Five Questions with Duncan Weatherston, CEO of Smile Digital Health

Smile Digital Health is a Canadian health technology leader dedicated to improving how healthcare organizations share and manage data. By leveraging open standards, Smile helps providers, insurers, and researchers securely connect systems, streamlining access to vital health information and enhancing patient care.

CEO Duncan Weatherston sat down with CCI President Benjamin Bergen to talk about Smile’s approach to health data, the challenges of connecting diverse healthcare systems, and the future of digital health innovation.

Cette transcription a été éditée pour des raisons de longueur et de clarté.

Benjamin Bergen: Thanks for joining me, Duncan. To kick things off, can you tell us a bit about how Smile Digital Health got started and what the inspiration was that led to its creation?

Duncan Weatherston: Absolutely. Smile Digital Health began as Smile CDR, which was a product developed by our original company, Simpatico AI. We launched in 2016 with a vision of transforming how healthcare data is managed, with AI playing a big part in our strategy. Over time, it became clear that our main strength was the platform itself—our clinical data repository. This platform allows healthcare providers to securely share and access vital health information, which is often scattered across different systems. We rebranded to Smile Digital Health to reflect this focus. Our goal is to improve how healthcare data flows, making it easier for clinicians to provide better care to patients everywhere.

BB: How do you see solutions like this being most effective? Are they mainly about helping healthcare providers deliver better care, or do they also support patients in navigating these complex systems? How do these benefits balance out across different areas?

DW: The value of health information extends across the entire healthcare system, whether you're in life sciences, a provider, a payer, or even a patient. What we've found is that priorities can vary significantly depending on the region. In the U.S., for instance, payers drive much of the technological change because they control funding. In other countries, governments often take the lead, focusing on public health or broader strategies to improve population health. Globally, there’s also a clinical need, with many companies building capabilities to support healthcare providers.

Patients, of course, are increasingly interested in their own health data, but access to consistent and reliable information varies widely. In some places, it's difficult for patients to obtain their records, while in other places, they can access comprehensive health data through digital portals. Our goal is to create a consistent foundation where everyone—providers, payers, and patients can effectively participate and benefit from better information.

BB: It's interesting to see how different economic and geographical structures play out and affect these systems. When it comes to Canada, how would you say the country is doing in terms of adopting and utilizing these kinds of health data solutions?

DW: Canada has been a leader in adopting healthcare technology for years, with each province developing its own systems to improve data accessibility for care providers. While the focus may vary, the approach is consistent: making essential health information available within each region.

For example, Ontario has systems in place for labs, drugs, diagnostic imaging, and acute care, with efforts to expand into primary care and e-referrals. Other provinces like British Columbia and Alberta have similar initiatives, each with different areas of focus. British Columbia, for instance, emphasized pharmacy data early on, while Ontario's efforts have been shaped by the Ministry of Health.

Overall, Canada’s approach has been effective. Based on my experience, few places globally match the consistency and accessibility of healthcare data seen here. The country’s investment in these technologies has also boosted the economy, helping companies like ours grow and create jobs.

BB: We often hear that trust is a major concern when it comes to health data, especially around where and how the data is stored and accessed. Given past issues, like concerns in British Columbia over data being held outside Canada and the implications of laws like the U.S. Patriot Act, how do companies like Smile Digital Health build trust with its clients?

DW: Trust in healthcare data varies greatly by region. In Canada, there is generally a high level of trust in how the government manages health information, largely because healthcare is viewed as a public service funded by the government, which creates a sense of national pride. While Canadians tend to feel secure about how their data is handled domestically, they are more cautious about sharing it across borders, particularly with the U.S., where there are concerns about how data might be used by payers.

A key issue is how all health data is treated uniformly, regardless of its nature. For example, a simple detail like having a cast on your arm is considered just as private as more sensitive information, like a diagnosis of a sexually transmitted infection. This uniform approach, while necessary for privacy, can hinder the practical use of data for care. If people feel like their data is being misused, we won’t have the opportunity and value that the health information gives.

BB: It sounds like there’s a real sweet spot that companies like Smile Digital Health need to hit in order to get the trust of consumers. We've talked about balancing privacy with the need for openness in health data to improve outcomes. What do you wish politicians or civil servants better understood to help strike that balance here in Canada?

DW: In Canada, we’ve established a policy framework around health data that is much more restrictive than most people realize. The measures in place to protect patient information are incredibly stringent, but this often leads to confusion and inefficiencies. For instance, the legislation on data privacy is written ambiguously, and governments have chosen to interpret it very tightly.

One example I've seen is around patient consent. You might assume that a patient can easily consent to view their own data, but because the legislation doesn’t explicitly state this, policy interpreters can get stuck. It leads to situations where there's uncertainty about whether a patient can even see their own information, which should be common sense. This over-interpretation ends up preventing us from sharing data, not because it’s unsafe but because of how the rules are read. It’s a clear case where the restrictive approach, intended to protect privacy, actually ends up being a barrier to effective care.

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À propos du Conseil

Le Conseil des innovateurs canadiens est un conseil d'affaires national regroupant plus de 150 entreprises technologiques à grande échelle dont le siège social se trouve au Canada. Nos membres sont des créateurs d'emplois, des philanthropes et des experts en commercialisation dans l'économie numérique du 21e siècle.