Background: The Canadian Partnership Against Cancer (the Partnership) launched its Electronic Synoptic Pathology Reporting Initiative (ESPRI) to advance the implementation and promote the wide adoption of standardized synoptic pathology reporting tools in Canada. This presentation will highlight strategies to ensure successful implementation of this program across the Canadian health system as well as lessons learned. Methods: Upon consultation with clinical and system leaders, clear and measureable program targets (such as 90% completeness rates against mandatory elements of the College of American Pathology cancer protocols and disease-specific clinical indicators) were agreed upon. Thorough provincial planning to understand the variances across provincial current states, establish strategies and solidify plans was supported by the Partnership; followed by implementation of those plans. Key approaches to enable adoption and implementation include coordination of Pathologist and Vendor-led education sessions, establishment of clinical expert panels and assignment of Canadian representatives to the College of American Pathologists’ (CAP) Cancer Protocol Review Panels. The Partnership continues to collaborate with national/international standards organizations such as NAACCR, CAP, and Canada Health Infoway to support standards maintenance. Results: As a result of ESPRI, approximately 80% of Canadian pathologists will be reporting synoptically by 2017, across 7 of 10 provinces. It is expected that this will reflect approximately 25,000 reports per year for the five cancer types of focus (breast, colorectal, lung, prostate and endometrial) from about 950 pathologists. The Partnership, with CAP-ACP, has partnered with pathology communities from the US, UK, and Australasia to form the International Collaboration on Cancer Reporting (ICCR) to collaborate on internationally-harmonized core datasets for cancer pathology. Conclusions: Adoption of structured pathology reporting in Canada will enable better patient care, improve data quality, create efficiencies and enable interoperability. Through adoption and implementation efforts, this will impact patient care.