Jurisdictional Content

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.

Jurisdictional Patient Summary Content

Implementers are encouraged to review the additional constraints and localizations published by jurisdictions:

Differences between the PS-CA and Jurisdictional Content

Jurisdictional content 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.