Ontario eForms HL7® FHIR® SDC Implementation Guide

Introduction

This Implementation Guide defines how Ontario Health supports standardized digital forms using HL7 FHIR® Structured Data Capture (SDC). It provides technical and business guidance for implementers to enable structured, interoperable, and clinically meaningful electronic data collection across Ontario’s digital health ecosystem.

The initial focus of this guide is on electronic referral (eReferral) forms. These forms play a critical role in facilitating timely and coordinated care transitions between providers. As Ontario Health expands its digital health initiatives, this guide may be extended to support additional use cases such as clinical intake, patient self-assessments, and remote monitoring.

This guide is intended for:

EMRs, hospital systems, and RMS vendors that need to render and process structured questionnaires;
Implementers and developers working with FHIR-based APIs and digital form rendering engines;
Standards and interoperability teams seeking consistent artifacts for cross-system data exchange.

All in-scope forms produced by Ontario Health will comply with the Questionnaire profile defined in this guide.

For further context on the goals, scope, and business requirements driving this work, see the Business Context section.

For guidance on supported capabilities, rendering expectations, and form logic, see the Form Behavior and Rendering section.

Any updates to the rules governing form structure, behavior, and rendering will be reflected in future versions of this guide. Timing expectations for systems to migrate to handle newer versions of this guide will be established by Ontario Health in consultation with implementers. This includes expectations for full support of the initial release of this guide.

Structured Data Capture

This guide relies on the HL7 International Structured Data Capture (SDC) implementation guide. Implementers must familiarize themselves with the content of that guide. Definitions and explanations found in that guide apply to all elements supported by this guide.

Copyright Notice

This specification is fully copyright protected by the owner. The owner has the exclusive right to make copies of this specification. No alterations, deletions or substitutions may be made without the prior written consent of the owner. No part of it may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, email or any information storage and retrieval system, without the prior written consent of the owner.

This specification contains information for which copyright is held by Health Level Seven, Inc. There is no membership requirement for individuals and organizations which merely install or use software with built-in HL7 interfaces.

HL7® and FHIR® are registered trademarks of Health Level Seven, Inc. (https://www.hl7.org).

LOINC® is a registered trademark of the Regenstrief Institute, Inc. (http://regenstrief.org).

This material includes SNOMED Clinical Terms® (SNOMED CT®) (https://www.snomed.org/snomed-ct/) which is used by permission SNOMED International. All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists.

“SNOMED” and “SNOMED CT” are registered trademarks of SNOMED International (https://www.snomed.org/).

Disclaimer

Pursuant to O. Reg. 329/04, Ontario Health is required to, subject to the review and approval of the Minister, establish, maintain and amend interoperability specifications. The Minister may direct Ontario Health to establish or amend interoperability specifications, and Ontario Health is required to comply with such direction.

In accordance with O. Reg. 329/04, Ontario Health makes the interoperability specification most recently approved by the Minister available to the public by posting it on Ontario Health’s website or by such other means as Ontario Health considers advisable.

As the Minister may direct Ontario Health to amend the interoperability specifications from time-to-time, Ontario Health advises the public and any other users of information concerning interoperability specifications to regularly review Ontario Health’s website where the interoperability specifications are posted, or such other means Ontario Health considers advisable, in order to confirm that they are accessing the interoperability specifications most recently approved by the Minister. You understand and agree that:

(i) This specification is provided “AS IS” without any warranties or representations of any kind, express or implied, in fact or in law;

(ii) Ontario Health is not responsible for your use or reliance on the information in this specification or any costs associated with such use or reliance; and

(iii) Ontario Health has no liability to any party for that party’s access, use or reliance on this specification or any of the information contained in it.