This table provides key implementation guidance around Information Models, Applications and Infrastructure for the Patient Summary-CA specification.
Information Models: Information models are widely used to express structure and process resulting in data interchange formats and behaviours.
Application: Functional specifications are laid down at the Information level. These form the basis for the technical specifications, which are described at the Application level. At this level, agreements have to be made within both the PS-CA Producer and PS-CA Consumer regarding the
integration of various applications between which information is exchanged
Infrastructure: Infrastructure refers to the communication between systems in the different healthcare organizations. Agreements are defined between Patient Summary-CA Solutions and jurisdictions on the design of the infrastructures, databases, networks, exchange protocols, tokens and other technologies.
| Categories | Concept | Implementation Guidance Description |
|---|---|---|
| Information Models | Common Minimum Dataset
| A Patient Summary-CA minimum dataset will be created by Infoway and aligned by jurisdictional priorities for the Patient Summary-CA specification in Release 1. This minimum dataset was validated through stakeholder consultation with clinicians across Canadian jurisdictions. More information about this can be found in the Preface section. |
| Information Models | Valuesets
| Data residing in clinical system will need to be mapped to appropriate FHIR profiles and Valuesets from the Content Data Model of the Patient Summary-CA specification in Release 1. More information on the Valuesets implementation patterns please refer to the IHE Profile SVCM in the Appendices. Valuesets define the possible choices of coded concepts for a data element within a Patient Summary-CA. The concept domains often serve the function of a predicate to be tested. In any clinical setting, implemented systems usually host many Valuesets. A Valueset ‘just’ specifies, a (value set definition) or enumerates a (value set expansion), a list of coded concepts. Possible associated terms, relationships and any other attribute or property associated to that concept belong to the code system. Because Valuesets are often localized, making semantic interoperability between systems very difficult without extensive cross-mappings, Infoway will create pan-Canadian value sets that are applicable for the Patient Summary-CA. Furthermore, these mappings are difficult to maintain in practice. The number of concepts chosen for value sets in the Patient Summary-CA have been minimized, to give examples that might be expressed in any terminology resource so as to avoid implementation dependence. Infoway does not restrict the values that can actually be used in practice and is not intended to be an exhaustive set. |
| Application | Patient Summary References (e.g. Patient Identity) | The Patient Summary-CA Solution (e.g EMR, EHR) will leverage their existing product standards and policies for identifying the patient/subject of care. However, if there is a central service available for patient identity, then the Patient Summary-CA Solution can leverage those services for uniquely identifying the patient/subject of care. More information on the patient identity implementation patterns, please refer to the IHE Profile PDQm and PMIR in the Appendices. |
| Application | Render to Specific Format (e.g., PDF, CDA) | It is recommended that the Patient Summary-CA Solution leverages the CA:FMT profile to perform transformation between different formats. More information on the patient identity implementation patterns, please refer to the IHE Profile CA:FMT in the Appendices. |
| Application | Data Interchange Format
| Implementation of the Patient Summary-CA interoperability use cases will prefer JSON over XML as a data interchange format. However, the Patient Summary-CA standard will still support XML as an alternative option. |
| Application | Data Conversion / Structured Data
| The Patient Summary-CA document should be generated in a structured format. For scenarios where the format is unstructured (e.g., PDFs), jurisdictions should use conversion and translation services that can standardize and transform the way unstructured data is converted to structured data to favour FHIR-based documents. For Release 1, the Patient Summary-CA Standard will assume FHIR V4 JSON representation. |
| Application | On-Demand
| The long-term vision for the Patient Summary-CA standard is to include an on-demand option where a PS-CA consumer submits a request and based on that request, a Patient Summary-CA is assembled on-demand and returned to the consumer. |
| Infrastructure | Jurisdictional Infrastructures | Integration of the recommended actors and transactions of the Patient Summary-CA standard into existing jurisdictional healthcare infrastructures may differ; therefore, it is highly recommended that local implementation guidance is reviewed prior to the implementation of the Patient Summary-CA standard. |
| Infrastructure | Document Management | Implementation of the Patient Summary-CA standard must refer to jurisdictional specific requirements and policies for document management, including archiving, replacement, etc. |