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FHIR Artifacts

This implementation guide defines conformance criteria for four different roles that a system participating in a eReferral integrations may perform.

Behaviour: Capability Statements

Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

Capability Statement Description Artifact
(JSON)
RMSSource A software application that participates in Direct Messaging as an RMS Source JSON
RMSTarget A software application that participates in Direct Messaging as an RMS Target JSON
SMARTApp A software application (typically an RMS) that can be launched in context from a SMART Server in a SMART Integration JSON
SMARTServer A software application that can launch a SMART Client in context in a SMART Integration JSON

Note that a single software application can and often will have all of the capabilities above.

Behaviour: Message Definitions

MessageDefinitions are referended within CapabilityStatements within this IG to define the conformance requirements for different systems.

Note: Links to MessageDefinitions are currently provided on pages with an overview of the bundle.

Event Payload Source Description Example Instance
(JSON)
add-servicerequest ServiceRequest Bundle RMS Source Request that a new ServiceRequest be performed on the RMS Target JSON
terminate-servicerequest ServiceRequest Bundle RMS Source Notify systems that a ServiceRequest has been terminated and request that the ServiceRequest and related information be removed JSON
notify-add-servicerequest ServiceRequest Bundle RMS Source Notify systems other than the RMS Target that a new ServiceRequest has been created JSON
notify-update-servicerequest ServiceRequest Bundle RMS Source Notify systems that a ServiceRequest or its status has been updated JSON
notify-data-correction ServiceRequest Bundle RMS Target Notify systems that the RMS Target has corrected information in a ServiceRequest or related resource JSON
notify-add-process-request Task Bundle RMS Target Notify systems that a Process Request Task has been created to perform a ServiceRequest JSON
notify-update-process-request Task Bundle RMS Target Notify systems that a Process Request Task, its status or related information has changed JSON
notify-add-appointment Appointment Bundle RMS Target Notify systems that an appointment has been created in response to a ServiceRequest JSON
add-communication Communication Bundle RMS Source or RMS Target Send a question or additional information (Communication) about a ServiceRequest JSON
add-rfi Task Bundle RMS Target Request for additional information about a ServiceRequest JSON

Structures: Resource Profiles

These define constraints on FHIR resources used within messages and/or RESTful interactions defined in this implementation guide.

Messaging Support

FHIR Messaging uses bundles of Resources with MessageHeaders to exchange information between systems.

Resource Type Description Example Instance (JSON)
Bundle Used to exchange a series of Resources (entries) to another system in FHIR Messaging. JSON
MessageHeader The first entry in the Bundle is used to specify the trigger event, the focus of the message and provides information for message routing. JSON
OperationOutcome Used to communicate error, warning and information messages that provide detailed information about the outcome of an attempted system operation. JSON

In Focus Resources

The focus of a message varies between events and reflects the key Resource being acted upon. These resources will contain references to other Resources representing the entities (people and organizations) participating in the request as well as supporting information.

Resource Type Description Example Instance (JSON)
ServiceRequest The eReferral Request (ServiceRequest) itself is the focus of most messages being sent from a RMS Source to RMS Target. JSON
Task A Task is used to track work doe JSON
Appointment The Appointment is used to provide information about a planned meeting that may be in the future/past JSON
Communication Communications (questions or information) may be exchanged between the RMS Source and RMS Target. JSON

Entities

Resources representing the entities (people and organizations) participating in the request.

Resource Type Description Example Instance (JSON)
Patient The subject of the referral request JSON
PractitionerRole Defines the requester or targeted service provider. Should reference one Practitioner or one Organization resource. Also referenced in other resources. JSON
Practitioner Provides the requester or service provider identity (PractitionerRole.practitioner). Also, in case the author is not the requester the author reference in the MessageHeader may refer to a second Practitioner resource. JSON
Organization Identifies the recipient HCC (PractitionerRole.organization) in the MessageHeader. Can also appear in other PractitionerRole.organization references. JSON
Location Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations. JSON

Supporting Information

Resources used to provide supporting information for the request.

Resource Type Description Example Instance (JSON)
AllergyIntolerance Allergy information JSON
Condition Diagnosis information JSON
Consent Any consent information collected at source JSON
DocumentReference Any additional PDF forms/documents that have to be included as documents. JSON
QuestionnaireResponse A list of nested Questions and Answers items that complement the Service Request order details JSON

Structures: Extensions

These define extensions to FHIR resources created for use within the Resource Profiles defined in this guide.

Extension Description Related Profile(s)
Communication Barrier The extension is required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not an interpretor is required. Patient: Patient.communication.extension
HCNVersionCode An assigned sequence code, uniquely identifying a Health Card issued (or potentially issued) to a Registered Person Patient: Patient.identifier.extension
PatientPresentLocation Extension is used to communicate the present location of the patient if it is different than the patient's home address. ServiceRequest: ServiceRequest.extension
RoutingOptions This is an extension required for Referral Source Type identification. Only one referral routing object expected. MessageHeader: MessageHeader.extension
ServiceRequest: ServiceRequest.extension
ReferralIdentifier For requisitions this extension is used to convey the ServiceRequest.requisition identifier in the message header. MessageHeader: MessageHeader.extension
ReasonForNoHCN This extension is used to convey the reason for not providing the patient's health card number as a business identifier. Patient: Patient.identifier.extension

Terminology: Value Sets

Various coded values which are used to describe clinical concepts within health records as well as codes used within messages to meet the structural requirements of interfaces. See Terminology for information about terminology used in this IG.