Ontario Digital Health Drug Repository HL7® FHIR® Consumer Access Implementation Guide -v 0.9.0 (DRAFT)

DHDR Conceptual Data Model

This model is linked to Ontario’s Electronic Health Record (EHR) Conceptual Information Model 2.0 (CIM 2.0). See: https://ehealthontario.on.ca/files/public/support/Architecture/Ontario_EHR_CIM_2.0.pdf

To support the use of structured data through the adoption of data content and health terminology standards in the solution, this CDM also includes high-level entity relationships and attributes discovered in versions of the FHIR R4.0.1 interoperability standard. The model does not repeat the structure of the messages laid out in FHIR. Links to FHIR specs are included for entity definitions and field code values. In any difference of meaning between cited FHIR elements and this model, FHIR is the authoritative voice. This model relies on the following specifications:

FHIR R4.0.1 - The current official version of FHIR as of the time this implementation guide was published

Conceptual Data Model ERDs and Metadata

Entity Relationship Diagrams (ERDs) follow. These include:

a conceptual high-level ERD for solution data structures, including metadata for each entity
an ERD for the Client & Provider subject area (including metadata for each entity) which is not called out as a FHIR Profile but is included because all other entities in the model are dependent on it,
two subject area ERDs, each Subject Area corresponds to a Profile and metadata is included for each attribute

DHDR Conceptual Data Model

The Conceptual Data Model that follows describes the concepts that are available via DHDR, but are general descriptions of the concept within the context of the broader health care system and an Electronic Health Record (EHR). The definitions of the entities are taken specifically from the EHR Conceptual Information Model and are meant to cover the broad spectrum of the data across the EHR. The information that is available via the DHDR interface may only contain a subset of the concepts described in the definition of the Entity. For information related to the specific concepts and data subsets available via the DHDR API, please see Information Available to Health Care Providers through the Digital Health Drug Repository, EHR Health Care Provider Guide and www.ontario.ca/mydruginfo.

Entity Name	Description	FHIR Resource Name
Healthcare Client	An individual participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. (U.S. National Library of Medicine - Medical Subject Headings) A natural person (i.e. a human being) who: is eligible to receive health care services in Ontario, or has received or is receiving health care services in the province of Ontario (i.e. a health care client). This entity covers personal identifying information but not health information. It includes information about: identity within the health system e.g. a Health Number; each care setting may have a separate unique ID. E.g. a research study may uniquely identify a health care client as a test subject. administrative gender, e.g. Male, Female, undisclosed adoption: whether or not the health care client was adopted birth and death dates official versus preferred name whether or not the health care client would prefer to receive correspondence The health care client's identity may be unknown e.g. for a protected person or if the identity of the health care client is unknown. A health care client may be a VIP whose identity must be omitted from reporting. A health care client may be identified by an alias. Health care client-identifying information could include a photograph. May be elated genetically or by physical co-location (e.g. residential, occupational, travel, etc.) to another person not necessarily a health care client. Depending on care setting, a health care client may be referred to as: Patient (currently receiving care) Participant (in a clinical study) Resident (of a long term care facility) Subject (in a public health case) Client (in home care/community care cases/ settings)	Patient
Health Care Provider	Describes a health care provider involved in the delivery of healthcare services. Encompasses both professional and non-professional members. Has professions, areas of practice for which the provider is qualified. May have information on clinician credentialing and privileging as defined by the applicable professional and governing organizations. This includes remote participation (e.g., via tele-health activities such as tele-consultation, home health monitoring.) Includes any information about licensing status and license suspension. May be an author, authenticator or scribe/transcriber of clinical documentation. Has a Unique Provider Identifier, a key assigned by eHealth to uniquely identify each Provider. May have a health system universal ID. May have a license number or national provider identifier (U.S.). May have multiple unique identifiers.	N/A
Provider Organization	An organization that provides health care or other health-related services or products. Includes e.g. insurers and transcription services.vMay have information on service classification e.g. Regional Cancer Centre. (For Single Sign on application, a Provider Organization may be a Sponsoring Organization, a Health Care organization that has users that require access to at least one Federated Service. 2015-6-15)	Organization
Provider Person	Describes a health care provider involved in the delivery of healthcare services. Encompasses both professional and non-professional members. Has professions, areas of practice for which the provider is qualified. May have information on clinician credentialing and privileging as defined by the applicable professional and governing organizations. This includes remote participation (e.g., via tele-health activities such as tele-consultation, home health monitoring.) Includes any information about licensing status and license suspension. May be an author, authenticator or scribe/transcriber of clinical documentation. Has a Unique Provider Identifier, a key assigned by eHealth to uniquely identify each Provider. May have a health system universal ID. May have a license number or national provider identifier (U.S.). May have multiple unique identifiers.	Practitioner
Drugs	Any substance or mixture of substances used in the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, or when used for non-medical purposes, solely for its effects on the central nervous system. Includes prescription drugs, herbal medicine, vitamins, minerals, Chinese medicine, and other over the counter medicines. Also there are extemporaneous mixtures which are combinations of drugs. May have the following attributes: administration route drug identification e.g. DIN name, including brand name and generic name, in English and French manufacturer therapeutic class pharmaceutical format (e.g. capsule, tablet) strength (e.g. 200 mg.)	Medication
Medication Order	Documented instruction on intended therapy for an individual person with a medicinal product issued by an authorized health professional. A medication order contains information on the medicinal product(s), the intended dosage instruction and the period of time during which the medication was intended to be given.	MedicationDispense / MedicationRequest

Client and Provider Subject Area

Metadata for the attributes in this subject area are available at the following location(s):

See below for related Subject Area details

Medication Order Subject Area

Metadata for the attributes in this subject area are available at the following location(s):