Introduction
Interoperability enables information to flow seamlessly between different solutions and devices. When different parts of the health system are interoperable with each other, they can “speak the same language.” Interoperability improves continuity of care, collaboration between health providers and patient access to 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.
In support of the provinces and territories, Infoway is facilitating a national collaborative effort to advance interoperability. While there are many interoperability-related challenges, this specification addresses sharing of Patient Summaries.
Canada is not alone in trying to solve for this challenge. The International Patient Summary (IPS) project started in Europe several years ago and has been adopted by ISO, IHE and HL7 International. In addition, there is an active working group led by the Office of the National Coordinator (ONC) in the United States called the Global Digital Health Partnership (GDHP) that is actively working with member countries to find solutions for scaling Patient Summary exchanges at an international scale. Canada is an active participant in this partnership and has made a commitment at the G7 meeting in June, 2021 to collaboratively work on aligning Patient Summary implementations to the IPS standard.
This project is part of those efforts. The Implementation Guide and FHIR profiles contained in this project are part of a pan-Canadian effort to develop an implementable set of specifications aligned to the IPS that reflect Canada's jurisdictional realities.
The overarching principle adopted for the project is to maintain as close of an alignment to the IPS profiles as possible while creating the instruments to allow jurisdictions to properly represent their desired clinical workflows. In alignment with the IPS, the pan-Canadian Patient Summary specification will need to include support for unscheduled/scheduled local care and unscheduled/scheduled cross-border care, such that vendor systems will not have to change to support either-or and change management associated with adoption activities will make it a worthwhile investment.
The pan-Canadian Patient Summary specification implementation approach for alignment with the IPS will span a number of releases on a roadmap. Release 1 will focus on three use cases, that have been identified as priority for Canadian jurisdictions, and their supporting requirements, reference architecture, terminology and FHIR profiles. This release will include supports for sharing Patient Summaries for scheduled or unscheduled local care with information from a single source.
Future releases will incorporate additional use cases and their supporting requirements, reference architecture, terminology and FHIR profiles. For example, the implementation roadmap will include a use case for creating the Patient Summary with information from more than one source and additional scenarios for supporting scheduled or unscheduled cross-border care.
