Premier Fréchette insists on “security guarantees” for Santé Québec’s digital health records

Premier Christine Fréchette warned on Thursday the provincial government will not proceed with Santé Québec’s controversial pilot projects for digital health records unless it obtains guarantees to safeguard patient data against potential breaches by U.S. authorities.

“I’m in discussions almost every day with our health minister Sonia (Bélanger) to make sure that all the guarantees for the security of the data — and the overall conditions to deploy the projects — are fulfilled,” Fréchette told reporters in Montreal after announcing $700 million in funding to modernize Maisonneuve-Rosemont Hospital.

“We still have a few requirements to resolve in the coming days and it’s going well. If the guarantees are not obtained, we will not launch the projects.”

Fréchette’s remarks follow an unexpected declaration by Bélanger on Tuesday that she reserves the right to veto the projects, which have already run over budget by nearly $135 million and are to be deployed on May 9. At issue is so-called digital sovereignty, given that an American software giant, Epic Systems of Wisconsin, will be storing sensitive patient data on its servers in Toronto and Montreal.

The issue has gained urgency amid tensions between the Trump administration and Ottawa over trade, heightened border security by U.S. customs and remarks by the president that Canada should become the 51st state. Experts have also raised concerns about the U.S. CLOUD Act, which empowers law enforcement south of the border to access data held by American companies on foreign soil.

Similar concerns arose in Alberta after it implemented digital health records with Epic Systems in 2019. But the issue has struck a deep chord in Quebec, especially within nationalist circles. Two weeks ago, Gilles Bélanger, the former cybersecurity and digital affairs minister, criticized his own government publicly for partnering with Epic Systems.

“Is our health data safe right now? I don’t think so. Not at all,” Bélanger had told Radio-Canada.

On Wednesday, Fréchette dropped Bélanger from her cabinet shuffle, and several hours later he quit the caucus of the Coalition Avenir Québec government. In a statement on Facebook, Bélanger did not back down from his criticism, saying, “I will continue to defend the principles of digital sovereignty.”

Although Santé Québec has insisted repeatedly that the “the vendor, Epic Systems, has no control over this data, regardless of the hosting environment,” Fréchette’s remarks on Thursday suggest the issue may be far from resolved.

Santé Québec board of directors nonetheless approves projects 

Despite Fréchette’s comments, Santé Québec’s board of directors approved on Thursday the deployment of what is known in French as the Dossier santé numérique (DSN). The two projects will be rolled out in the CIUSSS du Nord-de-l’Île-de-Montréal, which oversees Sacré-Coeur, Jean-Talon and Fleury hospitals, and in the CIUSSS de la Mauricie-et-du-Centre-du-Québec, also in charge of several hospitals.

“This decision marks a decisive step in the rigorous and structured implementation of this major digital transformation project for the benefit of the Quebec population,” Santé Québec board chair Christiane Germain said in a statement made public after 5:30 p.m.

“The DSN is an essential lever for modernizing the health and social services network. We have confidence in the teams’ preparation and their ability to ensure the continuity of care and services for the population in these two regions.”

Although Santé Québec is a state corporation, ultimately the Premier has the power to suspend, cancel or modify its pilot projects.

In 2025, the Canadian Medical Association Journal (CMAJ) weighed in on the debate surrounding digital sovereignty in a commentary that urged Ottawa to take steps to protect the privacy of Canadians.

“The value of Canada’s health data is immense,” the CMAJ commentary concluded. “The sovereignty risks associated with these data are real. If Canada is to lead in the health AI space, it must move quickly to establish long-overdue privacy and technology safeguards.”

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