When someone has a sick kid, a sudden injury, or chest pain at midnight, they need to know: which ER do I go to, and is it even open?
In most of Canada, there's no reliable answer. Some provinces publish wait time data. Most don't. Where data does exist, it's inconsistent and often impossible for a patient to make sense of.
Nova Scotia leads the country on ER transparency. Even there, advisories around virtual care leave patients unable to tell whether a doctor is physically in the building. If you're driving 45 minutes to a rural ER, that could mean showing up to find no physician on site.
Canada has no national standard for what emergency departments have to tell the public about their current status. This is ERstat's proposal for one.
Mandatory for every emergency department in Canada.
One clear classification. No ambiguity. Four possible states:
Time from arrival to physician assessment, in minutes. Updated at minimum every four hours, by staff confirmation or automated system or both. If the estimate is stale, flag it as stale.
Current number of patients in the department. At minimum, a low/medium/high classification. Wait time alone doesn't tell you whether a department is overwhelmed. Volume does.
When was this data last confirmed? Not when the system last pinged. When a human or verified automated source actually validated it. Patients deserve to know if they're looking at live data or a number nobody's touched in six hours.
If a department is closed or running at reduced capacity, where should patients go? This field is mandatory any time status is anything other than Open. It should update automatically when status changes.
When capacity is reduced, which services are unavailable? Imaging, lab, pediatrics, surgical? Patients and paramedics need to know before they show up.
This is not an IT project. It doesn't need integration with hospital information systems, patient records, or clinical software. It needs a staff member to confirm or update six data points. That takes seconds from any browser on any device.
ERstat already implements this. Hospitals reporting through ERstat's portal provide exactly this information. It works. Takes less than a minute per shift.
Virtual care has expanded fast across Canada's rural and remote ERs. That's mostly a good thing. It extends physician coverage to communities that would otherwise have none.
But it's created a gap that even the best provincial systems haven't solved.
Look at Glace Bay Hospital in Nova Scotia. Monday through Wednesday, virtual care runs alongside an open ER with a physician physically on site. Thursday, the ER is closed and virtual care is the only option. NS Health does publish this distinction, but you have to go to a separate virtual care page to find it. The advisory on the main ER page reads the same in both cases.
A patient deciding whether to drive to Glace Bay on a Thursday night sees the same advisory as someone going on a Wednesday morning. One of them is heading to a department with no doctor. NS Health's own virtual care guidance says it directly: at sites where there is no physician on site, patients with emergency health matters should call 911.
When an ER posts a virtual care advisory, patients can't tell from that advisory alone whether a physician is physically there alongside virtual coverage, whether virtual care is the only physician access available, or what that means for their situation. A broken arm and a stroke need different things. You can't set a bone over a screen.
ERstat's position: virtual care only should be a distinct status, separate from Open, and shown where patients are making the decision to travel. Not buried in a separate page.
ERstat publishes a Data Transparency Report Card grading every province and territory on their current ER transparency. 8 of 13 have some form of official system. The other 5 publish nothing.
Nova Scotia leads the country. It still doesn't fully meet this proposed standard.
This standard is proposed for adoption by:
This is a proposed standard, not a finished policy. But the problem is real, the fix is simple, and somebody has to say it out loud.
If you work in health policy, hospital administration, or provincial government and want to talk about this, get in touch.
ERstat is an independent project tracking 800+ Canadian hospitals across every province, built and operated from Cape Breton, Nova Scotia. It is not affiliated with any provincial health authority, hospital, or government body. About ERstat · Transparency Report Card