Canadian health IT buyers have a checklist, and vendors who can’t answer every item on it are getting screened out before the conversation starts.
Black Book Research, a health care IT market research firm, surveyed 212 Canadian IT leaders across hospitals, health authorities, primary care, community care, long-term care, diagnostics, and provincial digital health roles.
The findings come down to a simple question for vendors.
Can you prove it?
Buyers are requiring evidence of interoperability, Canadian data residency, AI governance, and measurable ROI before they’ll sign.
Broad promises about integration don’t cut it anymore. Among respondents, 96% say strict interoperability is mandatory or heavily weighted in their next major RFP or renewal. They want specifics, including FHIR standards and API readiness, patient-summary support, data portability, and transparent API pricing.
Canadian data residency for sensitive workloads is required or preferred by 88%, and that definition now extends beyond cloud region to include backup location, support access, subprocessors, and termination rights.
That expansion tracks with a real legal exposure. The U.S. CLOUD Act allows American authorities to compel U.S.-based cloud providers to hand over data regardless of where it’s stored, which means a Canadian-hosted server run by a U.S.-owned company may not meet a buyer’s data sovereignty expectations.
AI governance has become a contract issue, with 74% prohibiting vendors from using Canadian protected health information for AI training unless explicitly authorized in writing.
“Providers are not treating interoperability, data sovereignty, AI governance, cybersecurity and workflow ROI as separate technology issues. They are using them together as procurement tests,” says Doug Brown, founder of Black Book.
Then there’s the money. Among respondents, 82% say digital health investments now require proof that the tool saves time, reduces work, or lowers costs. That means if your platform saves nurses 30 minutes of documentation per shift, you’d better be able to show it.
The funding model makes this harder, with 70% saying SaaS, AI, cloud, or managed-service subscriptions are harder to fund than traditional capital projects. Vendors who can’t demonstrate predictable five-year costs are walking into budget conversations they’re going to lose.
Ottawa is moving in the same direction as buyers. Bill S-5, the Connected Care for Canadians Act, is working its way through Parliament and would require health IT vendors to make products interoperable and prohibit data blocking. Canada Health Infoway estimates that improved interoperability could save up to $2.4 billion annually.
The buyers in this survey are already writing those expectations into RFPs.
Canadian health IT buyers want proof that systems can connect, protect patient data, limit how AI uses sensitive information, and make work measurably easier for clinical and administrative teams.
That raises the bar beyond the product demo, which is exactly where it should be.
The full report is available here.
Final shots
- Buyers are now judging health IT vendors on several requirements at once, including interoperability, data sovereignty, AI governance, cybersecurity, and evidence that the software improves daily work.
- Data sovereignty requirements have expanded beyond hosting location to cover backup, subprocessors, AI training restrictions, and exit terms.
- Subscription-based software is harder to approve in publicly funded health systems. Vendors need to show the full five-year cost, including licensing, implementation, support, integrations, and future increases.