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Scope

This Implementation Guide (IG) will provide comprehensive guidance on leveraging the advanced Publish/Subscribe (Pub/Sub) capabilities of FHIR R5 within an existing FHIR R4 infrastructure. Specifically, the IG will focus on the use of the R5 Subscription Backport to enable healthcare organizations, solution vendors, and system integrators in Ontario to implement real-time, event-driven data exchange notifications using FHIR. This approach allows for the adoption of key R5 features, such as SubscriptionTopic and SubscriptionStatus resources, enhanced filtering, and standardized notification bundles, without requiring a full migration to R5.

In Scope

IG is focused on use cases, system interactions and FHIR profiles for integration between PoS (EMRs, HIS, Clinical Portals) and Ontario Health Subscription Service in support of Subscription management and retreivel of event notifications from OH LOBs.

Out of Scope

Following items are excluded from the scope of this IG and shall not be a concern for the system integrators:

  1. The creation of subscription topics and publishing of events to the Subscription Service by OH LoBs.

  2. Creation of inbound subscriptions, where Publisher is outside of Ontario Health ecosystem (not OH LoB).

The guidance will be tailored to the Ontario healthcare context, addressing relevant provincial standards, policies, and use cases. This IG aims to empower stakeholders in the Ontario healthcare ecosystem to enhance the efficiency, reliability, and interoperability of their FHIR-based solutions through the adoption of R5 Pub/Sub capabilities.

This guide covers:

  • Backport Overview: Introduction to the R5 Subscription Backport Implementation Guide.
  • SubscriptionTopic Implementation: Guidance on defining and using SubscriptionTopics in R4.
  • SubscriptionStatus Utilization: How to leverage SubscriptionStatus for monitoring and troubleshooting.
  • Advanced Filtering: Examples and best practices for using R5 filtering capabilities in R4.
  • Notification Handling: Processing standardized notification bundles in R4 clients.
  • Security Considerations: Best practices for securing Pub/Sub interactions.

This guide will empower you to:

  • Unlock the power of R5 Pub/Sub in your R4 environment.
  • Improve the efficiency and reliability of your FHIR-based event notifications.