Information Models, Application, and Infrastructure

A table representing the alignment of the PS-CA to the IPS, data domains of interest by Canadian jurisdiction and the PS-CA Release 1 and 2 plans has been created and validated through stakeholder engagement. Release 1 will include all of the data domains highlighted in the Release 1 column and Release 2+ will continue to build on the Release 1 data domains as well as add the additional data domains.

More information about this can be found in the Preface section.

Data residing in a clinical system will need to be mapped to appropriate FHIR profiles and Valuesets from the Content Data Model of the PS-CA specification in Release 1. For more information on the Valuesets implementation patterns, please refer to the Terminology Approach page in the Pan-Canadian Patient Summary v0.0.3 FHIR Implementation Guide.

Valuesets define the possible choices of coded concepts for a data element within a PS-CA. The concept domains often serve the function of a predicate to be tested. In any clinical setting, implemented systems usually host many Valuesets. 

Because Valuesets are often localized, which makes semantic interoperability between systems difficult without extensive cross-mapping, Infoway will create or identify suitable pan-Canadian valuesets that are applicable for the PS-CA.

The PS-CA specification promotes two simultaneous goals for terminology. It promotes standardized Canadian terminologies in use today for the purpose of facilitating semantic interoperability within and across jurisdictions through the exchange of patient summaries. These are referred to as the Proposed Pan-Canadian Value Sets.

The PS-CA specification also encourages global interoperability where possible for international exchange. Value sets that have been defined by the HL7® FHIR® Base Standard or by the IPS Specification for the purposes of interoperable international exchange are referred to as the Global Value Sets.

The PS-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 PS-CA Solution can leverage those services for uniquely identifying the patient/subject of care.  For more information on the patient identity implementation patterns, please refer to the IHE Profile PDQm and PMIR in the Appendices.  

It is recommended that the PS-CA Solution leverages the CA:FMT Interoperability Specifications that provides formatting support service. It provides support for transformation of documents between different formats (e.g., from FHIR to PDF, CDA, etc. ).

Content  is in development and will be added in future roadmaps

JSON is the recommended data interchange format for the implementation of the PS-CA interoperability use cases. 

• The server actors (PS-CA Recipient and PS-CA Responder) are required to support JSON and XML.
• The client actors (PS-CA Producer and PS-CA Consumer) can use either JSON or XML.

The PS-CA should be a FHIR Document (meaning that it is authored and assembled using FHIR). For scenarios where the implementation requires the delivery of the document in a different form (e.g., PDFs), jurisdictions should use conversion and translation services that can convert FHIR Documents

The long-term vision for the PS-CA standard is to include an on-demand option where a PS-CA consumer submits a request and based on that request, a PS-CA is assembled on-demand and returned to the consumer.

Integration of the recommended actors and transactions of the PS-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 PS-CA standard.  

Example: For user authentication, Alberta uses certificate-based security footprint while Ontario uses token-based security.

Implementation of the PS-CA standard must refer to jurisdictional specific requirements and policies for document management, including archiving, replacement, etc.