Relationship to PCHDCF

The CA Core+ Implementation Guide defines a foundational set of HL7® FHIR® profiles aligned with the Pan-Canadian Health Data Content Framework (PCHDCF). These profiles support semantic interoperability at the point of data exchange, while enabling jurisdictions, vendors, and solution providers to adapt them for local or domain-specific needs.

CA Core+ is structured into several key components:

• Common Data Exchange Profiles
  Reusable, pan-Canadian FHIR profiles that define foundational constraints on commonly exchanged resources. These are intended for consistent implementation across care settings and jurisdictions.

• General-Purpose Modules
  Context-aware artifacts (e.g., for workflow orchestration, consent, and identity) designed to support recurring interoperability patterns. See the Modules section for more information.

Note: Earlier versions of CA Core+ included mappings to the Data Content Standard (DCS), which has since been superseded by CACDI and the broader pCHDCF.

The Role of the pCHDCF

The pan-Canadian Health Data Content Framework (pCHDCF) provides a technology-agnostic, person-centric model of health data to support consistent information exchange across systems. It is organized into three complementary layers:

• Conceptual Model – Defines high-level clinical and business concepts and their relationships.
• Information Model – Provides a structured view of clinical content, semantics, and constraints.
• Logical Data Model (LDM) – Offers implementable, technology-neutral representations of data elements, cardinality, and relationships.

CACDI is a Subset of the Pan-Canadian Health Data Content Framework

The Canadian Core Data for Interoperability (CACDI) is a curated, prioritized subset of the Pan-Canadian Health Data Content Framework. It identifies health data elements and their associated value sets. CACDI is iterative and responsive to:

• Clinical priorities
• Jurisdictional needs
• pan-Canadian interoperability goals

While CACDI serves as a foundation for exchange, it does not limit the full scope of clinically relevant data defined in the pCHDCF. Instead, it informs—but does not constrain—the design of CA Core+ profiles.

Note: Earlier versions of CA Core+ included mappings to the broader Data Content Standards (DCS). These have been replaced by mappings aligned with the evolving CACDI artifacts.

Why CA Core+ Maps to the Logical Data Model

Although CACDI defines minimum expectations for data exchange, CA Core+ maps directly to the full Logical Data Model (LDM)—not just CACDI—for several reasons:

• Use-Case Independence
  CA Core+ must support a wide range of domains (e.g., eReferral, Patient Summary) and cannot be limited to a single use case.

• Extensibility and Flexibility
  Mapping to the full LDM enables implementers to support local or product-specific needs beyond what CACDI currently prescribes.

• Semantic Alignment
  The Logical Model offers a stable, semantically rich structure consistent with pan-Canadian information modeling practices.

• Future-Proofing
  As CACDI evolves, CA Core+ can adapt without major restructuring of core profiles.

In this model, CACDI serves as the essential definition, and the Logical Data Model provides the broader semantic foundation for interoperable, reusable FHIR profiles.

Example

If CACDI identifies birthDate as essential for identifying patients, the CA Core+ Patient profile represents this requirement by mapping to Patient.birthDate and adding appropriate flags such as changes in cardinality (e.g. 1..1) or by adding MustSupport. Technical Context and its sub-pages have more information about these, and other constraints and how they've been applied.

Jurisdictions may further constrain or expand this profile based on their needs—but adherence to this foundation ensures pan-Canadian consistency. For more details on the mapping visit the Mapping Logic page.

Mapping to the Logical Model

A detailed mapping of CA Core+ profiles to the pan-Canadian Logical Data Model will be available here (link to be updated).

This mapping supports traceability between CA Core+ FHIR artifacts and their semantic definitions in the pCHDCF, and will continue to evolve in alignment with updates to the Logical Model and CACDI.

Looking Ahead

The CA Core+ Implementation Guide is designed to serve as a reusable base for domain-specific specifications, such as:

• Patient Summary
• eReferral
• Immunization Exchange
• Other emerging areas such as public health reporting, virtual care, and care transitions

These domain-specific specifications will inherit and specialize CA Core+ profiles, ensuring interoperability, consistency, and reuse across projects and jurisdictions.

Ongoing Alignment and Evolution

To ensure semantic consistency and long-term sustainability, the following activities will continue alongside CA Core+ development:

• Harmonize the Logical Model and CACDI with CA Core+
  The current version of CA Core+ was accelerated using existing Canadian production specifications and refined through structured gap analysis with jurisdictions. Ongoing updates to CACDI and the Logical Model will reflect lessons from implementation feedback and further align with CA Core+ constraints and semantics.

• Align CACDI and the Logical Data Model
  Harmonizing these layers ensures that CACDI’s elements are traceable to structured clinical semantics in the Logical Model. This supports improved coherence across all layers of the pCHDCF.

• Evolve CACDI to support domain-specific specifications
  As new clinical domains adopt FHIR-based exchange, CACDI will expand to incorporate new data requirements. This ensures CACDI remains a reliable and current foundation for pan-Canadian interoperability.

This harmonized, feedback-driven approach follows industry best practices for standards development—ensuring alignment between semantic models, implementation artifacts, and real-world needs.