< + > Why Health IT Still Struggles to Move as One System According to Robert Fox

Healthcare IT leaders are surrounded by dashboards, standards, and roadmaps. Yet clinicians still juggle systems, duplicate work, and wait on data that should already be there Adding more technology won’t resolve this friction. It’s a structural issue, not a tooling gap.

Robert Fox, CEO of OntarioMD, joined Healthcare IT Today to talk through a pattern he sees accelerating across the industry and in particular the province of Ontario. His focus wasn’t products. It was how systems, teams, and technology either converge or continue to create drag.

What This Conversation Revealed

• Interoperability only accelerates when incentives, governance, and vendors align around a shared agenda
• Team-based care exposes integration gaps most health IT stacks were never designed to handle
• AI value emerges when it supports the entire clinical workflow, not just documentation

Convergence is the secret sauce in healthcare integration

Fox describes convergence as more than cooperation. It is what happens when governance, funding, technology standards, and vendor behavior pull in the same direction.

“We’re seeing a lot of people coming together, systems coming together, people coming together, care providers coming together. And I think that that’s the secret sauce to accelerating our healthcare system.”

At the system level, he points to Ontario Health, the Ministry of Health, the OMA, and primary care networks operating as an integrated whole rather than parallel actors.

“It’s not like they’re independent. They are completely integrated.”

That same expectation now extends to vendors.

“Vendors are now creating solutions that can integrate with any of the EMRs, can integrate with any of the hospital information systems like Epic, Oracle Health, and MEDITECH.”

When vendors collaborate, there are fewer seams between systems. Fewer seams mean less friction for clinicians.

Why interdisciplinary care stresses today’s digital foundations

As care delivery shifts beyond the solo physician model, integration complexity increases quickly. Fox is direct about both the opportunity and the lift.

“I’m super excited about team-based care. But as the board chair of the OMA says, health is a team sport.”

The challenge is that team members often rely on different systems, data models, and workflows.

“When a chiropractor or a physiotherapist or a dietician uses different systems than a primary care physician would, it’s about more integration and interoperability with systems that we haven’t considered in the past.”

Standards help, but they don’t eliminate the work.

“It is going to involve a lot more work to create those APIs or other abilities to connect those systems.”

Team-based care exposes the limits of point integrations and reinforces the need for vendors to collaborate earlier and more intentionally.

AI and the 360 Visit

AI scribes may be the most visible example of AI adoption today, but Fox is clear they’re only the starting point.

“AI Scribe has been a fantastic solution. We have incredible adoption in Ontario right now.”

The next phase is broader and more operational.

“In the clinical practice, it’s more about an iterative AI capability.”

Fox describes a future built around a full “360 visit,” where AI supports pre-visit preparation, in-visit decision-making, and post-visit follow-up.

“There’s the pre visit and the post visit too. We’re calling that the 360 visit. And that’s where AI is going to play a key role.”

More collaboration, less illusion

Across convergence, team-based care, and AI, the pattern is consistent. Healthcare IT advances fastest when systems reflect how care actually happens across people, workflows, and time.

Fox sums it up simply: “We can’t do it by ourselves. And the more people involved, the faster and better it’s going to be adopted.”

What Healthcare IT Leaders Are Asking

1. Why does interoperability still stall even when standards and integrations are in place?
   Because alignment matters as much as architecture. When incentives, governance, and vendor priorities are misaligned, data may technically move, but workflows remain fragmented and adoption slows.
2. How does team-based care change the way we should think about integration strategy?
   Team-based care introduces more systems, roles, and handoffs than most point integrations were designed to support. Without broader coordination across platforms, the burden simply shifts to clinicians and staff managing the gaps.
3. Where does AI reduce operational friction today beyond documentation?
   Real gains come when AI supports the full clinical workflow, before, during, and after the visit. That includes preparation, decision support, follow-up, and inbox management, not just note creation.

Learn more about OntarioMD at: https://www.ontariomd.ca/

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