Woman’s Stroke Highlights Gaps in Provincial Health Information Sharing

A stroke suffered by a 78-year-old woman from Creighton, Saskatchewan, underscores critical gaps in health information sharing between provinces. Frances Garinger, who regularly sought medical care at Flin Flon General Hospital in Manitoba, experienced a life-threatening incident due to delays in sharing her electronic medical records with her family doctor in Saskatoon.

Creighton, a small town of approximately 1,200 residents located about 430 kilometres northeast of Saskatoon, lacks a hospital. For residents, making a choice between traveling to Nipawin, Saskatchewan, or crossing into Manitoba for healthcare services is a routine but challenging decision. Garinger, who underwent open heart surgery in 2011, relied on regular blood thinning treatments monitored through International Normalized Ratio (INR) tests, typically conducted in Flin Flon.

On October 27, 2023, Garinger had her INR test, but the results did not reach her healthcare provider until it was too late. On November 4, she suffered a stroke. Her daughter, Kimberley Sautner, expressed concern that the stroke could have been avoided had there been a more efficient system for sharing medical information. “Sadly, when my mother had her blood work done on October 27, she didn’t get a call immediately, and eight days later, she had a massive stroke,” Sautner said.

The issue lies in the differing healthcare systems between the two provinces. In Manitoba, patients are entitled to access their health information under the Personal Health Information Act. However, they must request records directly from the healthcare facility, and there is no central repository for medical records. Sautner indicated that Flin Flon General Hospital would fax test results to her mother’s doctor in Saskatoon, a process that can take several days.

In contrast, Saskatchewan utilizes a centralized system known as eHealth for managing electronic medical records. According to the Saskatchewan Health Authority, when electronic records cannot be exchanged, hard copies are provided to patients for sharing with healthcare providers across provincial lines. Creighton Mayor Bruce Fiddler noted the challenges faced by residents who must navigate these complicated processes to access necessary healthcare services.

The broader implications of this situation reflect a systemic issue in Canadian healthcare. According to Canada Health Infoway, fewer than 40 percent of Canadians accessed their health information electronically, while only 29 percent of physicians shared patient information outside their practices as of 2024. Ann Chapman, director of Connected Care at the Canadian Institute for Health Information, pointed out that the lack of standardization in health data leads to fragmented systems, where patient information resides in separate databases that do not communicate with each other.

“Picture this: healthcare in Canada is full of islands, so that patient information is captured in separate systems… and those systems do not talk to one another,” Chapman stated. She emphasized the potential risks that arise when healthcare providers lack complete patient information.

In an effort to address these challenges, former federal Health Minister Mark Holland introduced Bill C-72, the Connected Care for Canadians Act, which aimed to facilitate secure access to personal health information and improve data-sharing among healthcare providers. The proposed legislation would have mandated compatibility between software systems used by different healthcare technology companies. Holland highlighted the importance of data in saving lives, stating, “It’s time for us to move past the archaic and siloed approach to managing and sharing patient information.”

Unfortunately, the bill was not passed before Parliament was prorogued, and it has not been reintroduced since. Chapman and other healthcare advocates are hopeful that a future government will prioritize similar legislation. “It really was a landmark piece of federal legislation that was really working towards enabling that health information to move, to be shared,” she remarked.

In response to the ongoing challenges, Health Canada acknowledged that some provinces and territories exceed the requirements of the Canada Health Act by entering into bilateral agreements for residents to access specialized care not available in their home province. However, the responsibility for healthcare services lies primarily with provincial jurisdictions, leading to a patchwork of agreements that can complicate patient care.

As Garinger continues her recovery in Flin Flon, where she now faces significant challenges, Sautner remains determined to raise awareness about the need for improved health information sharing. “We live in Canada. We have free health care, so the sharing of important information, such as my mom’s, should never be an issue,” she said. Sautner hopes that by sharing her mother’s story, she can help prevent others from experiencing similar trauma in the future.

The situation in Creighton serves as a stark reminder of the importance of efficient communication in healthcare. As provinces work towards better integration of health information systems, the hope is that no other family will have to endure the pain of preventable medical emergencies.