CNA News Room

Digital Health is Helping Canadian Nurses Improve Patient Care but Opportunities for Improvement Remain

May 11, 2020, Toronto — A new survey conducted by Canada Health Infoway (Infoway), the Canadian Nurses Association (CNA) and the Canadian Nursing Informatics Association (CNIA) found that:

1. Nurses using full electronic health records report more satisfaction and improved quality of care

The 2020 National Survey of Canadian Nurses: Use of Digital Health Technology in Practice found that 27 per cent of nurses are now working in fully electronic systems. These nurses are more satisfied than those working in hybrid environments (a mix of paper charts and electronic records systems). Other benefits revealed when comparing nurses using full electronic systems to those using hybrid systems:

  • 85 per cent report increased access to complete patient information (70 per cent for hybrid);
  • 68 per cent report improved continuity of care (53 per cent for hybrid);
  • 69 per cent report improved care team communication (51 per cent for hybrid); and
  • 63 per cent report improved quality of patient care (50 per cent for hybrid).

2. Virtual care has progressed from the 2017 survey, but more resources are needed to support nurses to provide care virtually

The survey found significant increases compared with the 2017 survey of nurses, in the proportion of nurses who:

  • Facilitate e-visits using secure email (36 per cent in 2020, up from 9 per cent in 2017);
  • Consult directly with patients via virtual videoconference (27 per cent in 2020, up from 3 per cent in 2017);
  • Conduct virtual visits with a remote clinical provider while in-person with a patient (29 per cent in 2020, up from 6 per cent in 2017); and
  • Have patients enrolled in remote telemonitoring services (e.g., telehomecare) under their care (34 per cent in 2020, up from 8 per cent in 2017).

This survey was conducted in January to March 2020, prior to the COVID-19 pandemic. Anecdotal information suggests that virtual care has increased across Canada in all settings as nurses explore ways to engage with patients and support quality patient care.

The survey also found that only six in 10 nurses who use virtual care technologies agreed they had the knowledge and skills required to use these technologies, demonstrating the need for further education and support.

3. Barriers still remain in nurses’ use of electronic health records

When asked to identify the main barriers to achieving full value from electronic systems:

  • 40 per cent report redundant data capture;
  • 38 per cent report the use of hybrid systems;
  • 25 per cent report issues with multiple logins;
  • 25 per cent report multiple systems in use;
  • 24 per cent report lack of available equipment; and
  • 18 per cent report lack of appropriate training.

These barriers are more likely to be experienced in hybrid paper-electronic workplaces.

Nurses report that they continue to experience increased administration burden (45 per cent). This can be a contributing factor to nurse burnout. It is important to consider these issues as new clinical information systems are built. This survey provides a rich data set to explore the relationships between burden, burnout and digital tools, which will be explored in the coming months.

Read the full report of the 2020 National Survey of Canadian Nurses: Use of Digital Health Technology in Practice.


“As the largest health-care profession providing direct patient care, one quarter of Canadian nurses report they are working in fully electronic systems, and that is having a huge impact on their ability to deliver quality care for patients,” said Mike Villeneuve, Chief Executive Officer, CNA. “It’s clear that more resources are required to dramatically scale up implementation of full electronic systems within organizations, integrate digital systems across health-care sectors, and create opportunities for nurses to unlock their full potential using digital systems and further improve the quality of the care they are able to provide.”

“We are pleased to see the increases in the proportion of nurses practising in fully electronic systems, and delivering virtual care” said Glynda Rees, President, CNIA. “These technologies provide numerous benefits to nurses and their patients, and we need to continue to ensure that nurses have appropriate systems to support their work and the knowledge and skills to use them. CNIA is ready to work with everyone in the health system to eliminate barriers to use and enable the full contribution of nurses in the health-care system.”

“It is encouraging to see the significant increases in the proportion of nurses who are delivering various types of virtual care to patients, and these results don’t even reflect the increased level of virtual care we’ve seen as a result of the COVID-19 crisis,” said Simon Hagens, Senior Director, Performance Analytics, Infoway. “Virtual care provides many benefits to patients and clinicians, including greater convenience, access to care and patient health information, and cost savings, so we are hopeful that these numbers will continue to increase as more nurses have access to the tools and knowledge to deliver care virtually.”

About the Canadian Nurses Association
The Canadian Nurses Association is a powerful, unified voice for the Canadian nursing profession. We represent regulated and retired nurses in all 13 provinces and territories. We advance the practice and profession of nursing to improve health outcomes and strengthen Canada’s publicly funded, not-for-profit health system.

About the Canadian Nursing Informatics Association
As the voice for Nursing Informatics in Canada, the Canadian Nursing Informatics Association partners with jurisdictions, nursing and health informaticians and health informatics organizations across Canada to ensure that nursing informatics informs clinical practice, education, research, administration and policy. Visit

About Canada Health Infoway
Infoway helps to improve the health of Canadians by working with partners to accelerate the development, adoption and effective use of digital health across Canada. Through our investments, we help deliver better quality and access to care and more efficient delivery of health services for patients and clinicians. Infoway is an independent, not-for-profit organization funded by the federal government. Visit

Media Inquiries
Karen Schmidt
Director, Corporate/Internal Communications
Canada Health Infoway
Follow us on Twitter @Infoway

Eve Johnston
Media and Communications Coordinator
Canadian Nurses Association

Glynda Rees
Canadian Nursing Informatics Association
Follow us on Twitter @CNIA_CA