Seven problems Ontario clinics have this year, each with a fixed first slice

The products

1. Scribe Check

   Fixed-scope pilot

   An independent test of the AI scribe your clinic already uses, on your own consented and de-identified visits, showing how often its notes are wrong and where.

   Measures it. Many clinicians use a scribe and like it, and the point is not that scribes are bad. The point is that nobody has told your clinic how often yours drops a medication or invents a finding on your kind of visit, and that is a number you can have.

   For family practice, multidisciplinary clinics, mental health, physiotherapy & rehab

   Why now, what you get, and what it never does

   Why now

   • The Auditor General found that the 20 approved AI scribes were not evaluated adequately. In procurement testing, 9 of 20 produced fabricated information, 12 of 20 recorded a different drug from the one prescribed, and 17 of 20 missed key mental health details in at least one of two tests.

     Auditor General of Ontario, Use of AI in the Ontario Government, May 12, 2026

   • The accuracy of the notes each scribe generated counted for 4% of the maximum procurement score.

     Auditor General of Ontario, Use of AI in the Ontario Government, May 12, 2026

   • OntarioMD responded that the audit did not account for physician review: under PHIPA, the clinician reviews every AI-generated note before it enters the record.

     OntarioMD, A missing step in assessing AI scribes, May 29, 2026

   • The Information and Privacy Commissioner published an AI scribe checklist that custodians "should" follow when procuring or using an AI scribe.

     IPC Ontario, AI Scribes: Checklist of Key Considerations, January 28, 2026

   What you get

   • A scored test set built from your own cases: omissions, fabrications, wrong drug or dose, missed history
   • The scribe vendor's privacy file reviewed against the IPC checklist: consent, retention, training use, subprocessors, where the audio goes
   • A one-page answer: keep it, configure it, or replace it

   What it needs from you

   • Visits recorded with patient consent, de-identified before we see them
   • A physician to mark up what the scribe got wrong
   • Whatever the vendor has already given you about privacy and security

   What it never does

   • Recommends a vendor for money
   • Replaces the physician's review of the note, which the College requires either way

   Runs inside PHIPA and Guardrails

2. Forms Desk

   Fixed-scope pilot

   Sick notes, insurance and disability forms, and referral letters, drafted from the chart for the physician to review and sign.

   The paperwork a scribe does not touch. A form arrives, the fields the chart already answers are filled from the chart, the rest are flagged, and the draft waits in one queue for the physician to read, correct and sign.

   For family practice, multidisciplinary clinics

   Why now, what you get, and what it never does

   Why now

   • In an OCFP survey of more than 1,300 family doctors, respondents reported spending an average of 19 hours a week on administrative tasks.

     OCFP statement on administrative burden, April 24, 2024

   • FHO+ pays for clinical administration time (Q313), but caps it at 5% of direct and indirect care hours, so most time spent on forms remains unpaid.

     OMA, FHO+ hourly rate FAQ, August 6, 2026

   What you get

   • Your most common forms and letters, drafted from your own templates
   • One queue for everything waiting on a signature, with what is missing flagged
   • A before and after count of the hours it returns, from your own week

   What it needs from you

   • The ten forms and letters your clinic sees most
   • Read access to the chart through the permissions staff already have
   • Synthetic or de-identified examples until the privacy review clears

   What it never does

   • Signs, sends or submits anything
   • Writes a clinical opinion the physician has not given

   Runs inside Working Pilot Worked example (a concept): The Drawer of Forms: Drafting Sick Notes, Insurance Forms and Referral Letters From the Chart

3. Access Desk

   Fixed-scope pilot

   Phone messages, portal requests, faxes and walk-ins in one prioritized queue, with cancelled appointments offered to waiting patients. Staff make every triage decision.

   Every way a patient reaches the clinic lands in one list, sorted by what it is and how soon it needs a person. A cancelled slot is offered to the next patient who fits it. The front desk works the list instead of the phone.

   For family practice, multidisciplinary clinics, physiotherapy & rehab, dental practices

   Why now, what you get, and what it never does

   Why now

   • The CPSO's guidance on AI covers tools that sort a clinic's incoming communications and direct them to the right staff member or physician. The physician remains accountable for their use.

     CPSO, Using Artificial Intelligence in Clinical Practice, August 2025

   What you get

   • One queue across phone messages, portal requests, faxes and the walk-in log
   • Cancellations offered to waiting patients, held for staff to confirm
   • The rules for what always goes straight to a person, written with your staff

   What it needs from you

   • The channels you already run, and who answers each one today
   • Your booking rules: visit types, lengths, who sees what
   • A front desk willing to try it for two weeks

   What it never does

   • Decides that a symptom is routine. A model may rank a queue; a person triages
   • Pretends to be a person on the phone

   Runs inside Working Pilot Worked example (a concept): The Phone, the Portal, and the Empty Slot: A Patient Access Desk for a Family Practice

4. Inbox and Fax Triage

   Fixed-scope pilot

   HRM reports, faxes and scanned documents sorted to the right person and the right chart task, with the fields pulled out. Staff confirm.

   The inbox gets read before a person opens it. Duplicates are matched, each document is labelled by what it actually is, the patient and the fields that matter are pulled out, and it is routed to the task it belongs to. Staff confirm before anything is filed.

   For family practice, multidisciplinary clinics, imaging & labs

   Why now, what you get, and what it never does

   Why now

   • OntarioMD's HRM Task Force identified the main problems: a high volume of reports that are not clinically relevant, duplicates when hospitals fax reports they also send through HRM, and inconsistent naming and formatting.

     OMA, HRM task force, July 19, 2023

   • Hospitals are asked to stop faxing reports they also send through HRM, with March 31, 2027 set as the priority date.

     Ontario Health memo, further digital updates, March 2, 2026

   What you get

   • Documents sorted and labelled by what they are, not by what the sender called them
   • Duplicates matched, so the same report is not filed twice
   • Key fields pulled out for staff to confirm, with the source page beside them

   What it needs from you

   • A sample of a normal week's inbox, de-identified
   • Who handles what today, and where each kind of document should go

   What it never does

   • Files anything to a chart without a person confirming it
   • Reads a result and acts on it clinically

   Runs inside Working Pilot Worked example (a concept): The Fax Machine Is the Bottleneck: Turning Requisitions Into Booked, Protocolled Studies

5. Referral Loop

   Fixed-scope pilot

   Every referral tracked from sent to booked to seen, with the quiet ones escalated to a person.

   A referral is not finished when it is sent. Each one is tracked through acknowledged, booked and seen, and the one that has gone quiet for longer than it should surfaces to a person with what to chase and who to call.

   For family practice, multidisciplinary clinics, imaging & labs

   Why now, what you get, and what it never does

   Why now

   • Primary care providers not yet using eReferral Ontario must adopt it by March 31, 2027. As of March 31, 2026, 62% of family physicians had done so.

     Ontario Health, operational direction on eReferral, June 8, 2026

   What you get

   • Every open referral in one view, with its last known status
   • An escalation rule for the ones that go quiet, set with your staff
   • The referrals still going by fax, listed, ahead of the eReferral date

   What it needs from you

   • How referrals leave the clinic today, by fax, eReferral or both
   • A few months of referral history, de-identified

   What it never does

   • Sends a referral on a physician's behalf
   • Decides a referral is no longer needed

   Runs inside Working Pilot Worked example (a concept): Down the Hall, Never Booked: The Internal Referral Nobody in the Clinic Owns

6. Claim Check

   Fixed-scope pilot

   OHIP rejections grouped by cause and fixed upstream, and FHO+ hourly claims checked for completeness before they go.

   Pattern-finding and completeness, not billing advice. Rejections are grouped by the cause behind them, so the fix happens once at the source rather than claim by claim. Hourly claims are checked against the caps before they are submitted, not after they bounce.

   For family practice, billing & rcm

   Why now, what you get, and what it never does

   Why now

   • FHO+ took effect on April 1, 2026. Hourly work is billed under codes Q310 to Q313 in 15-minute units, capped at 14 hours a day and 240 hours per 28 days, with indirect care and clinical administration limited to 25% of billable hours.

     OMA, FHO+ hourly rate FAQ, August 6, 2026

   • Of the more than 2,500 physicians surveyed by the OMA, 90% had OHIP claims rejected in 2024.

     OMA news release, March 23, 2026

   What you get

   • Your rejections grouped by cause, with the upstream step that produces each one
   • A completeness check on hourly claims against the daily, 28-day and share caps
   • A short list of fixes, ranked by what each one recovers

   What it needs from you

   • Remittance advice and error reports for the last few months
   • Your biller or the physician who reviews claims today

   What it never does

   • Gives billing advice or submits a claim. A biller or physician approves every resubmission

   Runs inside Working Pilot Worked example (a concept): Stop Resubmitting, Start Fixing: Reading the Rejection Pattern Instead of Working the Queue

7. EMR Switch Readiness

   Fixed-scope pilot

   Before anyone asks you to change EMRs, know what would move, what would break, and what to ask the vendor.

   An inventory, not a recommendation. Everything your clinic has built into its EMR over the years gets written down, then held against what a standard export would carry, so the conversation about switching starts from what you would lose rather than from a demo.

   For family practice, multidisciplinary clinics

   Why now, what you get, and what it never does

   Why now

   • In July 2026, Ontario began a Supply Ontario procurement for a provincewide Primary Care Medical Record system, part of the $3.4 billion Primary Care Action Plan. The province is working closely with OntarioMD.

     Canadian Healthcare Technology, July 22, 2026

   • OntarioMD's specification library lists the EMR Core Data Set Standard 5.2 and EMR Data Migration 5.2 as Final: the specs a certified EMR's export and migration follow.

     OntarioMD EMR specification library, read September 28, 2026

   What you get

   • An inventory of your templates, forms, custom fields, integrations and workflows
   • What a standard data export would and would not carry, item by item
   • The questions to ask any vendor, yours included, before a date is set

   What it needs from you

   • An afternoon with the person who knows the EMR best
   • Admin access to view the configuration, not the charts

   What it never does

   • Tells you whether to switch, or to which system
   • Touches patient records

   Runs inside Practice Audit