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Overview

The Longitudinal Record Access (LRA) project establishes a secure, standardized provincial gateway that enables seamless information sharing between clinical systems and healthcare settings. By reworking core provincial health data assets to align with national standards, LRA removes barriers to information sharing and facilitates communication between clinical systems across the province.

LRA acts as the foundational repository, built on SMILE CDR, to store and manage healthcare data. This repository allows for the consolidation and sharing of health information across various systems, ensuring data availability for providers and patients alike. The system serves a wide range of stakeholders:

  • Health authorities utilize LRA to ensure timely access to critical clinical data.
  • Care providers have the tools to securely view, update, and share patient - data, ensuring coordinated care delivery.
  • Administrative staff benefit from simplified access to health records, improving operational efficiency.
  • Patients gain improved access to their health information, empowering them to manage their care from their homes or mobile devices.

Key Benefits

  • Enhanced Access for Providers: Healthcare professionals access and share relevant patient data from multiple sources, enabling informed and coordinated care.
  • Patient Empowerment: Patients receive direct access to their health data, improving transparency and enabling better management of consent and preferences.
  • Operational Efficiency: Collaboration with health authorities to implement shared data repositories reduces administrative overhead, boosts performance, and lowers costs.
  • Improved Security and Privacy: Strong security measures, privacy controls, and auditing processes protect patient information from unauthorized access, ensuring compliance with privacy standards.

SMART on FHIR Integration

While LRA serves as the underlying repository within SMILE CDR, existing SMART on FHIR (SoF) implementations are layered on top to provide FHIR-compliant access to the data. These SoF applications will interact with the LRA repository to enable healthcare providers and patients to engage with the data stored in LRA in a secure and standardized manner.

The first primary use case for the SoF implementation is the Patient Summary SoF app. This app will allow healthcare providers and patients to view a consolidated summary of a patient’s medical history, including key clinical data necessary for informed decision-making. The app integrates directly with LRA, retrieving up-to-date information from the repository and presenting it in a user-friendly format.

Additional SoF use cases and implementation details are being developed and will be expanded in future releases of the Implementation Guide (IG).

Source System Integrations

LRA integrates with several source systems to ensure comprehensive access to provincial healthcare data:

  • Client Registry: LRA integrates with the Client Registry, providing access to patient identification and demographic information using FHIR profiles for Patient and $MergePatient operations.

  • Provider Location Registry (PLR): LRA connects to the PLR, enabling access to provider information through $entityQuery operations for Practitioner, Organization, and Location resources.

  • Medical Services Plan (MSP): Through integration with the MSP Eligibility service, LRA retrieves direct eligibility information for patients.

  • Provincial Attachment System (PAS): LRA supports the management of provider-patient relationships via FHIR message exchanges, with resources such as MessageHeader, Group, Practitioner, and Patient enabling panel management.

  • Immunization (Panorama): LRA integrates with the Immunization Distribution Service (IDS), consuming immunization data published from Panorama and storing it for query and reporting purposes.

These source system integrations provide critical health information in a standardized format, enabling providers and patients to access necessary data across multiple healthcare settings.