DFT-preBallot - The specification is a DFT-preBallot version of CA Core+ for collecting community feedback. For a full list of available versions, see the Directory of published versions

Known Issues & Future Development

Open issues are those for which no decision has been made, are pending feedback, or, for which there is an outstanding action. Issues are marked as closed once a decision has been made or the issue has been resolved.

Feedback is requested on both open and closed issues. Instructions for feedback submission can be found on the Specification Feedback page.

Known Issues

1. Referenced ValueSets and CodeSystems are not resolvable.

   Some referenced ValueSets are not available at their canonical URL; some (particularly Canada-specific not managed by Infoway) ValueSets are not on the terminology servers used in IG publication (i.e. tx.fhir.org). Some referenced ValueSets are not currently available as FHIR R4 and may require conversion before use. Primarily, these issues impact validation against Canada Health Infoway-hosted ValueSets during development of derived Implementation Guides. (This doesn't affect deployed systems, since, in that environment, instances will be validated against locally present value sets.) For several of these ValueSets, "stub" resources have been created to stand-in within this Implementation Guide for the unresolvable ValueSets.

   Current guidance is to manually download the referenced value sets from, for example, the Terminology Server. These issues will be resolved using features from the forthcoming Infoway Terminology Server and tx.fhir.org, and will be reflected through updated canonical URLs in a future release of the CA Core+. 2025-03-31 Update: Stubs have been updated with placeholder codes which are expected to change with updates to the CIHI Logical Data Model. Canonical URL redirection to the Terminology Service will be live on 2025-04-30.

2. Pre-Adopting R5 Elements

   Current tooling does not support the rendering of elements that are pre-adopted from later versions of FHIR (e.g., Appointment.class). This rendering does not impact the ability for implementers to follow the standard convention for expressing and utilizing content in later FHIR versions.

3. Packaged Profiles do not include Snapshots

   Current tooling is unable to generate FHIR profile snapshots when creating packages for this project. If you wish to retrieve the snapshots for a particular profile, you can select the "Download snapshot as XML/JSON" option from the respective profile page within the Simplifier project (top-right corner of the project profile page, not the IG page)

4. Updated Mappings to PCHDCF

   CA Core+ to pCHDCF Mapping mappings are continuing to evolve as both products continue to mature. The StructureDefinition mappings of PCHDCF to CA Core+ are expected to receive a major update as PCHDCF becomes more comprehensive.

5. AdditionalBindings in Terminology Tables

   Mapping tables are now produced using FHIR Query Language (FQL). The Terminology bindings tables each Profile is currently not including these additional bindings

6. Example Patient Profile

   On the Artifact Status Summary the Example Patient Profile is listed in the Profiles section, but should be in the examples section. A fix for this issue is forthcoming in FHIR Query Language (FQL) generated table.

Closed Issues

1. AdditionalBinding Rendering

   This version introduces the AdditionalBinding Extension to convey additional terminology that is relevant under certain contexts (e.g., proposed for use with countries that do not have SNOMED CT licensing, utilized heavily in legacy data, etc.).

   • This extension is applied to the binding element and previously did not have rendering support in Simplifier (requiring the profile pages to indicate the terminology indicated as additional bindings). This rendering is now supported in the Simplifier interface.

2. Extensions in the Extension Registry

   The profiles in this guide currently utilize the RecordedSexOrGender Extension, the Pronouns Extension, the No Fixed Address Extension, the Abatement Extension and the Obligation Extension. Previously, the Extension Registry guide that hosts this content had not produced a package update that can be consumed by the project and the tooling required this project to "re-publish" the extensions in this project. The HL7 Extensions Pack now includes both the R5 and R4 versions of this extension and dependencies have been updated accordingly.

   • individual-recordedSexOrGender Extension: Implementers are advised to take note that the data type for the extension part sourceDocument (Reference) is not forwards compatible to the R5 type for that part (CodeableReference). No other material differences are present between the R4 extension published in this guide and R5 extension published the FHIR Extensions Pack.