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Standard

Fit for Purpose

Stewardship

Quality

Fits
Requirements

Implementation
Type

Vendor Support

Canadian
Steward

SDO
Maintained

Complexity

Standard
Maturity

Training,
Support
 and Tooling

FHIR Immunization

Yes

Pilot
in Canada

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No

Yes

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Draft for Use

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pan-Canadian Immunization Messaging Standard (Public Health MR 02.05)

Yes

Production
in Canada

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Yes

Localized

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Normative

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Architectural Constraints and Considerations

Secondary Benefits

FHIR’s modular components, foundation on web standards and support for RESTful architectures make the standard generally less complex and more accessible to developers of client applications than the pan-Canadian standards which are based on HL7 v3.

No notable secondary benefits.

Recommendation

Supporting Rationale

It is recommended that Panorama based new implementations adopt FHIR.

FHIR supports the use cases described above without further extension or localization. In the event that extension is required to support future requirements, FHIR provides a straightforward mechanism for creating extensions.

Canada-specific terminology value sets can be used while remaining “FHIR conformant”, as the FHIR Immunization resource only specifies examples; implementers are free to use any value set they choose.

FHIR has significant momentum among vendors and developers, meaning the long-term sustainability of FHIR-based implementations will likely be superior.

There is a substantial ecosystem of open-source tools and reference implementations for FHIR that implementers can leverage to accelerate their projects.

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Standard	Fit for Purpose			Stewardship		Quality
Standard	Fits Requirements	Implementation Type	Vendor Support	Canadian Steward	SDO Maintained	Complexity	Standard Maturity	Training, Support and Tooling
pan-Canadian Public Health Immunization Subsets (SNOMED-CT)	Yes	Production in Canada	HighImage Added	Yes	Localized	LowImage Added	Normative	GoodImage Added
iTerm ValueSet	Yes	Custom	LimitedImage Added	Yes	No	LowImage Added	N/A	NoneImage Added
Architectural Constraints and Considerations				Secondary Benefits
Both options were designed to support Panaroma's data model.				Using pan-Canadian terminology subsets supports inter-jurisdictional interoperability. SNOMED CT’s terminology model can be leveraged to support aggregation and analysis of the information captured within vaccination records.
Recommendation				Supporting Rationale
It is recommended that new implementations adopt the custom reference value sets developed by Ontario.				The pan-Canadian Public Health Immunization Subsets reflect Canadian requirements (e.g. Canadian vaccine lists), and is aligned with the PHAC Canadian Immunization Guide. It is being adopted in additional projects across Canada (including AB, SK, MB, Canadian Forces, CIHI), so additional implementations that adopt the Ontario standard will be well positioned for interoperability with these groups or organizations.

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