The following table provides a list of terms and acronyms that you may encounter throughout the pan-Canadian interoperability specifications (e.g. PS-CA, CA:FeX) and/or in the prototyping and validation information.
| Term / Acronym | Meaning |
|---|---|
| ATNA | The Audit Trail and Node Authentication (ATNA) Profile specifies the foundational elements needed by all forms of secure systems: node authentication, user authentication, event logging (audit), and telecommunications encryption. It is also used to indicate that other internal security properties such as access control, configuration control, and privilege restrictions are provided. |
| Author (e.g., PS-CA Author) | A health care provider who authors and/or curates clinical data (e.g. Patient Summary). |
| Business/Legal Interoperability Requirements | Requirements that enable independent organizations to execute a collaborative process or service. |
| Business Requirements: Non-Testable | Business requirements that are not directly traceable to an IHE profile in the PS-CA specifications (e.g., provided for consideration and to support and provide guidance to implementers of the PS-CA). |
| Business Requirements: Testable | Business requirements that are directly traceable to an IHE profile in the PS-CA specifications. |
| CA:FeX | The CA:FeX Interoperability Specifications (Canadian FHIR Exchange (CA:FeX)) seek to promote FHIR RESTful exchange patterns, developed by industry-leading FHIR standards that can be applied on top of an existing non-FHIR infrastructure just as easily as it can be applied on top of FHIR servers. |
| CA:FMT | Canadian Formatting Service (CA:FMT) is a Canadian Integration Specification that provides formatting support service. It provides support for transformation of documents between different formats (e.g. from FHIR to PDF, CDA, etc.). |
| CCDD | The Canadian Clinical Drug Data Set (CCDD) is the drug terminology for use in digital health solutions such as electronic prescribing in Canada. |
| Central Infrastructure | A Central Infrastructure collects health information from participating organizations and stores the information in a centralized place. The Infrastructure also provides access control. Typically, the Central Infrastructure is under jurisdictional control. |
Clinical Data Repository (Local or Central) | A Clinical Data Repository (i.e., document repository) is a shared storage space for clinical documents that can be hosted locally (e.g., at the data producer) or at the Central Infrastructure and can be accessed by authorized users. |
| Clinical Solution | Any combination of health information technology assets and processes that enables clinical data to be communicated, managed, and dispositioned between a Producer and a Consumer. Clinical Solutions can be comprised of various Producer and Consumer systems including: EMR, HIS, CIS, PHR, EHR or any combination of these systems. |
| Conformance Testing | Conformance testing is a formal process of assessment focused on ensuring clinical solutions and systems accurately implement a particular specification (e.g. PS-CA Specifications) by ensuring there is conformance to the stated parameters that are being claimed in the standard. |
| Consumer (e.g., PS-CA Consumer) | A health records system (e.g., EMR, HIS, CIS, PHR, Patient Portal or EHR) that enables access to or receipt of a clinical document (e.g. PS-CA) by an authorized health care provider or the subject of care/patient. |
| Cross Border, Scheduled Care | Scheduled care of a resident of Canada that is delivered in/by another country. |
| Cross Border, Unscheduled Care | Unscheduled care of a resident of Canada that is delivered in/by another country. |
| CT | The Consistent Time Integration Profile (CT) provides a means to ensure that the system clocks and time stamps of the many computers in a network are well synchronized. This profile specifies synchronization with a median error less than 1 second. This is sufficient for most purposes. |
| DIN | A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. |
| Document Repository (Local or Central) | See Clinical Data Repository (Local or Central) |
| DPD | The Drug Product Database (DPD) is used to find drugs authorized for sale by Health Canada. The DPD is updated nightly and includes availability of the drug in Canada. |
| Electronic Health Record (EHR) | The EHR represents the Clinical Solution that contains a secure and private collection of a patient's health information in a digital format, which is shareable across different health care settings / clinical solutions that are integrated. The EHR facilitates better sharing and interpretation of health information among the health care professionals involved in the care of the patient. For example:
|
| Extensible PS-CA Dataset | Extensible PS-CA Dataset: PS-CA content that can be extended for use in a PS-CA use case scenario that complements the primary PS-CA use cases. *Note: Extensible PS-CA Dataset refers to the addition of data domains such as Family History. |
| FHIR® Repository | A FHIR repository is a clinical data repository built around the HL7® FHIR® standard used for storing clinical data. |
| Gazelle | Gazelle is a suite of virtual tools, developed by IHE Europe used to support interoperability testing. Gazelle will allow jurisdictions and vendors an opportunity to validate the role they will be playing in an ecosystem and ensure they are able to satisfy the interoperability requirements. Gazelle offers several self-serve, self-test and innovation opportunities for jurisdictions and vendors to test their alignment to the represented integration profiles. |
| HCP | Health Care Provider |
| Health Information Access Layer (HIAL) | An interface specification for the EHR infostructure that defines service components, service roles, information model and messaging standards required for the exchange of EHR data and execution of interoperability profiles between EHR services. (Source:https://www.infoway-inforoute.ca/en/component/edocman/resources/technical-documents/391-ehrs-blueprint-v2-full ; Page.340) |
| Health Information Exchange (HIE) | Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care. While electronic health information exchange cannot replace provider-patient communication, it can greatly improve the completeness of patients' records, (which can have a big effect on care), as past history, current medications and other information is jointly reviewed during visits. Appropriate, timely sharing of vital patient information can better inform decision making at the point of care and allow providers to avoid readmissions, avoid medication errors, improve diagnoses and decrease duplicate testing. (Source: https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/what-hie) |
| Health Records System | A health records system may include an electronic medical records system, a hospital information system, a clinical information system, an electronic health records system or a personal health records system. The term is broadly used to describe system actors that may produce and/or consume a PS-CA. Jurisdictional implementation patterns will determine which systems are used to create, access, consume and manage patient summaries. |
| HIS | Health Information System |
| Health Level 7 (HL7®) | Founded in 1987, HL7 is a not-for-profit standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. (Source: http://www.hl7.org/about/index.cfm?ref=nav) |
| HL7® Fast Healthcare Interoperability Resources (FHIR®) | Expected to be a next generation standards framework created by HL7. FHIR® combines the best features of HL7‘s Version 2, Version 3 and product lines while leveraging the latest web standards and applying a tight focus on implementability. |
| Information/Semantic Interoperability Requirements | Requirements for syntax and semantics such that data exchanged between health record systems can be interpreted and the meaning of the data ascertained. |
| Integrating the Healthcare Enterprise (IHE) | IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively. (Source: https://www.ihe.net/) |
| IHE Actor | IHE Actors are responsible for producing, managing and/or acting on information in the context of an IHE Profile (e.g., Primary Care Provider, EMR, EHR, etc.). (Source: https://wiki.ihe.net/index.php/Actors) |
| IHE Domain | IHE Domains are responsible for the development and maintenance of the IHE Technical Frameworks that document the Integration Profiles. Each Domain manages Integration Profiles in a particular part of healthcare (e.g., Virtual Care). (Source: https://wiki.ihe.net/index.php/Domains) |
| IHE Integration Profiles | IHE Integration Profiles provide a solution to the interoperability challenges which have arisen in daily clinical work, as described in the Use Cases. Integration Profiles include detailed technical specifications for the use and implementation of relevant standards thus ensuring an uninterrupted flow of information between different healthcare IT applications in support of the specific use case. The Profiles describe how healthcare IT systems can provide integrated support for a clearly defined workflow, each of which individually supports a clinical task within a specific clinical domain. IHE Profiles can be used for a step-by-step implementation of systems in different domains and the gradual building of interoperable eHealth applications. (Source: https://www.ihe-europe.net/about-us/faq) |
| IHE Transactions | IHE Transactions are interactions between actors that communicate the required information through standards-based messages (e.g., patient look-up query, send patient summary information, etc.). |
| International Patient Summary (IPS) | The IPS is a minimal, non-exhaustive set of data elements defined by ISO/EN 17269 and realized by HL7 in both CDA and FHIR. The IPS is a snapshot clinical document that can be used for planned or unplanned care of a person locally or across borders. It emphasizes the data required and the necessary conformance of the use cases for an international patient summary. (Source: https://wiki.ihe.net/index.php/International_Patient_Summary_(IPS)) |
| Interoperability | Interoperability enables information to flow seamlessly between different solutions and devices. When different parts of the health system are interoperable with each other, they can “speak the same language.” Interoperability improves continuity of care, collaboration between health providers and patient access to their health information. By breaking down data silos, it also reduces inefficiencies and redundancies within the health system. Connection, collaboration and communication have never been more important for the health system. Increased use of virtual care has highlighted the need for safe and efficient electronic sharing of information across the circle of care. Continuing to improve Canadian health care will necessitate work in interoperability — connected systems are healthier systems. For more information about interoperability, please visit Canada Health Infoway - Interoperability. |
| IUA | The Internet User Authorization (IUA) Profile provides support for authorizing network transactions when using HTTP RESTful transports. IHE has authorization profiles for the Web Services and SOAP based transactions, and this profile provides an authorization profile for the HTTP RESTful transactions. (Source: https://profiles.ihe.net/ITI/TF/Volume1/ch-34.html) |
| Local, Scheduled Care | Scheduled care of a resident of Canada that is delivered in/by the Canadian health care system. This includes care provided in federal, provincial and territorial jurisdictions, as well as cross-jurisdictional care. |
| Local, Unscheduled Care | Unscheduled care of a resident of Canada that is delivered in/by the Canadian health care system. This includes care provided in federal, provincial and territorial jurisdictions, as well as cross-jurisdictional care. |
| Longitudinal Electronic Health Record | A longitudinal electronic health record is a single comprehensive patient record comprised of data from numerous data sources across the healthcare continuum. |
| Medical Home | The College of Family Physicians of Canada describes the Medical Home as: "The Patient’s Medical Home (PMH) is a family practice defined by its patients as the place they feel most comfortable—most at home—to present and discuss their personal and family health and medical concerns. It is the central hub for the timely provision and coordination of a comprehensive menu of health and medical services patients need." To read more about the Patient's Medical Home, please visit The College of Family Physicians of Canada's published document, A Vision for Canada - Family Practice - The Patient's Medical Home. |
| MHD | The Mobile access to Health Documents (MHD) Profile defines one standardized interface to health document sharing (a.k.a. an Application Programming Interface (API)) for use by mobile devices so that deployment of mobile applications is more consistent and reusable. |
| Patient Portal | A patient portal is a web-based access point that enables secure patient access to personal health information and other self-serve health IT services. For example, a patient portal can be hosted on an EMR solution. |
| Patient Proxy | An individual or entity that has the authority to act on behalf of a subject of care/patient. Proxies can include parents of dependent children, parents of dependent adults, powers of attorney, etc. |
Patient Summary-CA (PS-CA) | An electronic patient summary for use at the point of care comprised of, at minimum, the required elements of the Patient Summary-CA data set and specifications. The PS-CA is a health record extract, at a snapshot in time, comprised of a standardized collection of clinical and contextual information (retrospective, concurrent, prospective), including the minimum necessary and sufficient data to inform a patient's treatment at the point of care. The PS-CA is condition-independent and specialty-agnostic, irrespective of the condition of the patient or the treatment sought or specialty of the provider delivering care. |
| PDQm | The Patient Demographics Query for Mobile (PDQm) Profile defines a lightweight RESTful interface to a patient demographics supplier leveraging technologies readily available to mobile applications and lightweight browser based applications. (Source: https://profiles.ihe.net/ITI/TF/Volume1/ch-38.html) |
| PIXm | The Patient Identifier Cross-reference for Mobile (PIXm) Profile provides RESTful transactions for mobile and lightweight browser-based applications to create, update and delete patient records in a Patient Identifier Cross-reference Manager and to query the Patient Identifier Cross-reference Manager for a patient’s cross-domain identifiers. (Source: https://profiles.ihe.net/ITI/TF/Volume1/ch-41.html) |
| PMIR | The Patient Master Identity Registry (PMIR) Profile supports the creating, updating and deprecating of patient master identity information about a subject of care, as well as subscribing to changes to the patient master identity, using the HL7 FHIR standard resources and RESTful transactions. (Source: https://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_Suppl_PMIR.pdf) |
| Producer (e.g., PS-CA Producer) | A health records system (e.g., EMR, HIS, CIS, PHR, or EHR) that creates/produces a clinical document (e.g. PS-CA) in response to a request from an authorized health care provider, the subject of care or another authorized health records system. |
| Projectathon | A Projectathon is an important step and a best-practice approach in testing and validation of a specification package, where implementers collaborate to test their solutions using methodology and tools that accelerate interoperability. A Projectathon provides an opportunity for participants to test their systems among themselves and against a reference environment. It is also an opportunity to collaborate among peers to enable hands-on knowledge exchange. |
| PS-CA Solution | Any combination of health information technology assets and processes that enables a Patient Summary-CA to be created, communicated, managed and dispositioned between a PS-CA Producer and a PS-CA Consumer. Patient Summary-CA Solutions can be comprised of various Producer and Consumer systems including: EMR, HIS, CIS, PHR, EHR or any combination of these systems. |
| PS-CA Specifications | pan-Canadian Patient Summary Interoperability Specifications: The pan-Canadian Patient Summary Interoperability Specification is an implementable, testable specification, based on the IHE International Patient Summary specification and the HL7 IPS Implementation Guide. For more information on the PS-CA Specifications, please go here. |
| PT | Provinces and Territories |
| RA | The Reference Architecture (RA) is intended as an evolving blueprint of service availability that supports a broader interoperability landscape, not limited to patient summaries. Its purpose is to facilitate multi-stakeholder dialogue, collaboration and convergence towards common, open standards. It is a conceptual technical view that provides a common vocabulary and a set of actors and transactions representing typical components in a digital health ecosystem (public and private sector solutions). It is combination of building blocks adopted from international standards development bodies and Canadian developed implementation patterns. |
| SUT | System Under Test |
| SVCM | Sharing Valuesets, Codes and Maps (SVCM) defines a lightweight interface through which healthcare systems may retrieve centrally managed uniform nomenclature and mappings between code systems based on the HL7 Fast Healthcare Interoperability Resources (FHIR) specification. (Source: https://wiki.ihe.net/index.php/Sharing_Valuesets,_Codes_and_Maps_(SVCM)) |
| Technical Interoperability Requirements | Requirements for one health record system to send data to another health record system and for the receiving system to acknowledge receipt of the data payload. |
| Terminology | Collection of uniquely identifiable concepts with associated representations, designations, associations and meanings. |
| XDM | Cross-Enterprise Document Media Interchange (XDM) provides document interchange using a common file and directory structure over several standard media types. This permits the patient to use physical media to carry medical documents. This also permits the use of person-to-person email to convey medical documents. XDM supports the transfer of data about multiple patients within one data exchange. (Source: https://profiles.ihe.net/ITI/TF/Volume1/ch-16.html) |
| XDS | The Cross-Enterprise Document Sharing (XDS) IHE Integration Profile facilitates the registration, distribution and access across health enterprises of patient electronic health records. (Source: https://profiles.ihe.net/ITI/TF/Volume1/ch-10.html) |