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:establishing a new set of HL7 FHIR interfaces to existing EHR resources. Provider Registries have been implemented in various provinces and are mostly employing HL7 v3 messaging standards with sporadic HL7 v2. This guide is proposing extensions of interfaces to these systems using HL7 FHIR and reusing these in a broader, Canadian context.
- 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 | Implementation | Vendor Support | Canadian | SDO | Complexity | Standard | Training, Support and Tooling | ||||||||||
HL7 FHIR | Under Development | Yes | Yes |
| Draft | ||||||||||||
AB MR2009 (HL7 v3) | Production | Yes (AB) | Localized |
| High | ||||||||||||
pan-Canadian MR2009 (HL7 v3) | Production in Canada | Yes | Localized | High | PRS XML Messaging | Production | Yes | No | High | ||||||||
ON (v3, v2) |
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BC (v3) |
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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.
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Standard
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Fit for Purpose
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Stewardship
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Quality
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Fits
Requirements
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Implementation
Type
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Vendor Support
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Canadian
Steward
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SDO
Maintained
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Complexity
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Standard
Maturity
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| FHIR | Identify FHIR resources required to implement new interfaces to existing provincial assets to accelerate and ease adoption of content in these Provider Registries. | |||||||
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PRS XML Messaging
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Production
in Canada
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Yes
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No
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High
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pan-Canadian MR2009 (HL7 v3)
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Architectural Constraints and Considerations
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Secondary Benefits
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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.
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Supporting Rationale
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