Ontario EHR Interoperability Standards

Standards are the building blocks of electronic health records (EHRs). They allow one physician to define and send the results of an X-ray or CT scan to another, without having to worry about what technology they use.

In this case, we say the patient record is interoperable, meaning that health information will rapidly move between, and be instantly understood by, different electronic record-keeping systems.

This means that any time an Ontarian comes into contact with the health care system, their care provider will have immediate electronic access to all secure, pertinent and accurate patient information. That’s the power, and criticality, of standards.

How We Work

Standards can’t be developed behind closed doors. We work closely with health care providers, hospitals, community-based providers, the provincial government and vendors to develop and maintain the best solutions for Ontarians. This ensures that our solutions are designed to work in the real world.

Our standards program follows an internationally acknowledged development process.  Here’s how it works:

The First Step: Need Identification and Business Definition

A request for a new specification/standard, or a request to change an existing specification/standard, is initiated. Requests are assessed and prioritized against the eHealth Ontario's priorities.

Doing our Homework: Options Research and Analysis

Once a standard is requested, the work begins. The process for researching and developing a standard varies depending on the complexity, scope, strategic significance and likely impact of the request. As a starting point, however, we look to see if other standards exist that can be re-used, either in whole or in part.

Solutions Development

There is a continual feedback loop between the consultation phase and the research and development phase. In many cases, they happen simultaneously. Adoption, adaptation, and development require communication and engagement with stakeholders. Stakeholder engagement is a core strength of our standards program.

Testing and Pilot

Pre-production models or versions are tested to ensure we locate or estimate any design flaws or deficiencies.

Training and Education

Education and training is another fundamental undertaking of our standards program. We develop and distribute materials to help all interested parties get the information and achieve the understanding they need to succeed.


Standards implementation support is provided in the form of tools, guidelines and advice.


In this stage we check to ensure that standards have been properly implemented and that lessons learned are captured to be fed back into subsequent revisions or enhancements of solutions.

Maintenance and Support

Finally, standards require constant care and attention. Our standards program regularly reviews and updates our published specifications/standards to ensure they are accurate, contemporary and accessible.

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Current EHR Standards

Pending Review Specifications

The specifications posted here have not yet been approved by our EHR governance committees. These draft specifications are, however, available for use and will be reviewed / approved at a future date.