CA Core+ 1.0.0 DFT-preBallot

Draft preBallot - This specification is under preBallot review and subject to change. It should not be used for implementation purposes. . . . . For a full list of available versions, see the Directory of published versions

Change Log

CA Core+ v1.0.0 DFT-preBallot

Narrative Content:

IG was restructured into Business Context and Technical Context
Content was generally updated to reflect the Gap Analysis.
Business Context was updated to include additional scope.
An update was made to the MustSupport Definition on the Technical Context page.
The Technical Context page was also updated to include information on the DataAbsentReason Extension, terminology bindings, and other FHIR approaches.
An Artifact Status Summary page was added using FQL tables.
Guidance on Security And Privacy was added.
Updates were made to the Profiling Conventions & Approach to reflect additions such as AdditionalBindings extensions, an updates to MustSupport.

Profile Changes

Changes influenced by Gap Analysis done across different jurisidictional and Pan Canadian specifications.
Detailed changes by profile:
- AllergyIntolerance (CA-Core)
  - AllergyIntolerance.code: updated binding and added type profile
  - AllergyIntolerance.code.coding.code: min cardinality changed from 1 to optional, mustSupport removed
  - AllergyIntolerance.reaction.manifestation: updated binding
- Condition (CA-Core)
  - Condition.code.coding.code: mustSupport removed
  - Condition.code: updated type to reference CA Core+ terminology profile
- Encounter (CA-Core)
  - Encounter.type.coding.code: mustSupport removed
  - Encounter.type: updated binding and type reference
- Immunization (CA-Core)
  - Immunization.reportOrigin.coding.code: min relaxed (1 → 0)
  - Immunization.reportOrigin.coding.system: min relaxed (1 → 0)
- Medication (CA-Core)
  - medication.ingredient: removed (out of scope for CACDI v1)
  - Updated bindings and type references throughout the profile
- MedicationRequest (CA-Core)
  - MedicationRequest.reasonCode.coding.system: min relaxed (1 → 0)
  - MedicationRequest.reasonCode.coding.code: min relaxed (1 → 0)
  - MedicationRequest.dosageInstruction.route.coding.system: min relaxed (1 → 0)
  - MedicationRequest.dosageInstruction.route.coding.code: min relaxed (1 → 0)
  - MedicationRequest.doseQuantity.value: min relaxed (1 → 0)
  - Removed CACDI mappings for descoped drug code concepts
- MedicationStatement (CA-Core)
  - MedicationStatement.reasonCode.coding.system: min relaxed (1 → 0)
  - MedicationStatement.reasonCode.coding.code: min relaxed (1 → 0)
  - MedicationStatement.dosage.timing.code.coding.system: min relaxed (1 → 0)
  - MedicationStatement.dosage.timing.code.coding.code: min relaxed (1 → 0)
  - Removed EDQM and PrescribeIT bindings
  - Constraint added: doseQuantity.unit or doseQuantity.code must exist
- Patient (CA-Core)
  - Patient.name: added MustSupport
  - Patient.telecom: added type reference
  - Patient.identifier: removed obligation flags
  - Updated differential with refined CACDI and PCHDCF alignment

Updated extensions:

IndigenousIdentity
- Updated extension differential to match new base template
- New codes in ValueSet from PCHDCF
RacializedGroup
- Minor updates to align with updated extension guidance
- New codes in ValueSet

New Profiles

New Extensions and Supporting Artifact

New DataType Profiles

Terminology Updates

New CodeSystems

New ValueSets

CCI
ClinicalFindingCode
CommunicationBarrierCode
GenderIdentityCode
HealthConditionCode
MedicationReasonCode
PharmaceuticalBiologicProduceAndSubstanceCode
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recordedGenderCode
SexAssignedAtBirthCode
SexualOrientationCode
SocialHistory
TaskBusinessStatus

Changed ValueSets

These ValueSets existed as placeholders before and now have codes attached to them. These codes are subject to change as the PCHDCF continues to evolve.

Examples

Examples were created for every profile, including an example profile deriving from CA Core+ Patient.

Complete list of examples in this release:

Removed

Obligations have been temporarily removed as they are an evolving mechanism. They will be reintroduced in a future version as tooling improves.
ActorDefinitions have been removed, since their primary purpose was to support

CA Core+ v0.3.1 DFT-Ballot

Profile Changes

updated all FHIR profiles with MustSupport flags for elements with obligations, for better visibility and in alignment with other national cores and IPA.

CA Core+ v0.3.0 DFT-Ballot

Narrative Page Updates

Updated Business Context to reflect CACDI development
Updated Profile Page mapping tables to include a column for mapping.comment

Profile Changes (to align with CACDI Package 1 Ballot Release)

Patient (CA-Core)
- Patient.name: 0..* to 1..*
- Patient.name.use: 0..1 to 1..1
- Patient.identifier: Requirement text updated "numerical" to "alphanumeric"
- Updated CACDI mapping element names based on CACDI v1 final names:
  - Identifier System > Patient Health Identifier System
  - Effective Date Time > Patient Health Identifier Effective Date
  - Expiry Date Time > Patient Health Identifier Expiry Date
  - Name Type Code > Person Name Type Code
  - Effective Date Time > Person Name Effective Date
  - Expiry Date Time > Person Name Expiry Date
  - Birth Date > Person Birth Date
  - Service Language Code > Party Service Language Code
AllergyIntolerance (CA-Core)
- CACDI mapping element name updates:
  - Allergy-Intolerance > Patient Allergy-Intolerance
  - Allergy-Intolerance Reaction > Patient Allergy-Intolerance Reaction
  - Reaction Manifestation Code > Allergy-Intolerance Reaction Manifestation Code
MedicationStatement (CA-Core)
Encounter (CA-Core)
- Encounter.type.coding.code mapping to CACDI Health Service Event Type Code removed
Immunization (CA-Core)
- Immunization.reportOrigin.coding.code: 0..1 to 1..1
- Immunization.reportOrigin.coding.system: 0..1 to 1..1
MedicationRequest (CA-Core)
- MedicationRequest.reasonCode.coding.system: 0..1 to 1..1
- MedicationRequest.reasonCode.coding.code: 0..1 to 1..1
- MedicationRequest.dosageInstruction.route.coding.system: 0..1 to 1..1
- MedicationRequest.dosageInstruction.route.coding.code: 0..1 to 1..1
- MedicationRequest.doseQuantity.value: 0..1 to 1..1
- added constraint: doseQuantity.unit(string) or doseQuantity.code(code) must exist
- Update CACDI v1 mapping element names:
  - Drug Code Details > Drug
  - Drug Code Details > Drug Code
- Removed CACDI v1 mappings (due to descoping) for the following:
  - Point of Care Drug Code
  - Point of Care Drug English Description/French Description
  - Point of Care Drug Code System URI
MedicationStatement (CA-Core)
- MedicationStatement.dosage.route: removed binding to EDQM and PrescribeIT ValueSets
- MedicationStatement.reasonCode.coding.system: 0..1 to 1..1
- MedicationStatement.reasonCode.coding.code: 0..1 to 1..1
- MedicationStatement.dosage.timing.code.coding.system: 0..1 to 1..1
- MedicationStatement.dosage.timing.code.coding.code: 0..1 to 1..1
- added constraint: doseQuantity.unit(string) or doseQuantity.code(code) must exist
Medication (CA-Core)
- Removed medication.ingredient, out of scope for CACDI v1
- Removed CACDI v1 mappings (due to descoping) for the following:
  - Point of Care Drug Code
  - Point of Care Drug English Description/French Description
  - Point of Care Drug Code System URI

CA Core+ v0.3.0 DFT-preBallot

Updated the Relationship to PCHDCF, Relationship to Other Specifications and Profiling Conventions & Approach to include details on the guides relationship to the CACDI
Added profiles and pages for MedicationStatement (CA-Core) and Encounter (CA-Core)
Removed elements and extensions from the profile differential and mapping table that were not identified in early versions of the CACDI for simplicity (these may be re-introduced as CACDI is refined)
Updating mappings in profile differential to include equivalent concept names from CACDI
Reintroduced Obligations (SHALL:able-to-populate for servers/SHALL:handle for clients) on elements identified in early versions of the CACDI as essential to support
Applied minimum cardinality requirements on any elements identified as "no-absent" in early versions of the CACDI (if they were not already minimum of 1 in the FHIR Base Specification)
Introduced racialized-group-ca-core extension and indigenous-identity-ca-core extension, included pointers to the http://hl7.org/fhir/StructureDefinition/translation extension
Added MedicationStatement & Encounter profiles
Temporarily removed Practitioner, PractitionerRole, and Organization Profiles (that previously reflected DCS mappings) from the project until those concepts are modelled in future release of CACDI
Introduced additional terminology bindings/additional bindings
- introduced TherapeuticMoietyTM as an additionalBinding not previously identified on AllergyIntolerance.code

CA Core+ v0.2 DFT - Ballot Reconciliation

Updated the the profiles and pages to temporarily remove obligations from this release in order to align the approach to the forthcoming CACDI artefact in the pCHDCF
Updated the profile pages to remove the duplicative rendering of additionalBinding details now that they are rendering in the Simplifier profile views
Updated select mapping concept names and descriptions across all the Profile pages
Removed select mapping concepts from Patient (CA-Core) due to pCHDCF refinements:
- Person Name Text
Removed select mapping concepts from Condition (CA-Core) due to pCHDCF refinements:
- Health Concern Stage Summary
- Health Concern Stage Assessment
- Health Concern Stage Type
- Health Concern Specialist First Name
- Health Concern Specialist Last Name
- Health Concern Specialist ID
Removed select mapping concepts from Immunization (CA-Core) due to pCHDCF refinements:
- Immunization Reaction Time (consolidated into Immunization Reaction Date)
- Immunization Protocol (concept previously mapped to backbone element)
Removed select mapping concepts from Medication (CA-Core) due to pCHDCF refinements:
- Medication Brand Name (replaced by Medication Code or Description)
- Medication Generic Name (replaced by Medication Code or Description)
- Medication Amount
- Medication Status
Removed select mapping concepts from MedicationRequest (CA-Core) due to pCHDCF refinements:
- Medication Brand Name (replaced by Medication Code or Description)
- Medication Generic Name (replaced by Medication Code or Description)
- Medication Dose + Medication Prescribed Dose ( consolidated into Medication Dose Value)
- Medication Frequency + Medication Administration Instruction Time (consolidated into Medication Timing)
- Medication Request Priority
- Medication Prescriber First Name
- Medication Prescriber Last Name
- Medication Prescriber ID
- Medication Reason Preferred Product Not Prescribed
- Preferred Pharmacy Name
- Preferred Pharmacy Identifier
- Preferred Pharmacy Code
- Preferred Pharmacy Phone Number
- Preferred Pharmacy Fax Number
Updated Known Issues & Future Development to close issues related to additionalBinding and Extension Registry extensions, added an issue regarding extensions for cross-version concepts (e.g., Immunization.supportingInformation)
Refined re-profiled individual-pronouns extensions to include full valueSet from LOINC answer list (https://loinc.org/90778-2/)
Added General Guidance page to provide guidance around handling of Additional Elements not currently part of CA-Core+.

CA Core+ v0.2 DFT - Ballot

Added the following profiles and profile pages:
Updated the page urls for Patient, Practitioner, PractitionerRole, and Organization pages to remove additional dashes for consistency
Updated pCHDCF Concept names and definitions Patient (CA-Core), Practitioner (CA-Core), PractitionerRole (CA-Core), and Organization (CA-Core) pages
Changes to Patient (CA-Core) mappings and obligations to account for changes in the pCHDCF:
- Added mappings and obligations for concepts introduced in pCHDCF (e.g., patient.active, patient.address.extension:no-fixed-address, patient.telecom.period)
- Removed table mappings for Most Responsible Provider details (enrolment start and termination date, termination reason, etc.) which were replaced with Most Responsible Provider Period concept

CA Core+ v0.1 DFT - Ballot Reconciliation

Created Mapping Logic page to convey logic for how pCHDCF and obligation mapping was applied, ensuring that mapping is consistent and that reviewers have the rationale for primary and secondary mappings
Created Relationship to Other Specifications page to convey relationship between this guide and other pan-Canadian specifications
Created the Change Log , Known Issues & Future Development, and Specification Feedback pages
Shifted to using the updated obligation codes from the recent 5.1.0-snapshot publication of the extension registry guide
Removed identifier slices from Patient (CA-Core) and Practitioner (CA-Core)
Removed mapping & obligations on elements that mapped to concepts that have since been removed in the pCHDCF Data Content Standard: Patient Notes
Modified the way that the following concepts are profiled in Patient (CA-Core) to align to updates in pCHDCF Data Content Standard to allow for better concept separation
- name, telecom, address, contact relationship & role
Updated name invariant on Patient (CA-Core) to be better aligned to IPA modelling
Socialized individual-recordedSexOrGender extension on the Patient (CA-Core) profile
Temporarily removed obligations (and mappings) on provider concepts that could be mapped to Practitioner & PractitionerRole FHIR Resources until pCHDCF data modelling is further along for Care Team Member concepts
Applied technical corrections (typos, corrected mapping tables in guide to match mapping element in profiles, added hyperlinks to external content, adjusted diagrams, removed unintentional conformance language from actor definitions, etc.)
Applied update to CA Baseline package version (1.1.5->1.1.7) in the dependencies file to accommodate bug fixes between versions