FHIR Questionnaires and SDC

This section describes the value and necessity of using FHIR Questionnaires and HL7 FHIR® Structured Data Capture (SDC) standards to enable digital form management in Ontario. It also outlines the rationale for developing a provincial implementation guide (IG) to ensure alignment, interoperability, and scalable implementation across vendors and systems.

FHIR Questionnaires

  • Represent the digital equivalent of paper-based forms.
  • Define the structure, order, logic, and constraints of clinical questions.
  • Enable machine-readable, interoperable data collection.

FHIR SDC (Structured Data Capture)

  • Provides a framework for high-quality form design and data capture.
  • Defines the roles and interactions of systems involved in form lifecycle (design, render, complete, process).
  • Supports advanced form behaviors like conditional logic, pre-population, and validation.

Why an Ontario SDC IG is Needed

  1. Provincial Consistency

    • Aligns all eReferral and eForms implementations with a single, authoritative standard.
    • Reduces duplication of effort and variation in form behavior across regions.

  2. Vendor and System Interoperability

    • Provides vendors with clear implementation guidance for integrating Ontario’s standardized digital forms into their systems, including how to render questionnaires consistently, enforce required data elements, apply Ontario (and SDC) specific extensions and terminologies, and ensure interoperability with other solutions in the province’s digital health ecosystem.
    • Ensures that forms behave consistently across different platforms and care settings.

  3. Improved Data Quality and Reusability

    • Promotes structured, validated, and codified data that can be reused for analytics, reporting, and clinical decision support.
    • Reduces manual data entry and transcription errors.

  4. Support for Complex Clinical Workflows

    • Enables dynamic, intelligent forms that adapt to clinical context.
    • Supports pre-population from existing patient data and automated processing of submissions.

  5. Scalability and Future Readiness

    • Provides a foundation for new use cases (e.g., patient self-assessments, remote monitoring).
    • Aligns with national and international standards, ensuring future compatibility.

Proposed Solution

Publishing an Ontario-specific FHIR SDC IG will:

  • Standardize how referral and clinical forms are built and exchanged.
  • Ensure interoperability across systems and vendors.
  • Support scalability for future digital health initiatives.

Conclusion

Publishing an Ontario FHIR SDC Implementation Guide is a strategic investment in the province’s digital health infrastructure. It will ensure that eReferral and eForms are implemented in a consistent, interoperable, and scalable way—ultimately improving care coordination, data quality, and patient outcomes.