Alignment to Standards

Alignment with the International Patient Summary & Other Pan-Canadian Specifications

The Alberta Patient Summary (PS-AB) is based on the the Pan-Canadian Patient Summary (PS-CA) Standard, and the Canadian Baseline (CA-Baseline). It was developed in collaboration with Canada Health Infoway and with input from Alberta clinicians and solution vendors. The following diagram shows what are currently included in Alberta Patient Summary:

Figure 1: Pan-Canadian Patient Summary Composition and Inclusion Status for Alberta

The PS-AB is scoped for patient summaries generated, stored, and transmitted within Alberta. This contrasts with the PS-CA Standard, which is intended to support intra-jurisdictional use, cross-jurisdictional use, and cross-border use. This difference in scope is the root of most of the variances between PS-CA and PS-AB. The PS-AB attempts to profile in a way that allows the patient summary instances to be conformant to PS-CA, and CA-Baseline without having to formally derive from the profiles in these specifications. Alberta Health will continue to work with Canada Health Infoway to maintain alignment where applicable between PS-AB and PS-CA.

A few notable variances include:

Variance	Additional Description and Examples
Fewer patient summary sections supported	PS-AB is scoped based on Alberta needs and constraints (e.g. Immunizations, Medical Devices sections are not supported in PS-AB). Difference in scoping is core rationale behind many other differences.
Tighter MustSupport constraints	PS-AB MustSupport elements are a superset of PS-CA MustSupport elements; PS-AB includes some additional MustSupport elements on top of those specified by PS-CA (e.g. Patient.telecom and Patient.address are MustSupport elements in PS-AB).
Tighter cardinality constraints	PS-AB applies additional cardinality constraints on some elements to support business requirements including integration with provincial digital health assets in Alberta (e.g. PS-AB Composition.identifier has 1..1 cardinality vs. 0..m in PS-CA and PS-AB Patient.identifier has 1..m cardinality vs. 0..m in PS-CA).
Tighter constraints on optional data elements through use of invariants	PS-AB uses invariants or constraints in the Bundle to ensure that data not permitted to be sent/received for privacy and/or clinical reasons are not included in an instance of Alberta patient summary (e.g. Practitioner.birthDate and Location.managingOrganization are restricted in PS-AB).
Use/addition of extensions	PS-AB uses extension (e.g. Patient.extension.individual-recordedSexOrGender rather than Patient.gender to support additional gender such as "X") and also added extensions to support business requirements (e.g. addition of Section.extension.note to capture additional clinical notes at the section level).
Fewer use cases/functionality supported in CA:FeX	PS-AB supports create and submit (including update and cancellation) of patient summaries and is aligned to CA:FeX RESTful API protocol. It does not currently support querying of patient summaries.