Bill S-5 Connected Care for Canadians

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S-5 An Act Respecting the Inter-operability of Health Information Technology and to Prohibit Data Blocking by Health Information Technology Vendors

Short Title: Connected Care for Canadians Act

Bill Type: Senate Government Bill

Bill Sponsor: Hon. Sen. Pierre Moreau

STATUS

Status: At Second Reading in the House of Commons. This Bill has not passed yet. It comes into force on a day to be fixed by Order in Council.

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WHAT IS THIS BILL FOR?

Bill S-5 targets a specific problem in Canada's health care system:

  • your medical records are locked in silos
  • your family doctor's system can't talk to the hospital's system
  • the specialist can't see what the emergency room did
  • you move Provinces and your health history doesn't follow you

This Bill requires health information technology vendors — the companies that sell software and systems to hospitals, clinics and health authorities — to make their products inter-operable, meaning they must allow health information to flow freely between systems. It also prohibits those vendors from deliberately blocking that data flow.

The Bill only applies in Provinces and Territories that don't already have equivalent rules. Where a Province has its own comparable Legislation, the Federal Law stays out.

WHO GAINS POWER

  • The Governor in Council gains the power to decide which Provinces and Territories the Act applies to — and to repeal or amend those orders at any time
  • The Minister of Health gains the power to verify vendor compliance, require vendors to hand over information and documents and administer a penalty system
  • The Governor in Council gains broad regulation-making power including the ability to redefine key terms in the Act — including what counts as "data blocking" — by regulation, without returning to Parliament
  • Patients and health care professionals gain a legal right to expect inter-operable systems — though enforcement depends entirely on regulations not yet written

⚠️ Definition of "data blocking" set by regulation — The Bill defines data blocking broadly but then says the specific practices that count as data blocking will be "specified in the regulations." The Minister can expand or narrow what is prohibited without a Parliamentary vote.

⚠️ Entire enforcement framework set by regulation — Penalties, complaint processes, compliance verification powers and review mechanisms are all left to regulations. The Bill creates the prohibition but Parliament has no visibility into how it will actually be enforced until regulations are published.

⚠️ Living incorporation by reference — Section 9 removes the standard requirement that incorporated documents be fixed at a specific date. The technical standards vendors must meet can be updated at any time without returning to Parliament — the Law changes without a vote.

⚠️ Unlimited scope of incorporation — The Bill places no restriction on which documents, organizations or jurisdictions can be incorporated by reference. Standards set by foreign bodies, private industry associations or international organizations could become binding Canadian Law through regulation — without Parliamentary scrutiny of their content.

WHO LOSES POWER

  • Health information technology vendors lose the ability to lock clients into their systems through proprietary data formats or deliberate inter-operability barriers — a significant change to their current business model
  • Provinces and territories that do not have equivalent Legislation lose jurisdiction over this area to the Federal Government
  • Parliament loses ongoing oversight of the enforcement framework, penalty amounts and the definition of the core prohibition — all delegated to regulation

WHO GAINS MONEY

  • Patients may avoid duplicate tests, medication errors and treatment delays — reducing out-of-pocket costs and improving outcomes
  • Health system administrators and researchers gain access to more complete data for evidence-based decision-making
  • Inter-operable vendors who already meet or exceed the standards gain a competitive advantage over vendors who currently rely on data lock-in

WHO LOSES MONEY

  • Health information technology vendors who currently profit from proprietary lock-in face significant compliance costs and potential loss of competitive advantage
  • Vendors found in violation face administrative monetary penalties — amounts to be set by regulation
  • Provinces and Territories subject to the Federal order may face costs adapting their existing systems and procurement processes

THE CATCH

This Bill is almost entirely a framework — the actual rules live in regulations that don't exist yet. The prohibition on data blocking is real, but what specifically counts as data blocking, how it will be enforced, what the penalties are and how complaints will be handled are all left to the Governor in Council to determine after the fact.

⚠️ The Act doesn't apply anywhere until the Governor in Council orders it — Section 4 makes clear the Act only applies in a Province or Territory if an order is made under section 7. No order, no application. The criteria and process for making that determination are also set by regulation — not written into the Bill itself.

⚠️ Section 126 of the Criminal Code excluded — The Bill explicitly removes criminal liability for contravening its provisions. Enforcement is administrative only. Vendors who block data face fines, not criminal charges.

⚠️ Indigenous data sovereignty — The preamble commits to respecting Indigenous data sovereignty for First Nations, Inuit and Métis Peoples. However, the Bill contains no enforceable provisions implementing that commitment. It is a stated intention only.

⚠️Federal standard by default— Because health technology vendors operate nationally, Federal inter-operability standards will effectively apply across Canada regardless of which Provinces are formally subject to the order. A vendor won't build separate products for each Province. They will build to the Federal standard and deploy it everywhere. Provinces may retain nominal autonomy on paper while the Federal standard governs in practice.