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Major hospital information-system deployments across Canada

A jurisdiction-by-jurisdiction inventory of Oracle Health/Cerner, Epic, MEDITECH, and significant exceptions in Canadian acute care.

Canada’s major acute-care information systems are highly concentrated among three U.S.-headquartered vendors: Oracle Health (formerly Cerner), Epic Systems, and MEDITECH. The concentration is real, but it is not absolute. Altera’s Sunrise platform remains important in Saskatchewan, Manitoba, and New Brunswick; Quebec still has legacy and locally developed systems while it rolls out Epic; and the Northwest Territories combines a territorial TELUS record with substantial paper charting.

This inventory reflects publicly documented deployments as of July 31, 2026. “Installation” means a major hospital or health-authority clinical information system, not every server instance, departmental application, community physician EMR, long-term-care record, or provincial results viewer. A single shared installation may cover many hospitals, while one province may operate several separate instances of the same product.

A 2026 Canadian Medical Association Journal environmental scan provides the national baseline. It describes British Columbia as Cerner/MEDITECH, Alberta as unified Epic, Saskatchewan and Manitoba as Altera, Ontario as Epic/Cerner/MEDITECH, and Quebec as a mix of systems. In Atlantic Canada and the territories, it identifies New Brunswick as Cerner/Altera/MEDITECH, Prince Edward Island as unified Cerner, Nova Scotia as a MEDITECH/McKesson environment in transition, Newfoundland and Labrador as MEDITECH, Yukon and Nunavut as unified MEDITECH, and the Northwest Territories as TELUS plus paper hospital charts.[1]

British Columbia

Oracle Health/Cerner. Island Health has operated a Cerner-based record across acute, ambulatory, long-term-care, and mental-health services; a 2021 operational summary counted 14 hospitals, 285 clinics, 18 long-term-care facilities, and seven community health-service units using its electronic record.[2] The separate Clinical and Systems Transformation program created a single Cerner production domain shared by Vancouver Coastal Health, the Provincial Health Services Authority, and Providence Health Care.[3]

MEDITECH. Interior Health states that every Interior Health facility uses MEDITECH Expanse Web.[4] Fraser Health also operates MEDITECH Expanse. Public Fraser documentation identifies Eagle Ridge, Fraser Canyon, and Mission Memorial hospitals as Expanse sites in 2024, with subsequent expansion and modernization continuing across the authority.[5]

The province therefore illustrates the concentration claim particularly clearly: major regional authorities have standardized separately on Oracle Cerner or MEDITECH rather than on one provincial record.

Alberta

Epic. Alberta Health Services completed the ninth and final Connect Care launch in November 2024. AHS says Epic is now in place across all AHS and AHS-partner programs, services, sites, and locations in Alberta; the final launch alone added 155 sites and locations.[6] This is a single province-wide Epic clinical information system rather than a collection of unrelated hospital purchases.

Saskatchewan

Altera Sunrise — an exception to the three-vendor pattern. Saskatchewan Health Authority identifies Sunrise Clinical Manager as its acute-care health record. It is not a single provincial instance: separate environments are hosted for Saskatoon, Regina, Prince Albert, Yorkton, Moose Jaw, Swift Current, and Lloydminster/North Battleford, with variable data fields and continued paper records where fields are unavailable.[7]

Manitoba

Altera Sunrise — another exception. The 2026 national scan describes Manitoba’s hospital landscape as Altera Sunrise instances, with only a few hospitals using a full clinical suite and other sites using it mainly for admission, discharge, and transfer functions.[1] Current Shared Health training material confirms that Manitoba’s Electronic Patient Record opens in Sunrise Clinical Manager.[8]

Ontario

Ontario is the country’s clearest multi-instance market for all three dominant vendors. Ontario Health explicitly identifies Cerner, Epic, and MEDITECH as the province’s key acute-care hospital information systems and notes that Ontario has no common hospital platform.[9]

Epic. Confirmed major Epic deployments include:

  • University Health Network’s hospitals and clinics;
  • SickKids and CHEO, which operate a shared Epic instance;
  • The Ottawa Hospital and its Epic digital-health network;
  • Hamilton Health Sciences and St. Joseph’s Healthcare Hamilton;
  • Trillium Health Partners; and
  • Women’s College Hospital.

UHN’s patient documentation confirms its own deployment and identifies Trillium, SickKids, St. Joseph’s Hamilton, The Ottawa Hospital, Women’s College, and Alberta Health Services as other Epic organizations.[10] SickKids separately confirms its shared instance with CHEO.[11]

Oracle Health/Cerner. Niagara Health’s Oracle Cerner installation covers all five Niagara Health sites plus Hotel Dieu Shaver Health and Rehabilitation Centre. Niagara Health reported that the Oracle Cerner solution was already used by more than 60 Ontario hospitals.[12] London Health Sciences Centre and St. Joseph’s Health Care London also use Cerner and have historically shared the regional platform with hospital partners in Ingersoll, Tillsonburg, Listowel, Wingham, Strathroy, Exeter, St. Thomas, and Woodstock.[13]

MEDITECH. Twenty-three hospitals in northeastern Ontario participate in the MEDITECH Expanse-based ONE shared system, beginning with Sault Area Hospital, North Bay Regional Health Centre, and West Parry Sound Health Centre and expanding to another 20 hospitals.[14] Southlake Health, Oak Valley Health, and Stevenson Memorial Hospital operate another shared MEDITECH record through the SHINE partnership.[15]

These are large documented clusters, not a complete hospital-by-hospital count. Ontario’s many separately governed hospitals make a durable, exhaustive public installation list difficult, and deployments continue to change.

Quebec

Epic, newly live in two regions. Quebec selected Epic for its provincial Dossier santé numérique. The first production deployments went live on May 9, 2026 at the CIUSSS du Nord-de-l’Île-de-Montréal and the CIUSSS de la Mauricie-et-du-Centre-du-Québec; more than 6,000 professionals and physicians logged into the platform on its first day.[16]

Outside those first two regions, Quebec remains a mixed legacy environment with numerous hospital and locally developed systems.[1] Epic is the selected provincial direction, but describing every Quebec hospital as an Epic installation would be premature.

New Brunswick

Oracle Cerner, Altera, and MEDITECH. The national scan identifies all three in New Brunswick’s hospital landscape, consolidated regionally rather than provincially.[1] New Brunswick has two regional authorities—Horizon, with 12 hospitals, and Vitalité, with 11—but current public documentation does not provide a reliable site-by-site mapping of those three products.[17] The defensible conclusion is therefore that New Brunswick is a mixed-vendor jurisdiction, not that a particular vendor covers every facility in either authority.

Prince Edward Island

Oracle Cerner. PEI operates a unified Cerner Clinical Information System linking all Island hospitals. The province says its CIS provides real-time exchange among every Island hospital; provincial system-review documentation identifies that CIS as Cerner.[18]

Nova Scotia

Oracle Health/Cerner, replacing a mixed legacy environment. Nova Scotia’s One Person One Record system launched at IWK Health in December 2025 and across Nova Scotia Health’s Central Zone in May 2026.[19] The province is rolling the Oracle Health platform out province-wide. During the transition, other sites continue to reflect the legacy MEDITECH and McKesson landscape recorded in the 2026 national scan.[1]

Newfoundland and Labrador

MEDITECH transitioning to Epic. Newfoundland and Labrador Health Services reports that its existing MEDITECH Magic and MEDITECH Client Server systems are being replaced by a single provincial Epic hospital information system. The Epic implementation is intended to replace more than 100 application instances and create one patient record across the province; the contract and project kickoff were completed in 2023–24.[20] Until that rollout is complete, this remains a MEDITECH-to-Epic transition rather than a fully live provincial Epic installation.

Yukon

MEDITECH. All three Yukon hospitals use the territory’s single MEDITECH Expanse-based 1Health network. Yukon Hospitals describes it as one integrated record, and a 2025 territorial briefing confirms that MEDITECH Expanse is in use across every Yukon hospital.[21]

Northwest Territories

TELUS and paper — outside the three-vendor pattern. The territorial TELUS electronic medical record has been deployed at health centres and hospitals, including Stanton Territorial Hospital, Hay River, Fort Smith, and Inuvik.[22] However, the 2026 national scan characterizes hospital charting as still paper-based, with the unified TELUS Wolf instance functioning as the territorial EMR.[1] That makes the NWT an important qualification to any claim of complete national vendor consolidation.

Nunavut

MEDITECH. Nunavut’s interoperable electronic health record is MEDITECH. The territorial government reported in 2025 that it was operational in all 25 Nunavut communities and at two southern referral centres: the Ottawa Health Services Network and Kivalliq Inuit Services in Winnipeg.[23]

What this evidence supports

The evidence supports saying that major Canadian hospital systems have largely converged on Oracle Health/Cerner, Epic, and MEDITECH. It does not support saying that those three are literally the only systems in use. Their strongest footprint is visible in British Columbia and Ontario’s regional clusters and in the province- or territory-wide platforms of Alberta, PEI, Yukon, and Nunavut. Epic is also becoming the selected provincial platform in Quebec and Newfoundland and Labrador, while Oracle Health is replacing Nova Scotia’s mixed legacy estate.

The exceptions are material: Altera remains entrenched in Saskatchewan and Manitoba and is present in New Brunswick; the Northwest Territories uses TELUS and paper; and several provinces are mid-transition. “Triopoly” is therefore best understood as a description of market concentration and the direction of large procurements, not as a claim of 100-percent market coverage.

Sources

  1. Kannappan et al., “The current state of electronic health records across Canada: an environmental scan and interoperability maturity assessment”, CMAJ, 2026, tables 2–3.
  2. Island Health, IHealth by the Numbers, data through September 2, 2021; see also Island Health’s 2018–19 service-plan report identifying the Cerner-based EHR.
  3. Vancouver Coastal Health, 2016–17 Annual Service Plan Report, describing the shared VCH/PHSA/Providence Cerner production domain.
  4. Interior Health, “MEDITECH Expanse System Applications”.
  5. Fraser Health, Expedited provider provisioning for access to MEDITECH Expanse, July 30, 2024.
  6. Alberta Health Services, “Connect Care in more sites, programs in Alberta”, November 2, 2024.
  7. Saskatchewan Health Authority, Clinical Information and Research Accessible Datasets, August 2025.
  8. Shared Health Manitoba, EPR Core and Clinical: How to Delete Patient Lists, February 2026.
  9. Ontario Health, Patient Portal Provincial Service Standards, section 3.1.38.
  10. University Health Network, “Epic Information for Patients”.
  11. SickKids, “Epic: SickKids & CHEO Health Information Network Provider Statement”.
  12. Niagara Health, “Niagara Health selects Oracle Cerner to build modern hospital information system”, December 15, 2022.
  13. London Health Sciences Centre, “Hospitals introduce new Information Technology staffing model to enhance patient care”, March 8, 2011.
  14. MEDITECH, “20 Ontario hospitals transition to MEDITECH Expanse as members of the ONE Shared Service Organization”, January 10, 2023.
  15. Southlake Health, “Local hospitals to launch upgraded electronic medical record system”, October 2025.
  16. Santé Québec, “Dossier santé numérique: mise à jour quotidienne 17 mai 2026”.
  17. Government of New Brunswick, “Regional Health Authorities”; Vitalité Health Network, “Who we are”.
  18. Government of Prince Edward Island, “Electronic Health Records”; An Integrated Health System Review in PEI.
  19. Government of Nova Scotia, “One Person One Record to Launch Across Central Health Zone”, May 7, 2026.
  20. Newfoundland and Labrador Health Services, 2023–24 Annual Performance Report, p. 27.
  21. Yukon Hospitals, “1Health”; Government of Yukon, Digital health strategy briefing note, December 2025.
  22. Government of Northwest Territories, “Government of the Northwest Territories continues roll out of Electronic Medical Records”, July 12, 2016.
  23. Legislative Assembly of Nunavut, Hansard, September 17, 2025, Minister’s Statement 669.