Standards Selection Guide

    Standards Selection Guide

    Represents a collection of the recommended Standards, Resources, Implementation Guides created to satisfy a specific set of Clinical Requirement at a moment in time, following the discovery process presented in the guidance section of this site.

    Maturity Level
    • Under Development
    • Pilot
    • Draft For Use
    • Normative
    • Superseded (by...)
    • Retired
    Market Guidance

    ALBERTA RECOMMENDED

    Guide Status:

    • Draft
    • Published

     

    Effective Date

    August, 2012

    Key Contributors

    The following individuals/organizations contributed to the creation of this resource:

    NameTitleOrganizationContact Information
    Kris LewisTechnology PrincipalSierra Systems

    KrisLewis@sierrasystems.com

    Craig Mowat Manager, Systems Development and Source Engagement Alberta Health 

    Craig.Mowat@gov.ab.ca

    Table of Contents

    MaturityNormative
    StatusPublished
    StandardsHL7® v3, PRS XML Messaging
    DomainProvider Registry
    JurisdictionAlberta
    ClinicalN/A
    BusinessBusiness Requirements
    TechnicalSpecifications

    Purpose

    This document provides an overview of available standards and a recommended approach to support the requirements identified below.  The intent is to simplify standards selection decisions in future projects and, in turn, to promote standardization of solutions across projects by providing useful information to support decision making in a readily consumable format. 

    Content in this guide was generated using information from the Alberta Provider Domain Implementation Guide (R020403.AB.PM.01) and PRS HL7 Messaging Implementation Guide - AB MR2009.

    Business Context

    The Provider Registry (PR) is a foundational component of the Electronic Health Record (EHR) which provides a trusted and centralized source of regulated health service provider information to authorized consumers.  Health Service Provider Identifiers (HSPID) within the PR enable unique identification of individual health care providers across the systems participating in the EHR.  Demographic and licensing information for all providers is stored within the PR for validation and/or retrieval by source and consumer systems and organizations.

    This Guide relates to the messaging standards used to provide and maintain the information in the Provider Registry as well as those used to access it from consumer applications.

    Typical Use Cases

    The use cases outlined below are intended to provide context and frame the needs that the candidate standards must meet.

    The use cases identify different activities related to a provider registry:

    Table of Contents

    Source Systems

    Sources systems, such as the Alberta College of Physicians and Surgeons, provide information to the registry.

    Consumer Systems

    Consumer systems, such as electronic medical records systems used at the point of care, receive and consume information from the registry, either as notifications or in response to a query.

    UC-1 Maintain provider information

    Data received from source systems (such as information from the Alberta College of Physicians and Surgeons) is used to add or update provider information within the registry, including secondary identifiers and licensing information.

    Multiple business events relate to provider maintenance including:

    • Addition of a new provider
    • Update of provider demographic information
    • Association of a license with a provider
    • Nullification of a license with a provider

    Information updates in the registry then trigger notifications to distribute updated provider information to client systems UC-4.

    UC-2 Logically delete provider record

    Identify and logically delete a provider added to the registry in error.

    Information updates in the registry then trigger notifications to distribute updated provider information to consumer systems UC-4.

    UC-3 Merge provider records

    Two provider records are combined in the registry.

    Information updates in the registry then trigger notifications to distribute updated provider information to consumer systems UC-4.

    UC-4 Notify consumer of information updates (passive)

    Events in the PR trigger notification messages which are distributed to subscribing applications.

    • Add provider
    • Update provider
    • Merge provider
    • Nullify license

    UC-5 Consumer search for provider information (active)

    A consumer system sends a query to the provider registry:

    • Get provider details using HSPID
    • Get provider details using License and Role
    • Identify provider using License when HSPID role isn't known
    • Find candidate providers matching a set of search criteria

    If the request is authorized, the PR responds with the requested information.

    UC-6 Request transaction history

    A source system requests a history of provider record changes by date range or other criteria.

    If the request is authorized, the PR responds with the requested information.

    Evaluated Standards

    This guide focuses on the selection of messaging standards to support the in scope use cases.  Due to differences in business requirements, the standards evaluation is broken into two sets of standardization requirements:

    • Consumer messaging
    • Source messaging

    Consumer messaging

    A primary role of the Provider Registry is to enable provider identification within consumer systems contributing data to or consuming data from provincial EHR solutions.  The predominant means for exchanging data with the EHR is HL7 version 3 messaging.

    Standard

    Fit for Purpose

    Stewardship

    Quality

    Fits
    Requirements

    Implementation
    Type 

    Vendor Support

    Canadian
    Steward

    SDO
    Maintained

    Complexity

    Standard
    Maturity

    Training,
    Support
    and Tooling

    AB MR2009 (HL7 v3)

    Closely

    Production
    in Canada 

    High

    Yes (AB)

    Localized

    High

     

    High

    Available

    pan-Canadian MR2009 (HL7 v3)

    PartiallyProduction
    in Canada 
    HighYesLocalizedHighHighAvailable

    PRS XML Messaging

    Partially

    Production
    in Canada 

    Medium

    Yes

    No

    Low

    High

    Limited

    Architectural Constraints and Considerations

    Secondary Benefits

    Use of HL7v3 conforms with the architectural design of Canada's digital health blueprint.

    AB MR2009 extends the Canadian specification with the ability to merge and logically delete providers.

    HL7v3 messaging does not provide the means to transmit a the history of changes to a provider records.

    The PRS XML Messaging specification is proprietary to the registry solution but is shared across several provinces.

    Standardizing on MR2009 across EHR applications reduces complexity within the infostructure and for implementers by minimizing variability in models and vocabulary.

    Recommendation

    Supporting Rationale

    AB MR2009 (HL7 v3)The AB MR2009 specification was designed to meet the in-scope use cases for PRS consumers and conforms with the architectural design of Canada's digital health blueprint. It extends the Canadian specification with the ability to merge and logically delete providers.

     

    Source messaging

    Source messaging provides the means to transmit information from systems used at various licensing agencies, professional colleges, etc. to the Provider Registry.  

    Standard

    Fit for Purpose

    Stewardship

    Quality

    Fits
    Requirements

    Implementation
    Type 

    Vendor Support

    Canadian
    Steward

    SDO
    Maintained

    Complexity

    Standard
    Maturity

    Training,
    Support
    and Tooling

    PRS XML Messaging

    Closely

    Production
    in Canada 

    High

    Yes

    No

    Low

     

    High

    Limited
    AB MR2009 (HL7 v3)PartiallyProduction
    in Canada 
    None (Source)Yes (AB)LocalizedHighHighAvailable

    pan-Canadian MR2009 (HL7 v3)

    LimitedProduction
    in Canada 
    None (Source)YesLocalizedHighHighAvailable

    Architectural Constraints and Considerations

    Secondary Benefits

    Source systems are not typically EHR consumer systems.

    HL7v3 messaging does not provide the means to transmit a the history of changes to a provider records. (UC-6)

    The PRS XML Messaging specification is proprietary to the registry solution but is shared across several provinces.

     

    Recommendation

    Supporting Rationale

    PRS XML MessagingThe PRS XML specification was designed to meet the in-scope use cases for PRS source systems. Although the specification is proprietary to the specific provider registry solution used in Alberta it is relatively straightforward to implement.

    Recommended Standards

    The following standards and related specifications were identified as the recommended approach to support the in-scope requirements. The table lists the summary with the rationale.

    Standardization Requirement

    Options

    Choice

    Rationale

    Consumer Messaging

     

    AB MR2009 (HL7 v3)

    X

    The AB MR2009 specification was designed to meet the in-scope use cases for PRS consumers and conforms with the architectural design of Canada's digital health blueprint. It extends the Canadian specification with the ability to merge and logically delete providers.

    pan-Canadian MR2009 (HL7 v3)

     

    PRS XML Messaging 

    Consumer Messaging

    PRS XML MessagingXThe PRS XML specification was designed to meet the in-scope use cases for PRS source systems. Although the specification is proprietary to the specific provider registry solution used in Alberta it is relatively straightforward to implement.
    AB MR2009 (HL7 v3) 
    pan-Canadian MR2009 (HL7 v3) 

    Implementation Resources

    Community Pages

    Matters related to Provider Registry messaging in Canada are handled through the following Community on InfoCentral.

    Implementation Guides and Specifications

    The PRS HL7 Messaging Implementation Guide - AB MR2009 is available to organizations using the PRS solution.

    The HL7 Explorer structural specifications for the AB MR2009 HL7v3 messages referenced in this document are available in the for Alberta R02.04.03 specification.  This web-friendly documentation is very useful for those familiar with HL7v3 messaging.

    Technical Resources

    Infoway Message Builder allows developers to focus on their business problem by providing APIs that fosters quick and easy creation, population and access to HL7v3 requests and responses.

    Developers of clients for the PRS HL7 Interface can use Message Builder API which fosters quick and easy creation, population, validation, and access to HL7v3 requests and responses that are conformed to the jurisdictional specification. Further details can be found in the Message Builder section on InfoCentral (https://infocentral.infoway-inforoute.ca/3_Tools_and_solutions/Message_Builder).

    For further technical support please contact project teams listed in the header section or seek support through the community site.

    Existing Implementations

    The following organizations have been or are involved in implementing the solution outlined in this Guide:

    Implementing OrganizationContact InformationNotes

    Alberta Health

    Craig Mowat

    Manager, Systems Development

    Craig.Mowat@gov.ab.ca

     

    Sierra Systems

    Kris Lewis

    Technology Principal

    KrisLewis@sierrasystems.com

    The content of the guide reflects functionality that is available to all users of the WHIC PRS system although not yet deployed in all provinces.