The Canadian healthcare system is having a moment where the conversations are different. As we reflect back over the last 12 months, across many conferences, client meetings, ideation sessions and critical “go-live” moments the shift is unmistakable. We definitely have momentum. Leaders, clinicians, policymakers, and innovators are no longer talking about digital transformation as future goals. We are seeing implementation of interoperability frameworks discussed in years past and participating in implementations driving real change. And it’s accelerating.
For many years, we heard about AI on the horizon, interoperability coming soon, and modernized care models that would eventually take shape. Yet the reality on the ground rarely matched the ambition; the benefits were just not as promised, and it took so much longer than “the plan”.
But throughout 2025 the tone had changed. You can feel the urgency. You can see the growing alignment and excitement. As we step back and reflect, there is now a clear sense that Canada has entered a rare, time-limited window where meaningful progress is not only possible, its accelerating.
The question no longer seems to be whether transformation can happen. We do need to step back and assess what the critical barriers are to transformation as it’s definitely no longer a technology barrier; and it probably never was.
Trust: The Foundation for Digital Health
A single theme rises above all others. Trust is now the foundation that every success depends on. It surfaces repeatedly in conference keynote speeches, panel discussions, project implementations (large and small) and everyday hallway conversations and teams calls.
Trust influences how data is shared, how clinicians adopt new tools, and how patients engage with digital platforms. It is also at the heart of how provincial and national strategies can align and leverage innovation across our many jurisdictions
How much is Canada hampered without one “national healthcare”? Where can we use our distributed delivery model to our advantage. Perhaps the model is less relevant than we think. The Netherlands describe years of disjointed digital projects that only came together once patient-centered strategy and collaboration became the priority. Portugal and Australia echo that meaningful progress only happens after standards were backed by legislation.
Within Canada and throughout the myriad of healthcare models around the world; this is not a technical issue. It is a human one. And it is one that Canada must confront for digital health innovation to move forward and further realization of improved Healthcare outcomes for care receivers and care givers
AI Is Here. The Real Work is Implementation and Managing Change
A defining theme of 2025 is that AI has moved from horizon to reality. More than 10,000 primary care providers now use AI-based scribe tools, and provinces such as Nova Scotia, New Brunswick, and Newfoundland and Labrador are scaling production pilots that meaningfully improve outcomes while reducing administrative workload. Smaller jurisdictions in particular are demonstrating how their size enables agility that can further accelerate adoption.
But while the technology is ready (enough), it’s never been clearer that AI only succeeds when paired with strong change management. The real work begins after the demo: redesigning workflows, clarifying roles, establishing governance, addressing workforce concerns, and preparing clinicians and managers for new ways of working. Technology may still spark interest, but only effective change leadership enables adoption at scale.
A sampling of some of Canada’s high-impact AI implementations reinforce this point.
- Trillium’s AI-enabled mortality prediction model supported a 20 percent reduction in expected deaths.
- Nurse staffing optimization generated more than one million dollars in annual value within one system.
- Echo technologists now use AI to auto-prepare reports, enabling clinicians to focus on validation instead of manual preparation.
These successes were not driven by technology alone. They were driven by deliberate implementation and structured change processes.
Interoperability: A Governance Problem More Than a Technology Problem
Interoperability remains one of Canada’s most significant challenges. The issue is not technical capability. It is governance, alignment, and the human processes required to mobilize organizations around a shared way of working.
International comparisons make this clear.
- Portugal and Australia advanced interoperability only after legislating standards and mandating adoption.
- The Netherlands accelerated progress once patient-centered frameworks were paired with collaborative national governance.
Canada’s voluntary alignment model creates progress, but often slowly. Current initiatives — Ontario’s HALO architecture, Canada Health Infoway’s cross-jurisdiction pilots, New Brunswick’s MyHealthNB — demonstrate what is possible. But sustained interoperability requires the foundation of trust frameworks, legislative clarity, and structured change management.
Still, the message and reality remains. Canada will likely always have a fragmented system. The opportunity lies not in mandates or replacing platforms, but in connecting them.
The Clinician Experience Cannot Be Ignored
Clinicians consistently emphasize that they are not resisting innovation; they are resisting unmanaged change. Administrative burden, unclear workflows, and constant shifts without adequate support compound stress and erode trust.
Change management is essential to reversing that dynamic. Co-design, communication, training, and structured rollout processes ensure that clinicians can adopt new tools with confidence. AI scribes, documentation improvements, and workflow automation only reduce burden when introduced in a way that respects the realities of clinical practice.
If digital tools do not give clinicians time back, they will not be adopted, regardless of how advanced they are.
A Country Moving at Different Speeds, Yet in the Same Direction
Canada’s provinces move at different levels of adoption, but the national trajectory is converging.
- Newfoundland and Labrador is embedding transparency and accountability into its healthcare reforms, with digital modernization and AI-enabled triage/workflow tools gaining increased attention.
- Prince Edward Island continues to advance virtual care access and EMR optimization across primary care, leveraging its small size to scale quickly once decisions are made.
- Nova Scotia is accelerating practical AI deployment in clinical environments, building on strong legislative backing and bold reform strategies that emphasize measurable results.
- New Brunswick is preparing for a major CIS decision that will shape its digital direction for years, while expanding use of digital front doors and patient access platforms like MyHealthNB.
- Quebec is exploring expanded scope-of-practice models supported by AI, modernizing clinical workflows, and pushing ahead on province-wide CIS consolidation efforts.
- Ontario is advancing practical AI adoption, strengthening interoperability architecture (including HALO), and maturing its Ontario Health Teams model with more integrated data-sharing.
- Manitoba is in the midst of significant system restructuring, with digital transformation tied closely to workforce stabilization and streamlined provincial governance.
- Saskatchewan is expanding virtual care, implementing patient-access applications, and improving data coordination across rural and remote regions.
- Alberta is navigating CIS optimization at scale (Connect Care), one of the largest clinical information system initiatives in the country, while exploring selective AI-enabled workflow tools across acute and primary care.
- British Columbia Is balancing consultant reform and long-term workforce planning, while continuing to evolve digital platforms for mental health, primary care, and diagnostics.
Importantly, smaller provinces are disproving old assumptions. Their agility, clearer governance structures, and ability to implement change quickly have positioned them as leaders in areas like AI-enabled workflows and digital modernization.
Canada may be moving at different speeds, but the direction is increasingly aligned — and change management is the engine moving provinces forward.
This Window Will Not Last Forever
Canada has a rare opportunity to advance digital health in a way that is coordinated, practical, and centered on people. The momentum is real. But it is fragile.
Technology is ready. Funding is available. Public expectations have evolved. But the determining factor in whether Canada sustains this momentum is human: trust, governance, change readiness, and adoption capability.
The remaining barriers are human ones. Trust. Governance. Change leadership. Co-design. These are the forces that will determine whether Canada makes real progress.
The message that stayed with us was this. The opportunity is not abstract. It is here now. If we embrace it with clarity and collaboration, we have the chance to strengthen our health system for years to come.
Where Mariner Fits Into This Moment
Mariner’s view is simple: no healthcare transformation — whether AI adoption, CIS modernization, or interoperability — succeeds without strong change management.
Technology creates the possibility, but people, process, and governance determine whether that possibility becomes impact.
This belief is at the centre of Mariner’s healthcare practice. Our work is grounded in systems thinking, clinical insight, and a people-first approach to transformation. We partner with ministries, health authorities, and hospital organizations across Canada to modernize digital infrastructure, strengthen governance, and redesign workflows in ways that clinicians and care teams can sustain.
Mariner’s teams blend technical expertise with deep sector experience, including clinicians, public-health advisors, and certified change management professionals. That combination allows us to support the full lifecycle of healthcare modernization — from planning and readiness, to implementation, to long-term adoption and benefit realization. Whether supporting the rollout of emerging AI tools, guiding CIS transitions, or helping provinces advance interoperability, we focus on building the organizational capabilities that make transformation achievable and durable.
In a moment where the pace of change is accelerating, this integration of strategy, technology, and change leadership is what turns innovation into measurable outcomes. The window for meaningful modernization is open. With the right approach to change, Canada can translate this momentum into sustained improvements for clinicians, patients, and systems.
Mariner is ready to help organizations move forward with clarity, confidence, and the structures needed to make change last.
Connect with us to discuss how Mariner can help your organization act with clarity and momentum.
Further Reading
Learn more about how trust and data stewardship enable safe AI adoption in Trust but Verify: How HIM Professionals Keep AI Honest.