We, the undersigned physicians, write to express our significant concerns regarding the current implementation plan for CorCare and CorCare Link. While we support the modernization of our province’s health information systems, we have serious concerns regarding the current implementation plan for CorCare and CorCare Link.

We agree that replacing the current outdated health information system (Meditech) is necessary and long overdue. A modern, integrated digital platform has the potential to greatly improve patient care, communication and system efficiency. We appreciate the effort and investment that NLHS has undertaken towards this goal. However, we have serious concerns regarding the current implementation plan, the terms of the CorCare Link Access Site Agreement, and the proposed mandatory use of CorCare Link.

1 - Simultaneous launch of CorCare and CorCare Link

We are deeply concerned about the planned simultaneous launch of CorCare and CorCare Link on April 25, 2026.

Impact on patient care and healthcare system stability

NLHS has acknowledged that the launch of CorCare will result in a temporary reduction in patient access as the system stabilizes. Proceeding with a concurrent community rollout of Link risks compounding these foreseeable disruptions across both NLHS and community practices simultaneously. We believe this approach will negatively impact patient care and access to healthcare services across the province, while introducing avoidable system-wide risk.

We propose a staggered implementation, beginning with CorCare and followed by CorCare Link after an appropriate stabilization period. This would allow NLHS to identify and address inevitable system challenges early before extending its use to community practices. This would reduce system-wide risk, preserve patient access, and support a safer, more efficient transition. 

2 - CorCare Link Access Site Agreement

Open-ended financial risk

We have serious concerns with the terms of the CorCare Link Access Site Agreement. The contract, as currently written, contains terms that are unclear, unbalanced, and impose potentially significant and open-ended financial risk on physicians. Of particular concern is the clause stating that “the Provider shall bear its own costs (including legal costs…)” in cooperating with any investigation initiated by NLHS or a regulatory authority, regardless of outcome. This effectively requires physicians to absorb all costs associated with investigations—even in situations where no wrongdoing is ultimately found. 

Further, the Agreement stipulates that where a breach is alleged to involve a provider, physicians may also be responsible for covering NLHS’s costs, including legal expenses and costs incurred by related parties. This creates a disproportionate financial burden, without clear safeguards or accountability.

Agreement amendments at NLHS and vendor discretion

Clauses permitting unilateral amendment by NLHS and its vendor introduce significant uncertainty and and undermine the fairness and stability expected in a professional agreement of this nature

Commissioner of Oaths 

We have significant concerns with the requirement that physicians obtain a Commissioner of Oaths signature and stamp on the final page of the agreement. This requirement places an unnecessary administrative burden on already overextended physicians, particularly in rural and remote settings where access to such services may be limited. This requirement is not aligned with standard professional practice expectations and should be removed.

3 - Mandatory Use of CorCare Link 

Use of CorCare Link is being made mandatory, with NLHS indicating that laboratory, diagnostic imaging, and referral requests outside the system will be refused. This effectively removes physician choice while requiring acceptance of terms that have not been collaboratively developed.

In order to continue delivering quality care for our patients, physicians are effectively being bound to enroll in CorCare Link, even if it is not supported by their current clinic environments. For example, there remain physicians in our province who are providing quality care in paper-based practices. Requiring mandatory use of CorCare Link in these contexts may result in unintended loss of physician capacity.

Impact on Physicians Retention and Recruitment 

At a time when our province is already facing a physician shortage, we believe that if CorCare Link is launched as planned, we will experience an exodus of physicians from our province, and destabilization of our already strained health-care system. Newfoundland and Labrador already faces significant challenges in access to primary care, with approximately 30% (NLMA, 2024) of residents lacking a primary care physician.

We have already had colleagues indicate they may leave Newfoundland and Labrador rather than sign the current agreement. Others who are near retirement have said this will force them into early practice closure. CorCare Link has also not established a clear pathway for locum physician access. With the readily available Atlantic Registry, we fear that this additional administrative burden and bureaucracy will force current locums away, and deter new ones from coming. 

We respectfully call on NLHS to:

1. Postpone the launch of CorCare Link and adopt a staggered implementation approach, whereby 
      a. CorCare is initially launched 
      b. CorCare Link is launched on an opt-in basis, only after:
           i. An appropriate period of system stabilization
           ii. Meaningful engagement with community physicians and stakeholders prior to further implementation of CorCare Link, including direct involvement in the review and revision of the CorCare Link Access Site Agreement  
2. Review and revise the CorCare Link Site Access Agreement to ensure it is fair and balanced, including:  
      a. Removal or revision of clauses imposing open-ended financial liability on physicians
      b. Clear limits and protections regarding investigations and associated costs
      c. A commitment that material changes to the agreement require consultation and consent
      d. Removal of the requirement to obtain a Commissioner of Oaths signature and stamp

We are dedicated to providing quality health-care services to the people of our province, but believe that the current launch plan has an unacceptable risk level of destabilizing our already vulnerable system, and therefore cannot support an initiative which places patients at such significant risk of harm.  

We, the undersigned, are unable to support the CorCare Link implementation as structured or sign the current Site Access Agreement.

We remain committed to working collaboratively with NLHS to ensure a successful modernization of our healthcare system. Our shared goal is to provide safe, accessible, and high-quality care to the people of Newfoundland and Labrador. We believe these concerns must be addressed to achieve that goal.