eReferral/eConsult (CA:eReC): The Nervous System of Digital Health

Welcome back to Canada Health Infoway’s Anatomy of a Standard series, where we explore the essential digital health standards that power Canada’s healthcare system.

Just as the body’s vital systems rely on well-coordinated systems to function properly, digital health standards work together to ensure health information flows securely and efficiently. A digital health data exchange standard is a set of agreed-upon rules and specifications that ensure different healthcare systems can share and understand patient information in a secure and consistent way for supporting seamless, Connected Care across Canada.

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The ‘Nervous System’ within Canada’s Digital Healthcare System

The nervous system acts as the body’s internal communication network, sending and receiving signals between the brain and the rest of the body to coordinate everything from thoughts and movement to reflexes and vital functions like breathing and heartbeat.  

Similarly, referrals and consultations are touchpoints in a patient’s care journey that require coordination between providers and their patients. Whether it’s a primary care provider referring a patient to a specialist or seeking expert advice on a complex case, timely and secure communication can have a real impact on patient outcomes.

However, just as a disruption in the nervous system can lead to communication breakdowns in the body, challenges in timely access to health information, particularly when it arrives in paper-based, unstructured, or fragmented formats, can create inefficiencies in care delivery. These inefficiencies may contribute to delays in diagnosis, repeated tests, longer wait times, and added pressures on both patients and providers.

This is where digital solutions, like eReferral and eConsult, come in.

What is an eReferral and eConsult?

An eReferral is an electronic request for a patient to receive care from a specialist or other health services. eReferrals aim to streamline and improve the referral process compared to traditional paper-based methods, enabling primary care providers to submit, track, and update their patient referrals in a more timely, secure and efficient way.

An eConsult, on the other hand, is an electronic request from a provider to receive advice from a specialist without needing an in-person appointment. Through a secure, two-way exchange, clinicians can virtually ask questions and receive guidance, leading to more informed decision-making and reducing unnecessary delays or visits.

Together, eReferrals and eConsults rely on the pan-Canadian eReferral/eConsult Interoperability Specification (CA:eReC), a national health data standard that will enable standardized, secure, and efficient digital exchange of referral and consult information between providers, regardless of the system or setting they use. By supporting real-time communication, reducing paperwork, and streamlining handoffs, CA:eReC helps improve coordination, reduce wait times, and ensure patients receive the right care, from the right provider, at the right time.

CA:eReC as the Nervous System of Care Coordination

Just as the body’s nervous system is made up of the central nervous system (CNS) and the peripheral nervous system (PNS), which work together to send and receive signals quickly and accurately across the body, CA:eReC operates as a core framework for coordinating health information exchange between providers. Like nerves carrying messages between the brain and body, CA:eReC ensures that referrals and consults are transmitted securely, in real time, and without unnecessary delays.

When the nervous system works smoothly, the body functions as a whole. In the same way, CA:eReC helps the health system operate more cohesively by helping ensure that the right data flows securely and consistently between providers. This seamless data exchange supports faster diagnoses, reduces fragmentation, and enhances the overall experience for both patients and providers.

The Challenge: A Fragmented Communication Network

Despite the clear benefits of eReferrals and eConsults, many health systems still rely on outdated methods like paper forms and faxes, risking slower care, increased errors, and added burden for both patients and providers. A key barrier is the lack of integration between systems, which keeps health information siloed and inaccessible at critical moments.

When eReferral and eConsult data can’t move freely across care settings, it fragments the patient journey, delays care, and limits the effectiveness of even the best digital tools. Like a disrupted nervous system that struggles to transmit signals, disconnected health systems prevent critical information from reaching the right place at the right time. To fully realize their potential, these solutions must be supported by interoperable infrastructure that connects the entire health system.

The Solution: CA:eReC as a Unified Data Flow

The CA:eReC standard addresses fragmentation by establishing a consistent, interoperable framework for creating, sending, and receiving eReferrals and eConsults. Like a healthy nervous system transmitting signals across the body, CA:eReC enables critical health information to flow securely and efficiently between providers and care settings.

When adopted, CA:eReC supports:

• Faster, more coordinated communication across systems and between healthcare providers.

• Secure, real-time sharing of referral and consult information for more efficient patient diagnoses and care.

• Standardized processes that can help to inform decision-making while also reducing the potential duplication of patient information.

Whether it’s a patient referral for a follow-up or a specialist’s input on a complex case, CA:eReC ensures information reaches the right place at the right time, helping improve patient outcomes, reduce delays, and enhance the overall patient experience.

Looking Ahead

As part of the Shared Pan-Canadian Interoperability Roadmap, and working closely with federal, provincial and territorial governments, providers and care teams, industry, patients, and many more partners, Infoway is establishing a standardized, interoperable approach to ensure the adoption of pan-Canadian standards across Canada. As this work expands, Canada is moving closer to a truly interoperable health system, where data flows freely, care is coordinated, and patient outcomes are improved.

Stay tuned for the next article in our Anatomy of a Standard series, where we’ll explore another critical digital health standard and its role in Canada’s healthcare ecosystem.