The Digital Health Landscape at Children’s Hospitals in Canada

Objectives: Canadian hospitals have historically lagged behind peer nations in terms of adoption of digital health tools. The aim of this study was to assess the current state of adoption of digital health tools at children's hospitals in Canada. Methods: We conducted an online survey of Canadian pediatric tertiary-care hospitals between January and July 2023. The 35-item questionnaire was administered in English and French. Hospital characteristics, informatics infrastructure data and electronic health record (EHR) functionality data were summarized using descriptive statistics. Results: The survey was completed by 15 of the 17 (88.2%) pediatric hospitals in Canada. All institutions had an EHR with 10 (66.6%) being fully digitized and fve (33.3%) being partially digitized. Funding and availability of clinicians with expertise in clinical informatics were cited as barriers to implementing digital health tools. Te availability of core EHR functionalities ranged from 53.3% for medication to 100% for the presence of a laboratory and radiology information system. Only fve (33.3%) institutions reported that they had a patient portal. Discussion: While all hospitals in this study had an EHR, functionalities varied greatly between centers. Canada lags behind the United States in terms of adoption of digital health tools such as patient portals likely due to governmental mandates and incentives, and a focus on cultivating a physician informatics workforce. Conclusion: Canadian pediatric hospitals lag behind peer institutions in digital maturity. This study highlights the perceived need from hospitals for policies, funding, and resources from the Canadian government to help increase the uptake of comprehensive EHRs.