Canada Health Infoway (the federal agency that funds health-data systems) spent nearly $300 million and nine years trying to move doctors off the fax machine. In May, it gave up. Seven weeks later, Quebec decided to try on its own.
The Globe and Mail reported that on May 29, Infoway shut down PrescribeIT – the national e-prescription platform launched in 2017 – after uptake stalled below 5% of Canadian prescribers. Then on July 17, the province announced it would revive the same software as Prescription Québec and roll it out to every retail pharmacy in the province.
Why the federal version failed
PrescribeIT was a federal effort to give Canadian doctors a secure digital alternative to faxing prescriptions to pharmacies. The platform was built by Telus Health, which retained the underlying intellectual property. The pitch was straightforward: fewer misdirected faxes, fewer handwriting errors, less paper. What the pitch could not overcome was the pricing model. Pharmacists were charged per prescription received, and most simply kept taking prescriptions the way they always had. After nearly a decade of promotion, fewer than one in twenty Canadian prescribers had signed on.
Quebec’s rescue
Quebec Health Minister Sonia Bélanger negotiated with Infoway to keep a provincial pilot running past the federal shutdown. On July 17, Infoway interim CEO Abhi Kalra and Santé Québec president Geneviève Biron announced a four-year agreement to expand Prescription Québec to all 1,900 retail pharmacies in the province. Quebec is covering the operating costs, and the per-prescription fee that stalled the federal version is gone. As of July 10, the Estrie-region pilot had already processed roughly 283,000 electronic prescriptions across 14 pharmacies, 138 physicians, and 8 clinics.
The rework targets the pricing problem directly rather than the technology problem. The province known for pushing back on federal reach is now betting it can do the fax-replacement that federal Canada could not, by changing only the business model and leaving the software alone.
Why this keeps happening
There is a natural comparison to Ontario, which announced its own Axe the Fax push in 2023 and set a five-year deadline to phase fax machines out of the healthcare system. That plan hit its own wall: at the time of the announcement, more than 90% of Ontario doctors still relied on fax. The problem was never that Canadian doctors preferred fax as a technology. The problem was that each replacement system carried its own costs and workflow disruption. In PrescribeIT’s case, a per-prescription fee made the fax machine look, once again, like the cheaper option.
Whether removing that fee is enough to move an entire province’s pharmacy network in four years is an open question. Whether other provinces will follow is another.
That is also why services built on a pay per fax model, rather than monthly or per-transaction subscriptions, tend to attract the people who only send a fax when a doctor’s office, a lawyer, or a government agency asks them to. Sometimes the honest answer is not “stop using this technology” but “stop making people pay a subscription to leave it.”