The Canadian Document Classification Initiative (CDCI) is a grassroots community of informaticists and clinicians united by a shared belief: that interoperable documents have the power to improve health care for all Canadians.
Our members come from hospitals, health authorities, government agencies, private industry, clinics, and post-secondary institutions across BC, Alberta, Manitoba, and Quebec — all contributing alongside their day jobs
CDCI was originally founded as a working group of Canada Health Infoway (CHI). When budget cuts ended that funding, the group didn't dissolve — we kept working, and have grown since. We are a professional community that believes the work is necessary.
Canada's national health informatics body, CIHI, participates as an observer. They have been clear that pan-Canadian document classification is an important tenet of our health system, but feel the standard creation falls outside their current mandate; they are watching in our meetings and supportive of the initiative moving forward.
We understand the problem from the inside — clinicians who can't find documents they need quickly, informaticists who have tried to build interoperable systems without a document standard, and implementers who know what it takes to make something actually work in production.
Our standard is built on LOINC — a mature, internationally recognized foundation — and informed by real implementations already running in British Columbia and Ontario. We're not starting from scratch or operating in a vacuum.
We are informal by nature but rigorous in practice. Building something that works for everyone demands both accommodation and tough decisions. We won't get everything right, but we'll always show our work — so that others can understand, challenge, or improve on what we've done.
Whether you represent a province not yet at the table, a health information vendor, or a clinical organization with a stake in document interoperability, we want to hear from you. We need to know how medical documents are currently categorized in Canada so we can accommodate them.
Submitting a supportive comment in our Forum will help. Use the Contact section to let us know if you want to contribute in some other way.
Our work aligns with Bill S-5 and we are looking to talk to those who will be building the policy to support the bill. Please contact us if you can help with this.
The Canadian health system runs on documents — consultations, clinic notes, discharge summaries and the like. The most complete picture of a patient's health journey lives in the assessments and plans written by clinicians who heard the story firsthand and committed it to the record with clinical interpretation.
For this health information to reach the right people at the right time, documents must be transmittable and organized. That requires classification. When a patient moves from Hospital A to Hospital B, their records need to fit seamlessly into the receiving system — and that only happens when each document is identified by type. Without it, everything ends up in a miscellaneous folder. Today, no two hospitals in Canada running different clinical information systems can exchange a patient's chart digitally.
The same applies across the community. As patients see multiple specialists, the resulting consultation notes need to be classifiable so they can be found quickly — by the family physician coordinating care, or by any clinician seeing the patient for the first time. If we want to replace fax-based specialist consults with digital documents, classification is a prerequisite. Without it, clinics will continue spending hours a day manually sorting incoming consults and referrals.
Canada's interoperability efforts have focused on data, not documents — so the CDCI was created to fill that gap.
CDCI establishes a shared, practical standard for naming and categorizing clinical documents exchanged between Canadian health systems and electronic medical record (EMR) systems. Built on the international Logical Observation Identifiers Names and Codes (LOINC) Document Ontology and informed by mature implementations in British Columbia and Ontario, the project reduces administrative burden, improves clinician usability, and enables seamless interoperability across jurisdictions — including alignment with Fast Healthcare Interoperability Resources (FHIR) and readiness for artificial intelligence (AI) applications.
CDCI started in October of 2025, and this website in April 2026. The classification work has just begun. Please check back regularly.
| Province / Territory | Contact | CDCI Readiness | Existing Standard |
|---|---|---|---|
| Established ontologies | |||
| British Columbia (BC) | Active | Adopted | Curated LOINC · 1,600 terms · 90% hospital adoption · provincial repository |
| Ontario (ON) | None | Unknown | 1,900 terms in provincial repository · uncurated |
| Québec (QC) | Active (CDCI) | Contributing | ~800 curated terms · 1 region of Q.C. · FHIR Composition aligned · expanding to 2027 |
| Active or emerging projects | |||
| New Brunswick (NB) | CMIO engaged | Adopting | None yet · Symbio implementing in 2 health authorities · EHR repository distribution planned |
| Saskatchewan (SK) | Director of Interoperability engaged | Interested | LOINC codes per hospital · inter-hospital variation · unification project underway for 10–15 document types |
| Manitoba (MB) | CDCI participant | Aware | Informal document types in Sunrise EPR · DB Motion EHR is classification opportunity · mandate by Mar 2027 · no project initiated |
| Alberta (AB) | AMA supportive · AH Terminologist contributing to CDCI | Aware | EPIC province-wide · no document categorization between systems · political will needed |
| No implementation — contact initiated | |||
| Nova Scotia (NS) | CMIO and ACMIO | Unknown | They are investigating their use of LOINC. |
| Newfoundland & Labrador (NL) | Introduction arranged | Unknown | None known |
| No implementation — no contact | |||
| Prince Edward Island (PEI) | None | Unknown | None known |
| Yukon (YT) | None | Unknown | No information available |
| Northwest Territories (NT) | None | Unknown | No information available |
| Nunavut (NU) | Reached out | Unknown | No information available |
CDCI Readiness: