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Introduction

Interoperability ensures seamless and secure data exchange between health care systems. Interoperability improves care coordination, collaboration between health providers and patients' access to and control over their health information. By breaking down data silos, it also reduces inefficiencies and redundancies within the health system.

Connection, collaboration and communication have never been more important for the health system. Increased use of virtual care has highlighted the need for safe and efficient electronic sharing of information across the circle of care. Continuing to improve Canadian health care will necessitate work in interoperability — connected systems are healthier systems.

The panThe Pan-Canadian Core FHIR Profile Set (CA Core+) plays a critical role in advancing this interoperability. As Canada's national standard for healthcare data exchange, CA Core+ provides the foundation for consistent and efficient information sharing across the healthcare system.

Standardizing Data Elements and Value Sets

CA Core+ is Canada's national core set of essential HL7 FHIR (Fast Healthcare Interoperability Resources) profiles for data exchange. Its agnostic characteristics are designed to support consistent interoperability across common use cases and provincial health systems by defining a standard for healthcare FHIR profiles, data elements, value sets, constraints, and more.

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In support of the provinces and territories, Canada Health Infoway (Infoway) is facilitating a national collaborative effort to advance interoperability. While there are many interoperability-related challenges, this specification refers to a set of standards and implementation guidelines developed to facilitate the interoperable exchange of healthcare information in Canada.The

Development of CA Core+

Canada Health Infoway, in partnership with the Canadian Institute for Health Information (CIHI), is taking a collaborative, iterative approach in developing the CA Core+ specification and the CACDI. The pan-Canadian Core FHIR Profile Set (CA Core+) is based on the HL7 FHIR standards. It is the expression of constraints in the Canadian Core Data for Interoperability (CACDI), in the form of FHIR profiles. As a subset of the Pan-Canadian Health Data Content Framework (pCHFCF), led by CIHI, serves as the foundation for health data interoperability in Canada, providing a structured approach to defining, organizing, and exchanging healthcare data across different systems and jurisdictions. Within this framework, CACDI defines a standardized Canadian Core Data for Interoperability (CACDI) acts as a subset, focusing on defining a standardized set of essential health data elements and associated value sets to enable seamless interoperability and data exchange within the Canadian health care landscape. These elements are structured within a common data architecture to facilitate interoperability across Canada’s healthcare ecosystem.

In contrast, Pan-Canadian Core FHIR Profile Set (CA Core+), led by Canada Health Infoway, builds on this foundation by establishing FHIR-based profiles and implementation guides to enable standardized data exchange. It is the expression of constraints in the Canadian Core Data for Interoperability (CACDI), in the form of FHIR profiles. The CA Core+ specifications include a core set of common data exchange profiles, extensions, and value sets as well as domain-specific profiles that offer constraints applicable under certain contexts (e.g., patient summary, long term care).

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Together, CACDI and CA Core+

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work in tandem to enable standardized data exchange. CACDI establishes the core data elements needed for interoperability, while CA Core+ ensures these elements are structured according to FHIR-based standards.

Canada Health Infoway, in partnership with the Canadian Institute for Health Information (CIHI), is taking a collaborative, iterative approach in developing the CA Core+ specification and the CACDI. This approach includes extensive consultations with a wide range of interest holders, including:

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