Purpose

This Reference Architecture provides guidance on how to apply CA:FeX implementation patterns along with other IHE profiles to address interoperability needs pertaining to FHIR Health Information Exchange (HIE) implementation pattern.  It defines the rules of engagement and defines the interoperability landscape as well as developing a connectivity platform to allow external vendors to test solutions.

Intended Audience 

The intended audience of this Reference Architecture includes, but is not limited, to the following: 

• IT departments of healthcare institutions (technical product managers, IT managers, operations staff)
• Technical staff of clinical solution vendors 
• Experts involved in standards development
• Individuals and teams responsible for implementing software solutions such as project managers, CTOs, CISOs, software engineers, technical product managers, IT managers, operations staff, and other similar roles.

Overview

This section contains a list of recommended IHE candidate profiles that can potentially be grouped with CA:FeX that can meet specific needs for FHIR Health Information Exchange (HIE) implementation pattern. The sequence diagrams included in this section group together actors and transactions from multiple profiles including CA:FeX to address the scope of the use cases. 

How To Read The Reference Architecture 

• This document lists actors and transactions from candidate IHE profiles that can potentially be grouped with the CA:FeX Interoperability Specification and enable FHIR Health Information Exchange (HIE) implementation patterns. 
• The relationship between consuming and recipient actors are indicated by black lines. 
• There are two swim lanes that group together the actors and transactions: Clinical systems and Jurisdictional systems.  It is assumed that vendors will take on roles from the clinical systems while provinces and territories will take on roles from the jurisdictional systems.  
  • Dark green actors are required actors showcasing different roles within the clinical systems that are required for this release 
  • Light green actors are optional actors showcasing different roles within the clinical systems that are optional for this release 
  • Dark blue actors are required actors showcasing different roles within the jurisdictional systems that are required for this release 
  • Light blue actors are optional actors showcasing different roles within the jurisdictional systems that are optional for this release 
• The black lines are the interactions and standardized transactions of the actors and their association with one another as defined by the IHE methodology framework. 
• A list of all the IHE profiles are included at the bottom of the Reference Architecture.
• A list of pan-Canadian Profiles are listed at the bottom of the Reference Architecture. 
• A legend is found at the bottom of the Reference Architecture to help readers orient themselves to the diagram. 

How To Use The Reference Architecture 

The list below summarizes how to use this document:

• Role Identification: Jurisdictions and vendors will need to identify their role (e.g. actors) from the Reference Architecture and sequence diagrams for each of the use cases in scope. 
• Gap Identification: Based on the role(s) identified from the Reference Architecture and sequence diagrams, potential assessment is needed for identification of gaps for meeting the requirements of the standardized actors and transactions needed to satisfy particular use cases. 
• Provincial Reference Architecture: Provinces and jurisdictions may need to draft their own version of Reference Architecture specific to their needs. Current technology landscape, existing architecture and current business priorities will help in developing a version for the province.
• Document Evolution and Feedback: This is a living document and will evolve based on feedback and refinements to the the CA:FeX Interoperability Specifications and related use cases. This document is published on InfoScribe to capture comments and feedback from all key stakeholders. Additionally, multiple sessions will be conducted to discuss and update the content of this document.
• Vendor Conformance Testing (Connectathon / Projectathon): This document will provide an opportunity for vendors to prepare for conformance testing of the CA:FeX Interoperability Specifications on the IHE Gazelle platform. IHE Gazelle is an open-source, web-based test platform supporting a wide portfolio of interoperability test tools suited to validate interface conformity to IHE Profiles and project-specific standards-based interoperability specifications. Vendors can validate their products and eHealth projects to procure interfaces they deploy. For additional information on Gazelle, please refer to the following link: IHE Gazelle

*Note: It’s expected that the reader should have a moderate degree of familiarity with IHE profiles, esp.  ATNA, CT and IUA.

High Level View - Reference Architecture for CA:FeX

This is a high-level view of relevant IHE Integration Profiles to support the FHIR HIE implementation using CA:FeX. Required and optional capability support is described in the sequence diagrams associated with each Use Case analysis. Vendors or jurisdictions may decide not to implement optional IHE profiles showcased below, however it is highly recommended that areas pertaining to authentication, auditing and security are being addressed using solutions that currently exist in their respective enterprise architecture.