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Revision History
| VERSION NO. | DATE | SUMMARY OF CHANGE |
|---|---|---|
| v0.9.0 | 10th April 2019 | Original Draft |
| v0.9.1 | 13th June 2019 | Updated the implementation guide to include the Open Review comments and make it suitable for the provincial rollout |
| v0.10.0 | 1st Dec 2019 | Updated the provincial spec to incorporate Home and Community Care Pathway Leveraged tooling support (Forge & Simplifier) to profile resources Updated Terminology page with provincial value sets. |
| v0.10.1 | 20 July 2021 | Updates and clarifications to expected use of messaging, including updates to the MessageEventCode value set (agreed to by eReferral WG on June 22, 2021); Technical corrections to existing FHIR artifacts to enable resource validation, including: - slicing in AllergyIntolerance & all extensions, - fix URIs for references in profiles to match canonicals (vs Simplifier url); Rework implementation guidance, replacing "Method 1", "Method 2" language with separate specification pages for: - Direct Messaging integrations, and - SMART integrations; Added pages with implementation notes for Profiles and messages in the FHIR Artifacts menu; Added CapabilityStatements for key system roles specified in the specification pages to clarify requirements Added MessageDefinition artifacts to show expected use of message events / for reference in CapabilityStatements; Updated examples for resources and added examples |
| v0.11.0 | 29 July 2022 | Updated the implementation guide to incorporate eConsult workflow. The following sections were added/updated: - StructureDefinition: Questionnaire - Specification: RESTful FHIR API Updates to: - Scope - Renamed Acronyms to Glossary and added new terms - Business Context - Use Cases: Added eConsult Use Cases - Business Rules: added eConsult related business rules - Renamed Consumer Responsibility to Data Consumer Responsibility - Technical Backgroud: moved Conventions and FHIR Artifacts to this page - Integration Patterns: added REST related interactions - Direct Messaging: updated flow and state diagrams, added implementer notes for consult integrations - Supporting Workflow: added Use Case #4 - FHIR Artifacts: added links to RESTful Client/Server capability statements, updated message event codes, combined resource profile tables into one single table, added links to new extensions |
| v0.11.1 | February 28 2023 | Updated the IG following the Provincial Open Review, OH Privacy recommendations as well as IPC consultation: - Updated the Copyright section to address that FHIR is licensed under creative commons. - Fixed minor typographical errors - Updated the narrative in the use cases to address patient's consent prior to transmit any PHI data across the referral systems - eReferral Analytics repository use case has been added to the IG - Added hyperlinks for all of the extensions to the page where they are defined - Fixed the broken link on Downloads page - Updated meta.profile of the profiles to reflect the correct version - Added eConsult specific examples to the IG. |
| v0.12.0 | 31 October 2024 | - Changed FHIR resource baseline from base HL7 FHIR R4 to pan-Canadian eReferral/eConsult where possible- Added use cases, FHIR extensions and guidance to support central intake scenarios- Added clarifications, usage notes, etc. relating to retrieving information from the Ontario Provincial Health and Service Diretory (PHSD)- Added clarifications, usage notes, etc. for file/attachment handling- new discrete FHIR Resources (FamilyMemberHistory, Procedure, and MedicationStatement) as ServiceRequest supportingInfo- Apply ON FHIR profile harmonization decisions- Updated Conceptual Information Architecture Model- specification corrections- changes to improvide clarity and readability |
Differences between v0.10.1 and v0.11.0
| Menu Title | Page Name | Summary of change |
|---|---|---|
| Home | Introduction | - added DHIEX section - eConsult sentence added to background |
| Scope | -Scope – added RESTful API - Out of Scope – removed “Communication with a health services directory to expand the list of services/providers that can be searched” | |
| Glossary | - Renamed to Glossary from Acronyms - Added additional terms | |
| Business Context | Business Model | - Context – added sentence on Electronic Consult - Conceptual Architecture – diagram updated, added provincial digital health assets - Systems – added section on “Provincial Digital Health Assets” - Supporting eReferral Processes – added RESTful FHIR API sentence |
| Use Cases | - Added use cases 4 and 5 for eConsult | |
| Business Rules | - Added section on eConsult Business Events and HealthcareService Directories | |
| Technical Specifications | Technical Background | - Conventions and FHIR Artifacts moved to here |
| Integration Patterns | - Building Blocks: added RESTful Interactions - Workflow Support: added RMS GETs information using RESTful interactions and exchanges event-related information using Direct Messaging | |
| Direct Messaging | - Flow of Information – updated diagram with eConsult flow - Use of FHIR Messaging – updated table to align with flow diagram - Contributions to Repositories for Analytics and Performance Monitoring – added entire section - Diagram: ServiceRequest Message Bundle – diagram updated to include Questionnaire and HealthcareService - State Machines – Requester and Performer diagrams updated with new event codes - Performer State Machine – added workflow event table - Request completed by Requester – entire section added | |
| Specification: RESTful FHIR API | - Entire page added | |
| Supporting Workflow | - Use Case #4: Consultation Request added | |
| FHIR Artifacts | FHIR Artifacts | - Behaviour: Capability Statements – added RESTful Client and RESTful Server - Structures: Resource Profiles - Merged tables into one, added Questionnaire and HealthcareService profile - Structures: Extensions – New extensions added: o AccessInstructions o DART o DARC o CopiedParticipants o DeliveryMethod o Facet o PrimaryType o RoutingOptions o Media o UsageLicense |
| MessageDefinition: ServiceRequest Bundle | - Diagram updated to include Questionnaire and HealthcareService resources | |
| MessageDefinitions: Task Bundle | - Diagram updated to include Communication resource | |
| StructureDefinition: MessageHeader Profile | - Added extension – ContentType, updated usage notes | |
| StructureDefinition: ServiceRequest Profile | - Added extensions: DART, DARC, CopiedParticipants - Added Search Parameters - .reasonCode - updated usage notes | |
| Structure Definition: Task Profile | - Added extension - patientNeedsToBeSeen - Added Task Code - "process-request-consult" | |
| Structure Definition: Communication Profile | - Updated usage notes under .payload.content | |
| Structure Definition: HealthcareService Profile | - New profile added | |
| Structure Definition: Location Profile | - Added extension GeoJSON | |
| Structure Definition: Questionnaire Profile | - New profile added |
Differences between v0.11.0 and v0.11.1
| Menu Title | Page Name | Summary of change |
|---|---|---|
| Business Context | Business Model | - Narratives updated to add clarifications such as indicating that a referral recipient could be either performer or its delegate rather than only performer |
| Use Cases | - The IG has been updated to clarify that if the recipient is not a health information custodian then the family doctor is required to obtain the individual's express consent prior to disclosing any PHI to the other provider - The section headings on the page have been reworded to add eConsult to it |
|
| Business Rules | - Clarification added to the Patient Self Referral section - Updated the link to the US Core Birthsex extension - Reworded the Referral Status & Messaging Paradigm section |
|
| FHIR Artifacts | Usage Notes | Updated meta.profile to reflect the correct version of the profiles |
| FHIR Artifacts | - Added link on this page to navigate to the repository events - Fixed broken links for the sample messages - The FHIRArtifacts, Behaviour: Message Definitions section has been updated with eConsult specific sample bundles |
|
| Message Bundle: ServiceRequest | - Missing label on line from HealthcareService to Location has been added to the diagram - Bundle has been updated with the description of HealthcareService |
|
| Message Bundle: Task | - Diagram has been updated and the linkage between MessageHeader and ServiceRequest has been removed - Fixed broken link for Task & Communication bundle |
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| Structure Definition: ServiceRequest Profile: Search Parameters | - ServiceRequest Search Parameters has been updated with _include & _revinclude examples | |
| Structure Definition: HealthcareService Profile: Notes | - Updated missing URLs and valuesets in the profile | |
| FHIR Artifacts: Structures: Extensions | - Primary type extension has been renamed to 'isPrimary' to avoid data that duplicate with 'type' |
Differences between v0.11.1 and v0.12.0
| Menu Title | Page Name | Summary of change |
|---|---|---|
| Business Context | Business Model | - Conceptual Architecture – diagram updated |
| Use Cases | - Added use cases 6,7 and 8- Added use case specific sequence diagrams | |
| Business Rules | - Added wording around the use of discrete FHIR resources | |
| Technical Specifications | Specification: SMART Integration | - Added note about HALO alignment |
| Specification: RESTful FHIR API | - Added section on file handling | |
| FHIR Artifacts | FHIR Artifacts | - general corrections |
| FHIR Artifacts | - new extension: ServiceProviderPreference- new extension: ServiceRequestDelegate | |
| MessageDefinition: Appointment Bundle | - correction to diagram | |
| MessageDefinition: ServiceRequest Bundle | - correction to event table | |
| MessageDefinition: AllergyIntolerance Profile | - add guidance for recording "no known allergy" | |
| MessageDefinition: Appointment Profile | - set baseline to CA:eReC | |
| MessageDefinition: Bundle Profile | - set baseline to CA:eReC- update .entry cardinality to align with CA:eReC | |
| MessageDefinition: Communication Profile | - set baseline to CA:eReC | |
| MessageDefinition: DocumentReference Profile | - set baseline to CA:eReC- Add attachment/file handling guidance | |
| MessageDefinition: FamilyMemberHistory Profile | - NEW | |
| MessageDefinition: Location Profile | - set baseline to CA:eReC | |
| MessageDefinition: MedicationStatement Profile | - NEW | |
| MessageDefinition: MessageHeader Profile | - set baseline to CA:eReC | |
| MessageDefinition: Organization Profile | - set baseline to CA:eReC- add eConsult usage guidance | |
| MessageDefinition: Patient Profile | - set baseline to CA:eReC- add eConsult usage guidance | |
| MessageDefinition: Practitioner Profile | - set baseline to CA:eReC- bind .qualification to QualifiedCredentialRoleType | |
| MessageDefinition: PractitionerRole Profile | - set baseline to CA:eReC- bind .specialty.coding to QualifiedExpertiseRoleType | |
| MessageDefinition: Procedure Profile | - NEW | |
| MessageDefinition: Questionnaire Profile | - add statement regarding the use of Questionnaire/QuestionnaireResponse | |
| MessageDefinition: QuestionnaireResponse Profile | - set baseline to CA:eReC- add statement regarding the use of Questionnaire/QuestionnaireResponse | |
| MessageDefinition: ServiceRequest Profile | - set baseline to CA:eReC- additional usage notes- new extensions: ServiceProviderPreference, and ServiceRequestDelegate | |
| MessageDefinition: Task Profile | - set baseline to CA:eReC |