Business Rules

Data Contribution Business Rules

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 Provincial Client Registry (PCR) and the Provincial Provider Registry (PPR).	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.	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 PCR 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-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 number 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 Provincial Client Registry (PCR) and the Provincial Provider Registry (PPR).	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 is only completed when community pharmacy dispensed medication is queried. Queries for hospital administered medications will not return a COVax_ON record, even if it exists.
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	Ontario health card number (HCN) and Medical Record Number (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 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
Composition Type	This parameter specifies the type of document	`http://loinc.org\|29550-1` `http://loinc.org\|80565-5`

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 number	male or female
Birth Date	This parameter should contain the date of birth of the patient as on the Ontario health card number	1929-11-29
effective-time	This parameter contains the administration time of the medication. 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 Requirements (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’s gender for administrative purposes)
Patient Date of Birth	Date of birth of the patient
Patient Ontario Health 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	Phone number of the patient
Compound Indicator	Indicates the medication is a compound
Monitored Drug Indicator	Indicates the medication is, or contains, a controlled substance
PRN Indicator	Indicates the medication is only taken when needed
Compound Ingredients	A list of ingredients included in a product that was compounded by the pharmacy (CCDD identifiers or free text)
Original Prescription (Rx) Number	Number assigned by the Pharmacy Management System (PMS) to the first fill of a prescription. May remain the same throughout a prescription (i.e., all refills). Availability for medications: dependent on PMS ability
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
Filled/Prepared Date	Date when the medication/device was processed in the pharmacy management system (PMS)
Pickup/Delivery Date	Date when the medication/device was provided to the patient or an agent (e.g., delivery person)
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	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: ingredient(s) + strength + form Concatenation of fields derived from Health Canada’s Licensed Natural Health Products Database (LNHPD) when NPN code submitted to DHDR Free text description of the medication as submitted to DHDR in lieu of a code (e.g., compound medications) Free text description of the device as submitted to DHDR *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). For devices, is the CCDD Device Name when CCDD code is submitted to DHDR
Drug Identification Number (DIN) / Natural Product Number (NPN)	Drug identification Number (DIN) assigned by Health Canada to every medication (e.g., Synthroid – DIN 02172100) Natural Product Number (NPN) is an eight (8) digit numerical code assigned by Natural and Non-prescription Health Products Directorate (NNHPD) to each natural health product approved to be marketed under the Natural Health Products Regulations.
Prescriber	Name of the prescriber that provided the prescription
Prescriber Phone	Phone number of the prescriber that provided the prescription
Prescriber Fax	Fax number of the prescriber that provided the prescription
Prescriber Registration Number (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 of the pharmacist or dispensing physician that dispensed the prescription Note: Always available in Narcotic Monitoring System (NMS) records. Available in Ontario Drug Benefit (ODB) records if the pharmacist rendered a pharmacy service
Pharmacist Registration Number	License/registration number of the dispenser, 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. This is OCP in most cases but may be CPSO in the case of a dispensing physician
Pharmacy	Name of the pharmacy that dispensed the prescription
Pharmacy Address	Address of the pharmacy that dispensed the prescription
Pharmacy Phone	Phone number of the pharmacy that dispensed the prescription
Pharmacy Fax	Fax number of the pharmacy that dispensed the prescription
Pharmacy Accreditation Number (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 (ID Issuing College)	Identifies the registration authority (i.e., regulatory college) which issued the license/registration number to the dispenser of the pharmacy service. This is OCP in most cases.
Record Status	Composition status sent by the contributing organization (Final, Amended, or Entered in Error).
Last Updated	Date when the most recent version of the record was received in the DHDR

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’s gender for administrative purposes)
Patient Date of Birth	Date of birth of the patient
Patient Ontario Health 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	Phone number of the patient
Service Date	Date when the service was processed in the pharmacy management system (PMS)
Service Description	For PMS, a free text description of the pharmacy service rendered by a pharmacist (e.g., an annual medication review). For HNS, this is the Brand Name, which is often the type of pharmacy service.
Service Description 2	Available in HNS only. This is the HNS’s Generic Name, which is often the description of the pharmacy service that was rendered (e.g., MedsCheck).
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
Original Prescription (Rx) Number	Number assigned by a 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 service (i.e., public, private insurance plan or by patient)
Prescriber	Name of the prescriber that provided the prescription
Prescriber Phone	Phone number of the prescriber that provided the prescription
Prescriber Fax	Fax number of the prescriber that provided the prescription
Prescriber Registration Number (ID)	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 of the pharmacist that provided the pharmacy service and/or entered the service record in the PMS
Pharmacist Registration Number (ID)	Registration number of the pharmacist, issued by their licensing college
Pharmacist Issuing College (Assigning Authority)	Identifies the registration authority (i.e., regulatory college) which issued the license/registration number to the dispenser of the pharmacy service. This is OCP in most cases.
Pharmacy	Name of the pharmacy that rendered the service
Pharmacy Address	Address of the pharmacy that or provided the service
Pharmacy Phone	Phone number of the pharmacy that rendered the service
Pharmacy Fax	Fax number of the pharmacy that rendered the service
Pharmacy Accreditation Number (ID)	Registration number of the pharmacy that rendered the service. For an accredited pharmacy this will be the OCP Accreditation Number. For dispensing physicians this will be their CPSO assigned registration number
Pharmacy Issuing College (Assigning Authority)	Identifies the registration authority (i.e. regulatory college) which issued the license/registration number to the pharmacy which dispensed the prescription; this is OCP in most cases
Record Status	Composition status sent by the contributing organization (Final, Amended, or Entered in Error)
Last Updated	Date when the most recent version of the record was received in the DHDR

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’s gender for administrative purposes)
Patient Date of Birth	Date of birth of the patient
Patient Ontario Health 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
Medication Name	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)/Natural Product Number (NPN)	Drug Identification Number (DIN) assigned by Health Canada to every medication (e.g., Synthroid – DIN 02172100) Natural Product Number (NPN) is an eight (8) digit numerical code assigned by Natural and Non-prescription Health Products Directorate (NNHPD) to each natural health product approved to be marketed under the Natural Health Products Regulations.
Compound Indicator	Indicates the medication is a compound.
Monitored Drug Indicator	Indicates the medication is, or contains, a controlled substance.
PRN Indicator	Indicates the medication is only taken when needed
Compound Ingredients	A list of ingredients included in a product that was compounded by the pharmacy (CCDD identifiers or free text)
Ordering Provider ID	Registration number of the ordering provider, issued by their regulatory college, or provider’s hospital-issued local provider ID if the medication was ordered by a non-regulated provider
Ordering Provider ID Assigning Authority	Identifies the registration authority (i.e., regulatory college – CPSO, etc.) which issued the registration number to the ordering provider, or indicates a local hospital facility/organization identifier was issued.
Ordering Provider	First and last name of the ordering provider
Administering Provider	First and last name of the provider that administered the medication
Administering Provider ID	Registration number of the administering provider, issued by their regulatory college, or provider’s hospital-issued local provider ID if the medication was administered by a non-regulated provider
Administering Practitioner ID Assigning Authority	Identifies the registration authority (i.e. regulatory college) which issued the registration number to the administering provider, or indicates a local hospital identifier was issued.
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
Facility	Name of the facility as sent by the sending organization
Facility Phone	Phone number of the facility as sent by the sending organization
Indication for Use	The medical condition/reason for the medication order as provided by the Ordering Provider
Additional Order Instructions	Additional instructions provided by the ordering practitioner to the administrator (e.g., Hold PCA if patient confused or loses IV access)
Administering Provider Notes	Notes from the administering provider
Ordered Frequency	The frequency with which the medication is to be administered or taken by the patient (e.g., once a day, twice a day, every six hours)
Ordered Duration	The duration the medication is ordered to be administered (e.g. for two weeks)
Administered Dose	The amount and units of the medication administered to or taken by the patient (e.g. 100 mcg)
Administration Route	The route by which a medication is administered to or taken by the patient (e.g., oral, inhalation, transdermal, injectable, rectal)
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 and medications given over a period of time, this is the start time.
Administration End Date/Time	Date and time when the administration is completed. Available only for infusions and medications given over a period of time
Record Status	Composition status sent by the contributing organization (Final, Amended, or Entered in Error)
Last Updated	Date when the most recent version of the record was received in the DHDR

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	Date of birth of the patient
Patient Ontario Health Number	The number on an Ontario Health Card that uniquely identifies a patient
Drug Identification Number (DIN)	Drug Identification Number (DIN) of the vaccine
Brand Name	Brand name or trade name of vaccine administered
Generic Name	Generic name of the vaccine administered
Strength	Strength of the vaccine administered
Dosage Form	Dosage form of the vaccine administered
Source	The source of the data being disclosed. i.e., COVax_ON
Quantity	Quantity of vaccine administered
Dispensed Date	Date the vaccine was administered
Prescriber	Name of the health care provider who administered the vaccine
Prescriber Phone	Phone number of the health care provider who administered the vaccine
Prescriber Fax	Fax number of the health care provider who administered the vaccine
Prescriber Registration Number (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

Note: For further guidance refer to the Profiles and Operations section. Details on display of DHDR elements are outlined separately in User Interface Requirements document.