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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 patient’s 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.


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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. 

The current version of CA:FeX is focused on the FHIR RESTful exchange of documents, which FHIR offers multiple structures and patterns to achieve. CA:FeX aims to provide clarity to implementers by identifying some of the choices currently available using FHIR, ranging from simple to a higher level of sophistication. As the development of CA:FeX continues, the Interoperability Specifications may evolve into a more formal Integration Profile (similar to existing international profiles reviewed below) that provides more comprehensive guidance on FHIR RESTful exchange patterns than what currently exists today.

It should be noted that the scope of CA:FeX may evolve beyond document-based exchange to explore a more atomic nature of health information exchange in the future. This will depend on the development of a multi-phased CA:FeX roadmap, the evolving needs of the Canadian healthcare market, and emerging trends within the international FHIR health information exchange community.

For more information, please refer to the CA:FeX Interoperability Specifications.

In parallel with CA:FeX, Canada Health

  • Authentication and Authorization Services
  • Role Based Access
  • Information Data Models
  • Security Services
  • Audit Services
  • Provider Directory
  • Patient Registry (i.e., EMPI)
  • Patient Consent Services
  • Clinical Decision Support

In parallel with these CA:FeX specifications, Infoway is also facilitating a national collaborative effort to develop the pan-Canadian Patient Summary Interoperability Specifications (PS-CA). The PS-CA is , an implementable, testable specification, based on the IHE International Patient Summary specification and the HL7 IPS Implementation Guide. It defines building blocks to create and share condition-independent and specialty-agnostic patient summaries, irrespective of the condition of the patient or the treatment sought or specialty of the provider delivery care. PS-CA building blocks are configurable to address necessary Canadian jurisdictional variances. A patient summary is a health record extract, at a point 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 implementable specification contains the information necessary for an implementer to consume and develop the components necessary for creating, consuming and sharing a Patient Summary. The PS-CA Reference Architecture will reference this the CA:FeX specification Interoperability Specifications as an optional implementation pattern for submitting, searching and retrieving a Patient Summary document.