Ontario Digital Health Drug Repository HL7® FHIR® Implementation Guide

Terminology

This section lists the coded value sets that are referenced by the FHIR profiles in this implementation guide. These coded values are used to describe and standardize clinical concepts and other data content within health records.

Usage Guidance

Several ValueSets are not available at their canonical URL (e.g., Canada Health Infoway published value sets) or on the terminology servers used in implementation guide publication (i.e., tx.fhir.org). Primarily, this impacts validation against Canada Health Infoway-hosted ValueSets during the development of derived Implementation Guides. This does not affect deployed systems as these instances will be validated against loaded terminology. For several of these ValueSets, "stub" resources have been created to stand-in for the unresolvable ValueSets. These stub ValueSets include pointers to the locations where the full value sets can be downloaded. Current guidance is to manually download the value sets from, for example, the Terminology Gateway. When terminology is not readily available as FHIR® Release 4 ValueSets or CodeSystems, implementers should work with terminology producers to identify options.

* Please note that these are Code System and/or Value set created by Ontario Health.

** Use of terminology subsets hosted on Canada Health Infoway Terminology Gateway is required in order to comply with this interoperability specification.

Value Sets defined by this implementation guide:

Profile-Element	Binding Strength	Value Set(Code System)	Description
Patient:Patient.address.type Patient(Submission):Patient.address.type Organization: Organization.address.type Organization(Submission): Organization.address.type	Required	AddressType (HL7 FHIR)	Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both
Patient:Patient.address.use Patient(Submission):Patient.address.use Organization: Organization.address.use Organization(Submission):Organization.address.use	Required	AddressUse (HL7 FHIR)	The purpose of this address
MedicationDispense:MedicationDispense.dosageInstruction.additionalInstruction MedicationDispense(Submission):MedicationDispense.dosageInstruction.additionalInstruction	Example	AdditionalDosageInstructions (HL7 FHIR)	This value set includes additional Dosage Instructions
MedicationDispense:MedicationDispense.dosageInstruction.site MedicationDispense(Submission):MedicationDispense.dosageInstruction.site	Example	AdministrationSiteCodes (HL7 FHIR)	This value set includes Anatomical Structure codes
MedicationDispense:MedicationDispense.dosageInstruction.method MedicationDispense(Submission):MedicationDispense.dosageInstruction.method	Example	AdministrationMethodCodes(HL7 FHIR)	This value set includes some method codes
Patient: Patient.gender	Required	AdministrativeGender(HL7 FHIR)	The gender of a person used for administrative purposes.
Encounter:Encounter.hospitalization.admitSource	Required	AdmitSource (CIHI)	Specific type of encounter
Encounter:Encounter.location.physicalType.coding:slice-bed-type	Required	BedType(CIHI)	This field contains type of bed
Bundle: Bundle.type Bundle(Search Result):Bundle.type	Required	BundleType(HL7 FHIR)	Indicates the purpose of this bundle - how it is intended to be used.
Patient: Patient.telecom.system Patient(Submission): Patient.telecom.system Practitioner: Practitioner.telecom:TelecomPhone.system Practitioner(Submission):Practitioner.telecom.TelecomPhone.system Practitioner:Practitioner.telecom.telecomFax.system Practitioner(Submission):Practitioner.telecom.Telecomfax.system Organization: Organization.telecom:TelecomPhone.system Organization(Submission):Practitioner.telecom.TelecomPhone.system Organization: Organization.telecom:Telecomfax.system Organization(Submission): Organization.telecom:Telecomfax.system	Required	ContactPointSystem(HL7 FHIR)	Telecommunications form for contact point.
Patient: Patient.telecom.use Patient(Submission): Patient.telecom.use Practitioner: Practitioner.telecom.telecomPhone.use Practitioner(Submission):Practitioner.telecom.TelecomPhone.use Practitioner: Practitioner.telecom.telecomFax.use Practitioner(Submission):Practitioner.telecom.Telecomfax.use Organization: Organization.telecom:TelecomPhone.use Organization(Submission):Practitioner.telecom.TelecomPhone.use Organization: Organization.telecom:Telecomfax.use Organization(Submission: Organization.telecom:Telecomfax.use	Required	ContactPointUse (HL7 FHIR)	Use of contact point.
Patient:Patient.address.country Patient(Submission):Patient.address.country	Required	CountryCode`*`(urn:iso:std:iso:3166-3)	The set of 3-character country codes from the ISO-3166 standard, e.g., CAN, USA used in addresses by Ontario Health interfaces
MedicationDispense:MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek MedicationDispense(Submission):MedicationDispense.dosageInstruction.timing.repeat.dayOfWeek	Required	DaysOfWeek(HL7 FHIR)	The days of the week
Encounter:Encounter.hospitalization.dischargeDisposition	Required	DischargeDisposition (CIHI)	This field contains the disposition of the patient at time of discharge
MedicationAdministration: MedicationAdministration.category MedicationAdministration (Submission):MedicationAdministration.category MedicationDispense: MedicationDispense.category.coding MedicationDispense(Submission):MedicationDispense.category	Required	DispenseCategory`*`(OntarioHealth)	Dispense type, e.g. drug, device or pharmacy service. A reference to a code defined by a terminology system.
MedicationDispense:MedicationDispense.dosageInstruction.doseAndRate.type MedicationDispense(Submission):MedicationDispense.dosageInstruction.doseAndRate.type	Example	DoseAndRateType(HL7 FHIR)	The kind of dose or rate specified
MedicationDispense:MedicationDispense.MedicationDispense.extension:DrugServiceCoverage MedicationDispense (Submission): MedicationDispense.extension:DrugServiceCoverage	Required	DrugServiceCoverage`*`(OntarioHealth)	Codes indicate whether a medication or service cost was covered by a public plan, a private insurance plan or by the patient themselves.
MedicationRequestPrescription:MedicationRequest. dosageInstruction.timing.repeat.durationUnit MedicationRequestPrescription(Submission): MedicationRequest.dosageInstruction.timing.repeat.durationUnit MedicationDispense: MedicationDispense.dosageInstruction.timing.repeat. durationUnit MedicationDispense(Submission):MedicationDispense.dosageInstruction.timing.repeat. durationUnit	Extensible	DurationUnits(HL7 FHIR)	The units of time for the duration, in UCUM units.
Encounter:Encounter.class	Required	EncounterClass`*`(HL7 v3 + HL7 v2 + OntarioHealth)	Indicates the class of encounter.
Encounter:Encounter.priority	Required	EncounterPriority(CTAS)	The Canadian Triage and Acuity Scale (CTAS) is a scale used to determine the triage level.
Encounter:Encounter.reasonCode	Preferred	EncounterReasonCodes(HL7 FHIR)	Codes that indicate reasons for an encounter
Encounter:Encounter.status	Required	EncounterStatus(HL7 FHIR)	Current state of the encounter.
Encounter:Encounter.type	Required	EncounterType(HL7 FHIR)	Specific type of encounter
MedicationDispense:MedicationDispense.dosageInstruction.timing.repeat.when MedicationDispense(Submission):MedicationDispense.dosageInstruction.timing.repeat.when	Required	EventTiming(HL7 FHIR)	Code for time period of occurrence
Encounter:Encounter.identifier.type Patient:Patient.identifier:IdentifierOntarioHCN.type Patient:Patient.identifier:IdentifierMRN.type Patient(Submission):Patient.identifier:IdentifierOntarioHCN.type Patient(Submission):Patient.identifier:IdentifierMRN.type	Extensible	IdentifierType(HL7 FHIR)	A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
OperationOutcome: OperationOutcome.issue.severity	Required	IssueSeverity(HL7 FHIR)	How the issue affects the success of the action.
OperationOutcome: OperationOutcome.issue.code	Required	IssueType(HL7 FHIR)	A code that describes the type of issue.
Encounter:Encounter.location.physicalType	Required	LocationType`*`(HL7 FHIR + OntarioHealth)	The physical type of the location
MedicationRequest Prescription: MedicationRequest.dosageInstruction.timing.code MedicationDispense: MedicationDispense.dosageInstruction.timing.code MedicationDispense (Submission): MedicationDispense.dosageInstruction.timing.code	Extensible	MedicationRepeatPattern`*`(SNOMED CT CA)	The number of times to repeat the action within the specified period.
MedicationAdministration: MedicationAdministration.status	Required	MedicationAdministrationStatusCodes(HL7 FHIR)	A set of codes indicating the current status of a MedicationAdministration.
MedicationDispense:MedicationDispense.status MedicationDispense(Submission):MedicationDispense.status	Required	MedicationDispenseStatus(HL7 FHIR)	A code specifying the state of the dispense event.
MedicationRequestPrescription:MedicationRequest.intent MedicationRequestPrescription(Submission): MedicationRequest.intent	Required	MedicationRequestIntent(HL7 FHIR)	A code identifies the request intent.
MedicationRequestPrescription:MedicationRequest.status MedicationRequestPrescription(Submission): MedicationRequest.status	Required	MedicationRequestStatus(HL7 FHIR)	A code specifying the current state of the order.
MedicationRequestPrescription:MedicationRequest.reasoncode MedicationRequestPrescription(Submission): MedicationRequest.reasoncode	Extensible	MedicationRequestReasonCode `**`(SNOMED CT CA)	The clinical reason for which a medication is being ordered. The content of this subset includes commonly used concepts and may expand based on user experience.
OperationOutcome: OperationOutcome.issue.details	Required	OperationOutcome(HL7 FHIR)	Operation Outcome codes used by FHIR test servers
Encounter:Encounter.participant.type	Required	ParticipantType `*`(HL7 V3)	Role of participant in encounter
MedicationRequestPrescription:MedicationRequest.dosageInstruction.doseAndRate.dose MedicationRequestPrescription(Submission): MedicationRequest.dosageInstruction.doseAndRate.dose MedicationAdministration: MedicationAdministration.dosage.dose MedicationAdministration(Submission): MedicationAdministration.dosage.dose	Extensible	PrescriptionDoseQuantityUnit `**`(SNOMED CT CA)	Units of measure and/or products that convey the amount of drug to be given to a patient in one dose
Medication: Medication.code.coding:drugCCDD Medication(Submission):Medication.code.coding:drugCCDD	Required	PrescriptionMedicinalProduct`**`(CCDD)	Medicinal products for prescribing. The content of this subset only contains commonly used medicinal products that are available for prescribing and dispensing in Canada. This content will expand to include all human medicinal products over time.
MedicationDispense:MedicationDispense.quantity.code MedicationDispense(Submission):MedicationDispense.quantity.code	Extensible	PrescribedQuantityUnit`**`(SNOMED CT CA)	Units of measure and/or products that convey the amount of drug being prescribed to a patient
Patient:Patient.address.state Patient(Submission):Patient.address.state	Required	ProvinceStateCode`*` (Canada Post - ISO)	Codes for provinces, states and territories supported by Ontario Health interfaces
MedicationDispense:MedicationDispense.dosageInstruction.maxDosePerPeriod.numerator.comparator MedicationDispense(Submission):MedicationDispense.dosageInstruction.doseAndRate.maxDosePerPeriod.numerator.comparator	Required	QuantityComparator(HL7 FHIR)	How the Quantity should be understood and represented
MedicationDispense: MedicationDispense.dosageInstruction.route.coding MedicationDispense(Submission):MedicationDispense.dosageInstruction.route	Required	RouteofAdministration `**`(SNOMED CT CA)	The path the administered medication takes to get into the body or into contact with the body.
Encounter:Encounter.serviceType	Required	ServiceType (CIHI)	This field indicates description of the Hospital Service.
MedicationDispense: MedicationDispense.dosageInstruction.timing.repeat.periodUnit MedicationDispense(Submission):MedicationDispense.dosageInstruction.timing.repeat.periodUnit	Required	UnitsOfTime(HL7 FHIR)	The units of time for the period in UCUM units.