This is the current version of the PS-CA Implementation Guide. Other releases of the PS-CA Implementation Guide may be found at Guides.

Change Log

The following summarizes changes made to the PS-CA Implementation Guide. Changes to the accompanying Pan-Canadian Patient Summary Interoperability Specifications, and companion guides, are provided in those documents.

PS-CA Implementation Guide v1.0.0 TI (Projectathon Release)

  • Updated dependency on IPS to point to newly published IPS v1.1.0 package
  • Updated Bundle Examples to improve Projectathon validation (e.g., included meta.profiles, included SNOMED CT CA version)
  • Updated the Composition profile to remove the vital sign parent profile slice to provide better validation against individual viral signs profiles - with added comment with rationale of the change
  • Updated inclusion statement for PharmaceuticalBiologicProductAndSubstanceCode value set to align to changes in how intersections are evaluated in HL7 validator
  • Updated known issues & Future Development to remove issues that have been resolved

PS-CA Implementation Guide v1.0.0 TI

  • Refinement of language describing relationship with evolving IPS and CA Baseline Specifications
  • Removal of GPS terminology in accordance with the changes in IPS to recommend the IPS SNOMED Free Set which was developed and maintained for international use.
  • Inclusion of comment on Composition.encounter element to clarify optional use
  • Modification of slice name & value set name for licensed natural products (NPN -> LNHP)
  • Update of artifact versions & statuses to prepare for Version 1.0.0 package
  • Update of Composition.section All Slice to make the 1..1 cardinality on section.text and section.code clearer - this change was made in alignment with IPS-UV change
  • Inclusion of additional examples in project that were developed to support projectathon testing
  • Refresh Profiling Conventions and Approach with updated language on IPS approach to must support
  • Refresh IPS page to indicate any relevant changes in IPS that are due to the feedback from PS-CA and PS-ON
  • Refresh of the individual guide pages to remove IPS differences that have been resolved in the IPS UV August 2022 CI Build
  • Inclusion of FamilyMemberHistory profile (and update of Composition to include as optional section and profile)
  • Inclusion of a more generalized Social History Observation profile (and update of Composition to include as optional section and profile)
  • Update of Composition.section.entry to remove MS on SHx Tobacco Use & SHx Alcohol Use profiles under the Social History Section
  • Inclusion of separate IGuide section for Jurisdictional Context and page added for AB Jurisdictional Context (e.g., use of FamilyMemberHistory, business identifiers used, etc.)
  • Update of the Must Support page to include a comment regarding jurisdictional scope and provide clarifying note regarding MS expectations for backbone elements
  • Pointers to Supportive Reference Architecture pages added to the Exchanging Patient Summaries page
  • Added clarifying note regarding Projectathon testing expectations for terminology version use to the Usage Guidance Section on the Terminology page.

Changes From Prior Minor Releases

Version 0.3.0

  • Shift to new version convention in profiles and IGuide to align to the rest of the specification material, Evolution of Specification has been updated accordingly with new version convention in addition to the inclusion of a new interim v0.3.0 release.
  • Introduction of narrative describing the current evolutions that IPS-UV is undergoing for their own terminology and slice modeling approach in the next IPS release.
  • PS-CA and PS-ON worked with IPS to identify and test challenges with the slicing model currently put forward in IPS. These resulted in changes to the way all three specifications will model this slicing moving forward.
    • After extensive testing, this specification has shifted slicing from being applied on CodeableConcept to being applied on Coding. This was done in order to eliminate the risk of validation errors that arise under the previous slicing model.
    • Removed redundant profiling (e.g., claiming the base cardinality) on the new coding slices
    • Changed AllergyIntolerance.onset(x) and Condition.onset(x) rules from "closed" to "open" given the evidence from implementers for the need to supply for string and potentially other data types.
    • Temporary removal of slice pointing to three GPS Value Sets until modeling is corrected by IPS to ensure validator tools can identify and distinguish use of the value set. Added details on this challenge into Known Issues & Future Development :
  • Updated pointers to CA Baseline and PS-CA packages to align to most recent package updates (1.0.1 and 0.3.0) respectively
  • Removal of JPID and PPN slices in accordance with the recent removal of these slices from the CA Baseline (and the removal of the JPID type from the Canadian URI Registry)
  • Socialization of a MRN identifier type slice to ensure implementers are aware that some jurisdictions may use MRN as an alternative to JHN identifier types in some scenarios.
  • Inclusion of PrescribeIT extensions for medication strength and renderedDosageInstruction as these are extensions that directly impact elements that are profiled by the patient summary
  • Comment added to the medicationRequest.intent element to ensure it shows up in the differential view and isn't missed by implementers as an element that is required in the R4 FHIR specification
  • Comment added to CodeableConcept to further reiterate that the contribution of CodeableConcepts assumes at least one of coding or text will be present. If coding contains only a display value (no code) then CodeableConcept must include text to ensure the human readable description is present when there is no true coding.
  • Minor editing corrections (e.g., SNOMED changed to SNOMED CT, removal of spelling error in element description, modified CVC value set descriptions for easier differentiation between download and view links)
  • Updated a few examples that were demonstrating conformance to the Condition (PS-CA) profile and ConditionNotSupported (PS-CA) profile to more accurately reflect nuances of those profiles