Profiles & Interactions

Introduction

This PSON FHIR specification defines the FHIR profiles (constraints) and extension elements that are used in the PCIE project. All FHIR-based specifications rely on an underlying set of base “resources”.

Resources

Resources are the building blocks of the FHIR standard. These resources convey the content of clinical records, identify patients or providers, or otherwise support messaging between systems. These resources have been developed by several working groups at HL7, based on members’ experience and subject expertise. These resources are intended to capture and support 80% of all implementation use case requirements; projects are encouraged to meet the remaining 20% of requirements through extensions and profile constraints. The list of all available resources in the FHIR standard can be found at https://hl7.org/fhir/resourcelist.html, with additional details at https://hl7.org/fhir/resourceguide.html.

Profiles

Resources defined in the FHIR standard are intended to support a wide variety of use cases, resulting in a large number of available elements, and very few constraints. Implementers are encouraged to create and apply FHIR Profiles, which places constraints on the defined FHIR resources – tightening cardinality, identifying unused/unsupported elements, defining value sets for elements, and adding extension elements.

Transmission Specification

The formal MIME-type for FHIR resources is application/fhir+json or application/fhir+xml. The correct mime type SHALL be used by clients and servers:
  • JSON (preferred): application/fhir+json
  • XML (optional): application/fhir+xml
FHIR® uses UTF-8 for all request and response bodies. Since the HTTP specification defines a default character encoding of ISO-8859-1, requests and responses SHALL explicitly set the character encoding to UTF-8 using the charset parameter of the MIME-type in the Content-Type header. Requests MAY also specify this charset parameter in the Accept header and/or use the Accept-Charset header.Accept-Language field in HTTP header will be used to set the language of the search in the future releases. The allowed values are “en-CA” and “fr-CA”. If this field is not set by the requestor, the default is “en-CA”. In the current release, only “en-CA” is supported.

PS-ON FHIR® Resources

Actors

Actor Description Application Example
Patient Summary Document Source An Ontario Patient Summary Document Source is the producer and submitter of Patient Summary documents, conformant to this specification, and document metadata. EMR, HIS
Patient Summary Document Recipient An Ontario Patient Summary Document Recipient receives documents and metadata, sent by Document Source actor. Ontario Health Patient Summary Repository
Patient Summary Document Consumer An Ontario Patient Summary Document Consumer queries for document metadata meeting certain criteria and may retrieve selected document(s) EMR, HIS
Patient Summary Document Responder An Ontario Patient Summary Document Responder sends documents and metadata in response to a request from another actor. Ontario Health Patient Summary Repository

Profiles

Resources are the building blocks of the FHIR standard. These resources convey the content of clinical records, identify patients or practitioners, or otherwise support information exchange between systems. These resources have been developed by numerous working groups at HL7, based on members' experience and subject expertise. The elements defined within FHIR resources are intended to capture and support those elements that 80% of implementers of a given resource are expected to support. Less frequently implemented elements are supported through FHIR's extensibility mechanisms. The list of all available resources in the R4 FHIR standard can be found here.The base FHIR resources profiled / used in the Ontario Patient Summary are:

Summary of Interaction

Interactions Resource HTTP Verb
Fetch DocumentReference Bundle POST
Retrieve Patient Summary Bundle GET
Search Patient Summary Bundle POST, GET
Submit Patient Summary Bundle POST, PUT