The following terms appear throughout the CA:FeX Specifications:
| Term / Acronym | Meaning |
|---|---|
| Author | A health care provider who authors and/or curates clinical data. |
| CA:FeX | The CA:FeX Interoperability Specifications (Canadian FHIR Exchange (CA:FeX)) seeks to promote FHIR RESTful exchange patterns, developed by industry-leading FHIR standards that can be applied on top of an existing non-FHIR infrastructure just as easily as it can be applied on top of FHIR servers. |
| Central Infrastructure | A Central Infrastructure collects health information from participating organizations and stores the information in a centralized place. The Infrastructure also provides access control. Typically, the central infrastructure is under jurisdictional control. |
| Clinical Data Repository | A clinical data repository is built around the HL7 FHIR standard used for storing clinical data. |
| Clinical Solution | Any combination of health information technology assets and processes that enables clinical data to be communicated, managed and dispositioned between a Producer and a Consumer. Clinical Solutions can be comprised of various Producer and Consumer systems including: EMR, HIS, CIS, PHR, EHR or any combination of these systems. |
| Conformance Testing | Conformance testing is a formal process of assessment focused on ensuring clinical solutions and systems accurately implement a particular specification (e.g. CA:FeX Specifications) by ensuring there is conformance to the stated parameters that are being claimed in the standard. |
| Consumer | A health records system (e.g., EMR, HIS, CIS, PHR, Patient Portal or EHR) that enables access to or receipt of a clinical document (e.g. Patient Summary-CA) by an authorized health care provider or the subject of care/patient. |
| Document Repository (Local or Central) | A document repository is a shared storage space for clinical documents that can be hosted locally (i.e., at the document producer) or at the HIE Central Infrastructure and can be accessed by authorized users. |
| Electronic Health Record (EHR) | The EHR represents the Clinical Solution that contains a secure and private collection of a patient's health information in a digital format, which is shareable across different health care settings / clinical solutions that are integrated. The EHR facilitates better sharing and interpretation of health information among the health care professionals involved in the care of the patient. For example:
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| Foundational Interoperability | Foundational interoperability is the ability of one IT system to send data to another IT system. The receiving IT system does not necessarily need to be able to interpret the exchanged data — it must simply be able to acknowledge receipt of the data payload. This is the most basic tier of interoperability. |
| HCP | Health Care Provider |
| Health Information Access Layer (HIAL) | An interface specification for the EHR infostructure that defines service components, service roles, information model and messaging standards required for the exchange of EHR data and execution of interoperability profiles between EHR services. (Source: https://www.infoway-inforoute.ca/en/component/edocman/resources/technical-documents/391-ehrs-blueprint-v2-full ; Page.340) |
| Health Information Exchange (HIE) | Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care. While electronic health information exchange cannot replace provider-patient communication, it can greatly improve the completeness of patients' records, (which can have a big effect on care), as past history, current medications and other information is jointly reviewed during visits. Appropriate, timely sharing of vital patient information can better inform decision making at the point of care and allow providers to avoid readmissions, avoid medication errors, improve diagnoses and decrease duplicate testing. (Source: https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/what-hie) |
| Health Level 7 (HL7) | Founded in 1987, HL7 is a not-for-profit standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. (Source: http://www.hl7.org/about/index.cfm?ref=nav) |
| HL7 Fast Healthcare Interoperability Resources (FHIR) | Expected to be a next generation standards framework created by HL7. FHIR combines the best features of HL7‘s Version 2, Version 3 and product lines while leveraging the latest web standards and applying a tight focus on implementability. |
| Health Records System | A health records system may include an electronic medical records system, a hospital information system, a clinical information system, an electronic health records system or a personal health records system. The term is broadly used to describe system actors that may produce and/or consume a PS-CA. Jurisdictional implementation patterns will determine which systems are used to create, access, consume and manage patient summaries. |
| Integrating the Healthcare Enterprise (IHE) | IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Systems developed in accordance with IHE communicate with one another better, are easier to implement, and enable care providers to use information more effectively. (Source: https://www.ihe.net/) |
| IHE Actor | IHE Actors are responsible for producing, managing and/or acting on information in the context of an IHE Profile (e.g., Primary Care Provider, EMR, EHR, etc.). (Source: https://wiki.ihe.net/index.php/Actors) |
| IHE Profiles | IHE Profiles describe specific solutions to interoperability problems. Profiles specify how "Actors" use standards to address a specific healthcare use case (e.g., Medication, Allergy Intolerance, etc.). (Source: https://wiki.ihe.net/index.php/Profiles) |
| IHE Transactions | IHE Transactions are interactions between actors that communicate the required information through standards-based messages (e.g., patient look-up query, send patient summary information, etc.). |
| Producer | A health records system (e.g., EMR, HIS, CIS, PHR, or EHR) that creates/produces a clinical document (e.g. Patient Summary-CA) in response to a request from an authorized health care provider, the subject of care or another authorized health records system. |
| Patient Portal | A patient portal is a web-based access point that enables secure patient access to personal health information and other self-serve health IT services. For example, a patient portal can be hosted on an EMR solution. |
| Semantic Interoperability | Semantic interoperability is the ability of health IT systems to exchange and interpret information — then actively use the information that has been exchanged. Semantic interoperability is the highest level of interoperability. “Semantic interoperability takes advantage of both the structuring of the data exchange and the codification of the data including vocabulary so that the receiving information technology systems can interpret the data,” stated HIMSS. Achieving semantic interoperability allows providers to exchange clinical information with other caregivers and authorized parties using different EHR systems to improve care quality, safety, and efficiency. This level of interoperability allows healthcare organizations to seamlessly share patient information to reduce duplicative testing, enable better-informed clinical decision-making, and avoid adverse health events. Effective health data exchange can also help to improve care coordination, reduce hospital readmissions, and ultimately save money. Hospitals and health care systems can utilize existing health data standards to achieve the lower levels of interoperability and set a solid foundation for future improvements in health data exchange. |
| Structural Interoperability | Structural interoperability is “the uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data is preserved and unaltered,” HIMSS states. To achieve structural interoperability, the recipient system should be able to interpret information at the data field level. This is the intermediate level of interoperability. |
| Terminology | Collection of uniquely identifiable concepts with associated representations, designations, associations and meanings. |