Introduction

The purpose of this specification is to design a Consumer CMS to become the provincial solution managed and supported by Ontario Health.

The provincial CMS will support the context synchronization using HL7® FHIRcast. The object(s) in the context are represented using FHIR resources. Version 0.1.0 of the CMS Implementation Guide is based on FHIRcast STU1 and FHIR R4.

Digital Health Information Exchange (DHIEX)

On January 1, 2021, Ontario Regulation 329/04 ("O. Reg. 329/04") under the Personal Health Information Protection Act, 2004 (PHIPA), was amended to provide a regulatory framework for Ontario Health, as directed by the Minister of Health (“the minister”), to establish, maintain and amend interoperability specifications. This regulatory framework, as set out in sections 26 to 34 of O. Reg. 329/04, is referred to by Ontario Health as the Digital Health Information Exchange (DHIEX) framework.

Ontario Health guides and supports the adoption of modern interoperability specifications applicable to digital health assets as defined in s. 26 of O. Reg. 329/04. A health information custodian (HIC) is required to ensure that every digital health asset that it selects, develops or uses complies with every applicable interoperability specification, as it may be amended from time to time, within the time period set out in the specification.

Compliance with the requirements of the DHIEX framework does not relieve a HIC of its obligation to comply with the other provisions of PHIPA and its regulations.

Ontario Health is required to consult with and consider the recommendations of the Information and Privacy Commissioner of Ontario (where a specification relates to the confidentiality of personal health information, the privacy of individuals or the rights of individuals to access or correct records of their personal health information) prior to providing the specification to the Minister of Health for review and approval.

Ontario Health is also required to consult with any health care provider organizations, individuals, stakeholders and other parties as appropriate, in order to inform its decisions concerning the establishment, maintenance or amendment of interoperability specifications.

Background

The CMS specification was informed by the context synchronization requirements from Hamilton Health Sciences (HHS) and developed through collaboration with partners including HHS and OntarioMD to ensure their requirements are supported and the architecture design is cohesive. The CMS will meet HHS’ immediate requirements around EMR integration by allowing patient context information to be inserted by EMRs into the CMS during users’ sessions and by allowing the most recent patient context to be pulled from the CMS for a given user. The architecture and design of the CMS will ensure that it can be extended to other Points Of Service and Delivery Channels that are members of Ontario Health.

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HL7® is registered trademark of Health Level Seven, Inc. (http://www.hl7.org) This specification contains information for which copyright is held by Health Level Seven, Inc. Implementors of the standards (those developing software or otherwise making use of the specification) are required to be members of either Health Level Seven Inc., HL7 Canada or one of the other HL7 affiliates. There is no such membership requirement for individuals and organizations which merely install or use software with built-in HL7 interfaces.

LOINC® is a registered trademark of the Regenstrief Institute, Inc. (http://regenstrief.org)

This material includes SNOMED Clinical Terms® (SNOMED CT®) (https://www.snomed.org/snomed-ct/) which is used by permission from SNOMED International. All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists.

“SNOMED” and “SNOMED CT” are registered trademarks of the SNOMED International (https://www.snomed.org/) .

Disclaimer

Disclaimer

Pursuant to O. Reg. 329/04, Ontario Health is required to, subject to the review and approval of the Minister, establish, maintain and amend interoperability specifications. The Minister may direct Ontario Health to establish or amend interoperability specifications, and Ontario Health is required to comply with such direction.

In accordance with O. Reg. 329/04, Ontario Health makes the interoperability specification most recently approved by the Minister available to the public by posting it on Ontario Health’s website or by such other means as Ontario Health considers advisable.

As the Minister may direct Ontario Health to amend the interoperability specifications from time-to-time, Ontario Health advises the public and any other users of information concerning interoperability specifications to regularly review Ontario Health’s website where the interoperability specifications are posted, or such other means Ontario Health considers advisable, in order to confirm that they are accessing the interoperability specifications most recently approved by the Minister.

You understand and agree that:

(i) This specification is provided “AS IS” without any warranties or representations of any kind, express or implied, in fact or in law;

(ii) Ontario Health is not responsible for your use or reliance on the information in this specification or any costs associated with such use or reliance; and

(iii) Ontario Health has no liability to any party for that party’s access, use or reliance on this specification or any of the information contained in it.

Document Control

The electronic version of this specification is recognized as the only valid version.

Approval History

APPROVER(S) TITLE/DEPARTMENT APPROVED DATE
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