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Overview

The Canadian FHIR Exchange (CA:FeX) Interoperability Specification defines standardized, RESTful exchange patterns to support sharing health information across healthcare systems in Canada. The specification provides guidance for implementing FHIR-based document submission, discovery, and retrieval, supporting exchange across existing infrastructure as well as systems built natively on FHIR. This guide focuses on FHIR document submission, discovery and retrieval through the retained Bundle (A), Metadata (B) and Summary (D) options.These approaches provide implementation flexibility while promoting consistent interoperability across systems and jurisdictions.

Why CA:FeX

Healthcare information in Canada is often distributed across electronic medical records (EMRs), hospital information systems, provincial repositories, and digital health applications. These systems do not always communicate effectively, making it difficult for healthcare providers to access a complete view of a patient's health information and for patients to access their own records.

Fragmented information exchange can result in incomplete patient information, delays in care, and challenges during transitions between healthcare providers and settings.

Canada Health Infoway, in collaboration with provinces and territories, is advancing a national approach to improve health information exchange. A key priority of this work is the secure sharing of clinical documents (for example, patient summaries) across systems and jurisdictions.

What this guide covers

• Document Exchange
  Defines standardized FHIR RESTful patterns for submitting, discovering, and retrieving grouped FHIR resources as documents. It also establishes consistent search parameters to support document-sharing use cases.

• Extending APIs with FHIR Operations
  Describes functional FHIR Operations that can simplify client implementation by encapsulating multi-step interactions into individual API calls.

Note: Single Resource Exchange, previously covered in this guide is now addressed in the CA Core+ specification. Refer to CA Core+ release Information.

For full details, see Scope.

Role in the Canadian ecosystem

The CA:FeX specification is a foundational building block in Canada’s digital health ecosystem. It supports vendors in aligning to baseline expectations across jurisdictions and defines “Interaction Support” for all ecosystem participants. CA:FeX will continue to evolve with its roadmap, Canadian priorities, and international FHIR exchange developments.

Intended Audience

The intended audience of the CA:FeX Interoperability Specifications includes, but is not limited to:

• Those interested in integrating healthcare information systems and workflows
• IT departments of healthcare institutions
• Technical staff of clinical solution vendors
• Experts involved in standards development and
• Software developers.

Feedback

To provide feedback on the CA:FeX specification, please review the following page to obtain access to the Jira project: pan-Canadian Interoperability Specifications Feedback - Pan Canadian Interoperability - InfoScribe (infoway-inforoute.ca)