Understanding international approaches to certification of electronic medical records (EMRs) in an effort to achieve widespread meaningful use is particularly timely. Canada's 34,000 primary care doctors cover a population of 33 million in 13 jurisdictions. A recent survey suggested only 14 percent of Canadian doctors are utilizing EMRs in a clinically meaningful way. In order to accelerate EMR adoption, most jurisdictions have initiated EMR programs. The objectives of these programs are to 1.) certify EMRs to ensure they meet needs for high quality care delivery; 2.) provide funding for EMR acquisition, implementation and support; 3.) supply services to assist with EMR purchase and implementation; and 4.) measure adoption and impact of EMR use. In this article we review the impact of certification on the advancement of EMR use in Canada and discuss both the benefits that these programs have provided and the challenges that they have posed.