject to a foreign vendor's balance sheet.

01
The Fragmentation We Call a System

Thirteen jurisdictions, a dozen vendors, and no shared record. A survey of how Canada actually runs its clinical information systems today, and what fragmentation costs in dollars and in care.

published
02
The Sovereignty Risk Behind Canada's Clinical Information Systems

Canada's hospitals increasingly depend on foreign-owned clinical information systems. This paper explores the strategic, financial and sovereignty risks of that dependence.

published
03
What We Don't Have to Build Twice

Three open-source clinical platforms already run in production, at national scale, outside Canada. An assessment of OpenMRS, Bahmni, and openEHR as candidate foundations, and why Canada should extend the interoperability work Infoway has already funded rather than build from zero.

published
04
One Spine, Many Modules

A technical architecture where each jurisdiction owns a module, every module speaks CA Core+ FHIR, and no province is blocked on another's delivery schedule.

planned
05
Health Identity: A Framework for Canada

A governance model for a federal-provincial-territorial consortium that can make binding technical decisions without recreating the health-transfer disputes of the last thirty years.

published
06
Landscape Analysis: Existing open source health information systems

A survey of existing open source health information systems, their capabilities, and how they could be leveraged to build a shared clinical information system for Canada.

planned
07
Who Holds the Pen

A governance model for a federal-provincial-territorial consortium that can make binding technical decisions without recreating the health-transfer disputes of the last thirty years.

planned
08
The Mandated Contribution Model

How a shared-cost formula, tied to existing federal health transfers, could fund development once instead of thirteen times — and what happens to the money provinces already pay Oracle and Epic.

planned
09
Ten Years, Thirteen Jurisdictions

A realistic delivery sequence: which province goes first, which module ships first, and how the system stays useful at every step rather than only at the end.

planned