This is the current version of the PS-CA Implementation Guide. Other releases of the PS-CA Implementation Guide may be found at Guides.
Jurisdictional Context
Alignment to Work Underway with Jurisdictions
Some jurisdictions may already be working on their own jurisdictional content. Both PS-CA and jurisdictional content should be informed by the same high-level principles from the Pan-Canadian Coordinating Table.
Jurisdictional content is expected to be meet the minimum expectations outlined in the PS-CA specification, this ensures that all implementors across the country are building from same foundational data model (leading to economies of scale with vendors). With this approach, customizations and differences across jurisdictions are minimized to only implementation specific details (e.g., tighter cardinality on elements that support specific integration requirements from jurisdictional health assets).
In the cases where jurisdictions have begun profiling work, the PS-CA specification development team has worked collaboratively with the jurisdiction to compare the specifications, align where appropriate, and identify any areas that need to be relaxed in the national profile, or resolved further through the international specification. Jurisdictional content developed after the initial draft of the PS-CA is published is expected to align to the minimum expectations outlined in the PS-CA specification and ideally directly derive from the profiles in the PS-CA FHIR® package.
Differences between the PS-CA and Jurisdictional Content
Jurisdictional content will never break the expectations of this specification, meaning it is never expected to have looser constraints than those put forth the PS-CA. Rather any additional constraints put forth through jurisdictional content are expected to be the result of tightening of the expectations outlined in PS-CA (e.g., applying a Must Support flag to an element that is noted for tightening in future releases but is currently lacking support from a number of participating jurisdictions at the pan-Canadian level).
Additionally, some jurisdictions may also apply constraints on elements specifically needed for integration with their existing digital health assets (e.g., additional provider identity requirements to leverage an existing digital health asset integration).
Understanding the scope of the jurisdictional content also plays a critical role in understanding the differences between the two types of content. Additional expectations outlined in the jurisdictional content that has been developed to date solely reflect the expectations for systems generating, storing, and transmitting summaries produced within that jurisdiction. These additional expectations have not been scoped to apply to summaries received from other jurisdictions, and therefore should not be interpreted as such.
Additional guidance will be provided on interpreting jurisdictional constraints as jurisdictions move to support intra-jurisdictional and international exchange of patient summaries in later releases.
Jurisdictional Patient Summary Content
Jurisdictional details may be hosted in a jurisdictional guide or project space. In cases where a jurisdiction is starting to surface implementation details through derived profiles - those derived profiles can be found in their project space and have been rendered below (through packaging) for reader convenience.
Implementers are encouraged to review the additional constraints, localizations, and implementation details published by jurisdictions.
Ontario Implementation Details
The Ontario Patient Summary is based on the International Patient Summary standard and was developed in collaboration with Canada Health Infoway and other jurisdictions and with preliminary input from primary care clinicians and solution vendors.
The Ontario Patient Summary (PS-ON) Standard aligns, where applicable, to the International Patient Summary (IPS) HL7 FHIR standard, the Pan-Canadian Patient Summary (PS-CA) Standard (under concurrent development), and the Canadian Baseline (CA-Baseline).
Notably, the PS-ON Standard is scoped for patient summaries generated, stored, and transmitted within Ontario. This is in contrast to the PS-CA Standard, which is intended to support intra-jurisdictional use, cross-jurisdictional use, and cross-border use. This difference in scope is the root of most of the variances between PS-CA and PS-ON.
Implementers are encouraged to review the Ontario Patient Summary FHIR Implementation Guide to learn more about the relationship between the specifications and to review details regarding Patient Summary implementation in Ontario.
Ontario Patient Summary FHIR Implementation Guide
Alberta Implementation Details
Alberta is in the process of developing implementation details to provide to their implementers.
At the time of the September 2022 release, details lke usage notes, comments, mappings, and additional constraints have been applied within PS-AB profiles that are derived from the PS-CA profiles.
Implementers are encouraged to review the the Alberta Patient Summary space to read about the additional constraints, localizations, and implementation details published by jurisdictions.