DFT-Ballot - The specification is a DFT-Ballot version of CA Core+ for collecting ballot feedback. For a full list of available versions, see the Directory of published versions

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.

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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.

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Canadian Core Data for Interoperability (CACDI) is a Subset of the PCHDCF

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

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

CACDI serves as a foundation for exchange, but does not limit the full scope of clinically relevant data defined in the PCHDCF.

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How CA Core+ Maps to the Logical Data Model

CACDI defines minimum expectations for data exchange, while the LDM provides a broader semantic foundation to understand the CACDI elements in context. Expressing the CACDI and applying the LDM constraints in CA Core+ enables 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.

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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 LDM
  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.