share of data between the United States and Canada.195 Given the economic
and cultural ties between the two countries, and the fact that President Obama
and the Prime Minster Harper jointly announced the RCC, many of the
barriers that typically impede data exchange are absent.196 Indeed, the
potential development of a common electronic submission gateway for drug
and device approval would be an important step forward in the use of cross-border health data exchange.197 Whereas one commentator noted that
frequently there is a “lack of perceived benefits among policy-makers leads
to restricting the data that goes out of a country,”198 the RCC is built on the
premise of information sharing.199
B. Where the RCC cannot help. . . but might provide impetus
Not all data issues can or will be solved by the RCC at the country level.
As discussed earlier, some of the data sharing issues are at the provincial, not
national, level in Canada.200 Overcoming these provincial challenges may be
politically or procedurally difficult in a commonwealth. For example, the
provinces drive many regulatory decisions in Canada around interoperability
and data privacy, and the RCC process relies on bringing together federal,
not state or provincial, regulators together to harmonize national standards
and regulations.201 Further, Canada Health Infoway, the Canadian health IT
agency, is not actually a government agency, but rather, a federally-funded
non-profit organization that provides technical assistance and funding for
health IT decisions—it can help drive policy through funding decisions but
it does not have regulatory authority.202 Thus, if the RCC wanted to
harmonize interoperability standards between the United States and Canada,
it would be difficult because there is no natural Canadian regulatory
agency203 that is equivalent to the American Office of the National
Yet, having the RCC engage in some aspect of health data exchange, such
195. Sane & Edelstein, supra note 99, at 6.
196. Id. at 18.
197. JOINT ACTION PLAN, supra note 189 (discussing efforts under “Health and Personal
Care Product and Workplace Chemicals”); Zachary Brennan, FDA, Health Canada Look to
Implement Common Electronic Submission System, (Aug. 9, 2016), http://www.raps.org/Reg
198. Sane & Edelstein, supra note 99, at 12.
199. Joint Action Plan, supra note 189.
200. See, e.g., CATE, supra note 167.
201. See Joint Forward Plan, supra note 188.
202. About Canada Health Infoway, CAN. HEALTH INFOWAY, https://www.infoway-inforoute.ca/en/about-us (last visited Dec. 12, 2016).
203. Allin & Rudoler, supra note 140, at 23.
204. See About ONC, supra note 21.