Why Ottawa’s $298-million ‘axe the fax’ program PrescribeIT failed

✕ Loaded Labels: The headline frames the story around failure and uses the informal phrase 'axe the fax', which is a colloquialism used in health policy circles but may oversimplify the issue. It accurately reflects the article's focus on the program's shortcomings.

"Why Ottawa’s $298-million ‘axe the fax’ program PrescribeIT failed"

✕ Loaded Language: The article uses neutral language to describe the program’s failure, avoiding inflammatory terms and focusing on factual reporting.

"PrescribeIT failed, despite Canada Health Infoway, a federally funded nonprofit, spending $298-million over a decade..."

✕ Editorializing: Describes the CEO’s dismissal factually, without editorializing.

"the nonprofit’s board of provincial and federal appointees dismissed him."

✕ Loaded Adjectives: Refers to political actors (Conservative MPs, Liberal government) without loaded adjectives.

"Conservative MPs call for A-G probe into federal spending on failed digital prescription program"

✕ Loaded Verbs: Uses direct quotes from stakeholders without inserting judgment, maintaining objectivity.

"I just didn’t trust it"

✓ Comprehensive Sourcing: The article includes a pharmacist’s firsthand experience with PrescribeIT, providing a ground-level view of usability issues.

"Ms. Leach found that the PrescribeIT interface in her pharmacy software would not sync with doctors’ electronic records if a patient’s name was not exactly the same on both ends."

✓ Viewpoint Diversity: A physician from Toronto offers insight into adoption challenges and expresses disappointment at the program’s end, showing balanced emotional response.

"Dr. Owen, who liked PrescribeIT and is disappointed to see it go, was frustrated about the months it took to enroll new doctors in the system."

✓ Viewpoint Diversity: A rural doctor in Saskatchewan provides a counterpoint, attributing problems to workflow adaptation rather than software flaws.

"It was actually just they needed to figure out their workflows."

✓ Proper Attribution: The article includes official statements from British Columbia and Nova Scotia health ministries explaining their non-participation, adding government-level perspective.

"PrescribeIT also introduced data privacy and security risks, and its business model was cost prohibitive"

✓ Methodology Disclosure: Internal Infoway documents are cited, providing access to non-public data and enhancing credibility.

"Internal Infoway documents viewed by The Globe and Mail show that as of February, 2025, only 31 per cent and 44 per cent of prescribers were enrolled in Alberta and New Brunswick, respectively."

✓ Viewpoint Diversity: The CEO of a hospital shares positive feedback on PrescribeIT’s use in an emergency department, showing variation in user experience.

"We heard nothing but positive things"

✓ Proper Attribution: The article quotes Infoway’s board chair explaining the necessity of provincial mandates or incentives, linking structural governance issues to adoption failure.

"Every OECD country that has electronic prescribing as a national service has either mandated or used incentives"

✕ Framing by Emphasis: The article frames the failure as systemic and multifactorial, not reducing it to a single cause or villain. It explores technical, financial, jurisdictional, and behavioral factors.

"PrescribeIT’s downfall was 'a bit of a chicken and egg thing,' said James Owen..."

✕ Narrative Framing: It avoids moralizing or casting blame on individuals, instead focusing on structural and policy challenges in Canada’s decentralized health system.

"Infoway’s leaders have said PrescribeIT struggled because it lacked buy-in from provinces, a perennial challenge in Canada’s fractured public health system."

✕ Framing by Emphasis: The article acknowledges both successes and failures, such as high enrollment in Ontario and positive feedback from some hospitals, avoiding a purely negative arc.

"We heard nothing but positive things"

✕ Framing by Emphasis: It presents the shutdown as a strategic decision based on financial and adoption realities, not a sudden collapse.

"Infoway’s board decided to cut its losses."

✓ Contextualisation: The article provides historical context about the opioid crisis as a driver for the program, explaining its original policy intent and urgency.

"At the time, the opioid crisis was in its devastating early years, and one of the goals of the program was to cut down on forgeries that were easier to pull off with paper prescription pads."

✓ Contextualisation: It includes data on prescriber enrollment rates in key provinces, giving a quantitative sense of adoption levels.

"as of February, 2025, only 31 per cent and 44 per cent of prescribers were enrolled in Alberta and New Brunswick, respectively."

✓ Contextualisation: The article explains the funding model shift in 2025, including the transaction fee imposed on pharmacies, which helps clarify the financial unsustainability.

"Beginning Jan. 1, 2025, it started to charge pharmacies – but not doctors – a 20-cent fee for every transaction."

✓ Contextualisation: It notes that Quebec had planned to expand the program before its cancellation, adding nuance to the narrative of universal rejection.

"Quebec had been planning to expand the platform to 1,900 pharmacies in 2027-2028 before Infoway voted to wind it down."