Business Rules

Data Contribution Business Rules

The following Business rules should be considered for implementation:

Business Rules#	Business Rule Description	FHIR® field /JWT token
BR-C-100	The Data Contribution API must support FHIR R4 specifications.
BR-C-101	DHDR must validate received data against the patient and practitioner provincial registries.	patient, practitioner (prescriber), practitioner (dispense) and organization (pharmacy)
BR-C-102	The patient's date of birth received during data intake must match the date of birth in the PCR registry.	patient.birthDate
BR-C-103	During data intake DHDR shall augment drug information with information from the Health Canada Drug Product Database the Licensed Natural Health Products Database, and the Canada Health Infoway Canadian Clinical Drug Data Set.	medication
BR-C-104	The patient identifier shall be either an Ontario health card number or a Medical Record Number (MRN) issued by a hospital or community pharmacy.
BR-C-105	Patients that are not found in the patient provincial registry will be contributed to PCR.	patient
BR-C-106	The monitored drug indicator field will be set to true during intake processing if DIN of submitted drug has a CDSA (Canada Drug and Substances Act) schedule in the Health Canada Drug Product Database.	medication.extension.monitoredDrugIndicator
BR-C-107	The whenPrepared and whenHandedOver filelds cannot be greater than the date the data is submitted.	whenPrepared, whenHandedOver
BR-C-108	Data structural and conformance validations shall be done during initial data intake. Further data validations shall be done during processing of dispense and administration record submissions.	medicationDispense medicationAdministration

Data Query Business Rules

Business Rules#	Business Rule Description	FHIR® field /JWT token
BR-Q-100	The DHDR PoS API should support RESTful FHIR interface.
BR-Q-101	GET query should support search by mandatory patient identity parameter of Patient Identifier (health card number or MRN).	patient.identifier
BR-Q-102	The patient information provided in the query must be accurate according to the most recent Ontario Health Card or MRN	patient.identifier
BR-Q-103	Optional search parameter Dispensed Date should be supported if provided by the PoS application. The dispensed date should allow for a date range (FROM date and TO date) or block of time (e.g., last 30 days, last 60 days). If Dispensed Date is not provided by the PoS application, the DHDR response shall provide the records for the last 120 days for Community Pharmacy Dispensed information query and for the last 14 days for Hospital Administration medication query.	Whenprepared
BR-Q-104	When using End Date, End Date should be greater than the Start Date and should follow the equivalent parameter as in Start Date.	Whenprepare
BR-Q-105	The DHDR PoS API shall support all of the optional search parameters as per current FHIR IG.	All parameters
BR-Q-106	Any parameters chosen in the filtering criteria should not have a blank value.	All parameters
BR-Q-107	The DHDR PoS API shall support READ requests based on MedicationDispense ID and MedicationAdminstration ID.	MedicationDispense ID,MedicationAdminstration ID
BR-Q-108	If no DHDR data falls within the parameters of the request, DHDR must return appropriate notification in the query response.	OperationOutcome
BR-Q-109	All of the available DHDR data elements as per the current FHIR specification should be returned in response to the PoS application query.
BR-Q-110	DHDR must validate received data against the patient and practitioner provincial registries.	patient, practitioner (prescriber), practitioner (dispense) and organization (pharmacy)
BR-Q-111	Where query is made against patient with active Consent Directive DHDR must return response "Access to Drug and Pharmacy Service Information has been blocked by the Patient"	OperationOutcome
BR-Q-112	Where query is made against Temporary Consent Override DHDR must return response “information unblocked” to all users at the organization for the four-hour duration
BR-Q-113	When searching the DHDR, if the same record/event is found in community pharmacy dispensed data and HNS data, DHDR returns the community pharmacy dispensed record only
BR-Q-114	Query to COVax_ON requires HCN (as patient identifier) and request for community pharmacy dispensed information
BR-Q-115	The DHDR will return COVID-19 vaccination records only from COVax_ON as the sole and authoritative source.

DHDR Data Elements

Query Parameters Data

The following table summarizes the mandatory and optional parameters for the query

Mandatory Parameters:

Data Element	Definition	Example
Patient identifier	The 10 digit Ontario Health Card Number (HCN) and Medical Record Numeber (e.g. issued by hospital or community pharmacy) are allowed as an ID parameter in the current release. Note: HCN Version is not supported. DHDR uses Ontario HCN for unique identification of a patient while a version number is usually used for verification of the provincial coverage eligibility, which is out of scope for DHDR.	3821694372
Birth Date	This parameter should contain the Date of Birth of the patient as on the Ontario Health Card	1929-11-29

Optional Parameter:

Data Element	Definition	Example
whenprepared	This parameter contains the dispensed date of the substance. Note: If there is no lower limit in the search request, the server will use a configured default, e.g. 120 days for Community Pharmacy Dispensed information .	gt2015-02-24
Gender	This parameter should contain the sex at birth as noted on the Ontario Health Card	male or female
effective-time	This parameter contains the administration time of the medictaion. Note: If there is no lower limit in the search request, the server will use a configured default, e.g. 14 days for Hospital Administration medication query.	2015-01-15T04:30:00+01:00

Data Elements Returned From DHDR

The following tables provide business descriptions of data elements returned from the DHDR which are most relevant for providers and for the display of information in the user interface.

The information returned from the DHDR in response to a query depends on the query operation used, the data source (PMS, HNS or HIS) and the availability of the element for a record. Refer to the Profiles and Operations section and the User Interface Specifications (separate document) for further guidance.

Community Pharmacy Dispensed Drug and Device Information Data Field Description

Data Field	Description
Patient First Name	First name of patient
Patient Last Name	Last name of patient
Patient Gender	Gender of patient
Patient Date of Birth (DOB)	Date of birth of the patient
Patient Ontario Health Card Number	The number on an Ontario Health Card that uniquely identifies a patient
Patient MRN	Medical Record Number (identifier assigned by the community pharmacy)
Patient Address	Address of the patient
Patient Phone Number	Phone number of the patient
Category	Identifies if the record represents a medication (includes compounds), a device or a service
Compound Indicator	Indicates the medication is a compound. Derived by DHDR when the pharmacy submits a list of ingredients for a dispensed event
Monitored Drug Indicator	Indicates the medication is, or contains, a controlled substance. Derived by DHDR based on CCDD submitted
PRN Indicator	Indicates the medication is only taken when needed. Provided by the pharmacy
Compound Ingredients	A list of ingredients included in a product that was compounded by the pharmacy (CCDD identifiers or free text)
Source Prescription (Rx) Number	Number assigned by EMR or ePrescribing system to a new electronically-generated prescription
Original Prescription (Rx) Number	Number assigned by the PMS to the first fill of a prescription. May remain the same throughout a prescription (i.e., all refills)
Current Prescription (Rx) Number	Number assigned by the PMS that appears on the label of the dispensed medication/device
Indication for Use	The medical condition/reason for the medication/device as provided by the prescriber.
Refills Remaining	The number of refills remaining on a prescription (e.g., 3 refills) as calculated by the PMS
Quantity Remaining	The number of units of medication/device remaining on a prescription (e.g., 90 tablets) as calculated by the PMS
Drug/Service Coverage	Payment source for the medication/device (i.e., public, private insurance plan or by patient)
Quantity	Quantity of medication/devices dispensed
Estimated Days Supply	Estimated number of days of treatment based on the directions for use on the prescription and/or the pharmacist’s judgment on usage
Dispense Date	Date when the medication/device was processed in the pharmacy management system (PMS)
Pickup Date	Date when the medication/device was provided to the patient or an agent (e.g., delivery person)
Dosage Instructions: Dispensed Dose	The amount and units of the medication to be taken (e.g. 100 mcg)
Dosage Instructions: Route of Administration	The route by which a drug is to be taken (e.g., oral, inhalation, transdermal, injectable, rectal)
Dosage Instructions: Frequency	The frequency with which the medication is to be taken (e.g., once a day, twice a day, every six hours)
Directions for Use	Free text directions to the patient on how to take the medication or use the device, as recorded on the prescription label; the full sig (e.g., Take 1 tablet by mouth once daily in the morning)
Medication Name (Medication.code.text)	One of the following:  Drug name in format: Generic name + strength+ dosage form (E.g., levothyroxine sodium 25 mcg oral tablet) PMS data: CCDD NTP formal name associated with CCDD code when submitted to DHDR HNS data: concatenation of generic name, strength and dosage form fields  Natural product name in format of ingredient(s) + strength + form PMS data: concatenation of fields derived from Health Canada’s Licensed Natural Health Products Database (LNHPD) when NPN code submitted to DHDR Textual description of the medication/device as submitted to DHDR in lieu of a code (e.g., compound medications) Generic Name: non-proprietary name or chemical name of the medication (e.g., levothyroxine sodium) Strength: Strength of the medication; the amount of active ingredient in the medication (e.g., 25 mcg) Dosage Form: The physical form of a unit of the medication (e.g., oral tablet)
Generic Name	Non-proprietary name or chemical name of the medication (e.g., levothyroxine sodium)
Brand Name	Brand name or trade name of the medication (e.g., Synthroid)
Drug Identification Number (DIN)	Drug Identification Number (DIN) assigned by Health Canada to every medication (e.g., Synthroid – DIN 02172100)
Prescriber Name	Name of the prescriber that provided the prescription
Prescriber Phone Number	Phone number of the prescriber that provided the prescription
Prescriber Fax Number	Fax number of the prescriber that provided the prescription
Prescriber ID	License/registration number of the prescriber, issued by their licensing college
Prescriber Issuing College	Identifies the registration authority (i.e., regulatory college – CPSO, etc.) which issued the license/registration number to the prescriber that provided the prescription
Pharmacist Name	Name of the pharmacist or dispensing physician that dispensed the medication/device
Pharmacist ID	License/registration number of the dispenser that dispensed the medication/device, issued by their licensing college
Pharmacist Issuing College	Identifies the registration authority (i.e., regulatory college) which issued the license/registration number to the dispenser of the medication/device. This is OCP in most cases but may be CPSO in the case of a dispensing physician
Pharmacy Name	Name of the pharmacy that dispensed the medication/device
Pharmacy Address	Address of the pharmacy that dispensed the medication/device
Pharmacy Phone Number	Phone number of the pharmacy that dispensed the medication/device
Pharmacy Fax Number	Fax number of the pharmacy that dispensed the medication/device
Pharmacy ID	Registration number of the pharmacy which dispensed the prescription. For an accredited pharmacy this will be the Ontario College of Pharmacists (OCP) Accreditation Number. For dispensing physicians this will be their CPSO assigned registration number.
Pharmacy Issuing College	Identifies the registration authority (i.e. regulatory college) which issued the license/registration number to the dispensary which dispensed the medication/device or provided the pharmacy service; this is OCP in most cases

Community Pharmacy Dispensed Service Data Field Description

Data Field	Description
Patient First Name	First name of patient
Patient Last Name	Last name of patient
Patient Gender	Gender of patient
Patient Date of Birth (DOB)	Date of birth of the patient
Patient Ontario Health Card Number	The number on an Ontario Health Card that uniquely identifies a patient
Patient MRN	Medical Record Number (identifier assigned by the community pharmacy)
Patient Address	Address of the patient
Patient Phone Number	Phone number of the patient
Category	Identifies if the record represents a medication (includes compounds), a device or a service
Dispensed Date	Date when the service was processed in the pharmacy management system (PMS)
Pickup Date	Date when the service was provided to the patient
Service Description	A free text description of the service
Pharmacy Service Type	The category of pharmacy service that was rendered (e.g., MedsCheck). Returned for HNS data only
Quantity	Quantity of the service
Estimated Days Supply	Estimated number of days based on the directions for use (if prescription provided) and/or the pharmacist’s judgment on usage
Indication for use	The medical condition/reason for the service
Directions for use	Free text directions for the service
Source Prescription (Rx) Number	Number assigned by EMR or ePrescribing system to a new electronically-generated prescription
Original Prescription (Rx) Number	Number assigned by the PMS to the first fill of a prescription. May remain the same throughout a prescription (i.e., all refills)
Current Prescription (Rx) Number	The number assigned by the PMS to the service
Refills Remaining	The number of refills remaining on a service
Quantity Remaining	The number of services remaining
Drug/Service Coverage	Payment source for the medication/device (i.e., public, private insurance plan or by patient)
Prescriber Name	Name of the prescriber that provided the prescription or service
Prescriber Phone Number	Phone number of the prescriber that provided the prescription or service
Prescriber Fax Number	Fax number of the prescriber that provided the prescription or service
Prescriber ID	License/registration number of the prescriber that provided the prescription or service, issued by their licensing college
Prescriber Issuing College	Identifies the registration authority (i.e., regulatory college – CPSO, etc.) which issued the license/registration number to the prescriber that provided the prescription or service
Pharmacist Name	Name of the pharmacist that provided the pharmacy service
Pharmacist ID	License/registration number of the pharmacist that provided the pharmacy service, issued by their licensing college
Pharmacist Issuing College	Identifies the registration authority (i.e., regulatory college) which issued the license/registration number to the pharmacist that provided the pharmacy service
Pharmacy Name	Name of the pharmacy that provided the pharmacy service
Pharmacy Address	Address of the pharmacy that provided the pharmacy service
Pharmacy Phone Number	Phone number of the pharmacy that provided the pharmacy service
Pharmacy Fax Number	Fax number of the pharmacy that provided the pharmacy service
Pharmacy ID	Registration number of the pharmacy that provided the pharmacy service. For an accredited pharmacy this will be the OCP Accreditation Number.
Pharmacy Issuing College	Identifies the registration authority (i.e. regulatory college) which issued the license/registration number to the pharmacy which provided the pharmacy service; this is OCP in most cases

Hospital Medication Administration Data Field Description

Data Field	Description
Patient First Name	First name of the patient
Patient Last Name	Last name of the patient
Patient Gender	Gender of the patient
Patient Date of Birth (DOB)	Date of birth of the patient
Patient Ontario Health Card Number	The number on an Ontario Health Card that uniquely identifies a patient
Patient MRN	Medical Record Number (Identifier assigned by the hospital)
Patient Address	Address of the patient
Patient Phone Number	Phone number of the patient
Category	Identifies that the record represents a medication (includes compounds)
Medication Name (Medication.code.text)	One of the following:  Medication name in format: Generic name + strength+ dosage form (E.g., levothyroxine sodium 25 mcg oral tablet) CCDD NTP formal name associated with CCDD code when submitted to DHDR  Natural product name in format of ingredient(s) + strength + form concatenation of fields derived from Health Canada’s Licensed Natural Health Products Database (LNHPD) when NPN code submitted to DHDR Textual description of the medication/device as submitted to DHDR in lieu of a code (e.g., compound medications) Generic Name: non-proprietary name or chemical name of the medication (e.g., levothyroxine sodium) Strength: Strength of the medication; the amount of active ingredient in the medication (e.g., 25 mcg) Dosage Form: The physical form of a unit of the medication (e.g., oral tablet)
Generic Name	Non-proprietary name or chemical name of the medication (e.g., levothyroxine sodium)
Brand Name	Brand name or trade name of the medication (e.g., Synthroid)
Drug Identification Number (DIN)	Drug Identification Number (DIN) assigned by Health Canada to every medication (e.g., Synthroid – DIN 02172100)
Compound Indicator	Indicates the medication is a compound. Derived by DHDR when the hospital submits a list of ingredients for an administered event
Monitored Drug Indicator	Indicates the medication is, or contains, a controlled substance. Derived by DHDR based on CCDD submitted
Compound Ingredients	A list of ingredients included in a product that was compounded by the pharmacy (CCDD identifiers or free text)
Ordering Practitioner ID	Registration number of the ordering practitioner, issued by their licensing college, or practitioner’s hospital-issued local provider ID if the medication was ordered by a non-regulated practitioner
Ordering Practitioner ID Assigning Authority	Identifies the registration authority (i.e., regulatory college – CPSO, etc.) which issued the registration number to the ordering practitioner, or hospital that issued the practitioner ID if the practitioner is not regulated
Ordering Practitioner Name	First and last name of the ordering practitioner
Ordering Practitioner Phone Number	Phone number of the ordering practitioner (e.g., hospital phone number)
Administering Practitioner Name	First and last name of the practitioner that administered the medication
Administering Practitioner ID	Registration number of the administering practitioner, issued by their licensing college, or practitioner’s hospital-issued local provider ID if the medication was administered by a non-regulated practitioner
Administering Practitioner ID Assigning Authority	Identifies the registration authority (i.e. regulatory college) which issued the license/registration number to the administering practitioner (e.g., College of Nurses of Ontario (CNO)), or hospital that issued the practitioner ID if the practitioner is not regulated
Encounter Information	A Unique ID number and a set of additional fields (e.g., Start and end time, service type, discharge disposition, etc.) that describe a patient’s interaction with a hospital organization during which medication was administered
Hospital Organization ID	Unique identifier assigned by Ontario Health for the hospital organization where the medication is administered
Facility ID	Unique identifier assigned by Ontario Health for the facility where the medication is administered
Facility Name	Name of the facility as sent by the sending organization
Medication Order ID	Identifier for the order generated by the order entry system (placer Order ID). Identifier is applied to all medication administration events for that order
eMAR Order ID	Number assigned by the eMAR system to individual medication administration events
Indication for Use	The medical condition/reason for the medication order as provided by the ordering practitioner
Ordering Practitioner Instructions	Additional instructions provided by the ordering practitioner to the administrator (e.g., Hold PCA if patient confused or loses IV access)
Frequency (timing)	The frequency with which the medication is to be administered (e.g., once a day, twice a day, every six hours)
Duration	The duration the medication is ordered to be administered (e.g. for two weeks)
Dose Administered	The amount and units of the medication administered to or taken by the patient (e.g. 100 mcg)
Route of Administration	The route by which a drug is administered to the patient (e.g., oral, inhalation, transdermal, injectable, rectal)
Administering Practitioner Notes	Notes from the administering practitioner
Administration Status	State of the administration event (e.g., complete, in-progress) based on entry by the administering practitioner into HIS
Administration Start Date/Time	Date and time when the medication was administered. For infusions, this is the start time
Administration End Date/Time	For infusions, date and time when the administration is completed

COVID-19 Vaccination Data Field Description

Data Field	Description
Patient First Name	First name of the patient
Patient Last Name	Last name of the patient
Patient Gender	Gender of the patient
Patient Date of Birth (DOB)	Date of birth of the patient
Patient Ontario Health Card Number	The number on an Ontario Health Card that uniquely identifies a patient
Drug Identification Number (DIN)	Drug Identification Number (DIN) of the vaccine
Generic Name	Generic name of the vaccine administered
Brand Name	Brand name or trade name of vaccine administered
Strength	Strength of the vaccine administered
Dosage Form	Dosage form of the vaccine administered
Quantity	Quantity of vaccine administered
Dispensed Date	Date the vaccine was administered
Source	The source of the data being disclosed. i.e., COVax_ON
Prescriber Name	Name of the health care provider who administered the vaccine
Prescriber Phone Number	Phone number of the health care provider who administered the vaccine
Prescriber ID	License/registration number of the health care provider who administered the vaccine
Prescriber Issuing College	Identifies the registration authority (i.e., regulatory college – CPSO, etc.) which issued the license/registration number to the healthcare provider who administered the vaccine