Guidance

Conformance Language

This specification uses the conformance verbs SHALL, SHOULD, and MAY as defined in RFC 2119.

  • SHALL: Indicates requirements that must be met to be conformant with the specification.
  • SHOULD: Indicates requirements that are strongly recommended (and which could result in interoperability issues if not adhered to), but which do not, for this version of the specification, affect the determination of specification conformance.
  • MAY: Describes optional requirements that implementers are free to consider but where there is no recommendation for or against adoption.

A patient summary submitted SHALL be well-formed and conform with this specification including conformance to business rules and data curation.

Patient summary contributors SHALL use a PoS that has passed Alberta Health conformance, and the authoring provider SHALL be registered with Alberta Health to participate in this service.

Identifier Policy

The PS-AB uses URIs whenever Object Identifiers are required. URIs (Uniform Resource Identifiers) are globally unique identifiers for individual objects, as well as for value sets, code systems, profiles, namespaces, and more. URIs are the preferred object identifiers for FHIR objects, and are usually represented as URLs.

For more information, or to obtain the proper URLs for use in this project, contact Alberta Health at hisca@gov.ab.ca

The base namespace for global identifier such as the system identifier for Alberta Personal Health Number will be referred to as "[id-system-global-base]" throughout the specification.

The base namespace for a local identifier such as a Composition.identifier Assigning Authority will be referred to as "[id-system-local-base]" throughout the specification.

The base namespace for local code systems and value sets will be referred to as "[code-system-local-base]" and “[value-set-base]” throughout the specification.

Due to the evolving FHIR standard and its developing framework and governance, implementers should recognize that these identifiers may change if identifier registration becomes governed nationally or internationally. Implementers are recommended to implement URIs using configurable variables.

Identifier Variables

Variable Value
[base-structure] "https://www.alberta.ca/fhir/StructureDefinition"
[id-system-global-base] "https://fhir.infoway-inforoute.ca/NamingSystem"
[id-system-local-base] "https://www.alberta.ca/fhir/NamingSystem"
[code-system-local-base] "https://www.alberta.ca/fhir/CodeSystem"
[value-set-local-base] "https://www.alberta.ca/fhir/ValueSet"

Data Formatting

Letter Case

Information in patient summaries is stored as mixed case and information is preserved in the format provided by the source (e.g. ALL UPPER CASE, Mixed Case, lower case). Patient Summary consumers MAY apply data formatting rules where there is a local requirement to standardize information to a consistent format.

Extended Character Set

Information within patient summaries shall be in UTF-8 to support extended characters beyond standard ASCII/ANSI character set including French characters.

Date/Time

In this specification, the expected date format is "YYYY-MM-DD" or partial date formats “YYYY-MM” or “YYYY” in UTC format. If this format is not provided, or an invalid date is provided in the defined format, the request will be rejected. Below are the formats supported:

  • 2015-01-07T13:28:17-05:00
  • 2015-01-07T18:28:17Z
  • 2015-01
  • 2015

Telecom

For this specification, the telecom format is "+[country code]-[area code]-[exchange]-[subscriber number] ext."[extension]". Note that if country code is not used, the "+" prefix is skipped. Example: "+1-555-555-5555 ext. 123456"

URI/UUID

Uniform Resource Identifiers (URIs) leveraged in the Alberta Patient Summary are case sensitive. URIs can be absolute or relative, and may have an optional fragment identifier. Universally Unique IDs (UUIDs) are defined in lower case format (e.g. “urn:uuid:53fefa32-fcbb-4ff8-8a92-55ee120877b7”).

Referencing FHIR Resources

Referenced resources in Composition (e.g., Composition.subject references a Patient resource, Composition.author references a PractitionerRole resource, etc.) SHALL exist as entries in the Bundle. The following approach is used in PS-AB for referencing resources in the Bundle:

  • The Bundle.entry.fullURL SHALL use urn:uuid
  • The UUID used in fullURL SHALL be used in Reference.reference to reference the corresponding FHIR resource in the Bundle
  • The UUID used in fullURL SHOULD also be assigned as the Resource.id

Note: The Bundle.id assigned by patient summary submitter (e.g., EMR) will be ignored by the recipient (e.g. Alberta Health) when a HTTP POST is done (i.e., a new UUID will be assigned by the recipient for Bundle.id).