Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-Ballot
For a full list of available versions, see the Directory of published versions
| Term/Acronym/Abbreviation | Description |
|---|---|
| Application Programming Interface (API) | A set of standard software interrupts, calls, functions, and data formats that can be used by an application program to access network services, devices, applications, or operating systems. |
| Consent Management Technology Asset (CMTA) | The provincial consent management solution enables the uniform enforcement of privacy directives for all digital health services transactions. If a consent directive blocking a specific provider's access to a client's information is declared, integration with CMTA allows this directive to be enforced across all identities a provider may be using to access the provincial digital health record. |
| Content validation | Validation to confirm that the content in the record meets the classification, business, and codification rules (e.g. gender values, dispense date rules, Drug Identification Number/Product Identification Number). |
| College of Physicians and Surgeons of Ontario (CPSO) | The regulatory college for medical doctors in Ontario, Canada. |
| Date of Birth (DOB) | Refers to the year, month, and day a patient was born. |
| Diagnostic Imaging Common Services (DI CS) | To enable diagnostic imaging (DI) studies and DI reports stored in regional DI repositories and eHealth Ontario XDS repository to be accessible province-wide from anywhere and anytime, within the context of the provincial digital health record initiative. From a clinical and business perspective, the DI Common Service solution will deliver a private and secure shared common service for the DI repositories while following the principle of delivering the greatest clinical value relative to associated costs as a priority. DI Common Service currently provides access to DI reports and images via the DI Viewer integrated with the eHealth Ontario Portal. |
| Diagnostic Imaging Repository (DIR) | A repository that allows for the collection and storage of diagnostic images for Radiologists, Referring Physicians and Specialists across Ontario providing instant access. |
| Digital health asset | Has the meaning set out in section 26 of O. Reg. 324/04 and generally means a product or service that, (a) is selected, developed or used by a health information custodian, and (b) enables the custodian to use electronic means to collect, use, modify, disclose, transmit, retain or dispose of personal health information to provide care or assist in the provision of care. |
| Digital Imaging and Communications in Medicine (DICOM) | A standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol using Transmission Control Protocol/Internet Protocol to communicate between systems. DICOM files can be exchanged between two entities capable of receiving image and patient data in DICOM format. |
| Digital Health Information Exchange (DHIEX) | A regulatory framework that gives Ontario Health the ability to define and implement the health information standards and requirements for use in interoperability specifications. It regulates digital health information exchange in Ontario for consistent sharing of meaningful health information across health systems for the benefit of patients and health care providers. |
| Electronic Health Record (EHR) | A computer-based clinical data for an individual across multiple locations. This longitudinal health record includes data from a number of different interoperable Electronic Medical Records (EMRs) and Electronic Patient Records (EPRs) and is shared across multiple jurisdictions. |
| Enterprise Client Identifier (ECID) | A unique identifier for a patient in the Provincial Client Registry (PCR). Also referred to as Enterprise Patient Identifier. The PCR engine uses a probabilistic matching algorithm to link together an individual’s demographic records from multiple sources under a single identifier known as the Enterprise Client Identifier (ECID), and thus can provide identity cross-reference services in support of the Electronic Health Record (EHR). Note that the supporting PCR technology refers to ECID simply as Enterprise ID (EID). |
| Extensible Markup Language (XML) | A simplified subset of standard generalized markup language, capable of describing many different kinds of data. |
| Error Annotation | Annotation generated when a validation rule determined that data is incorrect or invalid in some way, therefore the dispensed or administration record is invalid for transmission to clinicians (e.g., record is missing a required data element). |
| HL7 Fast Healthcare Interoperability Resources Standard (HL7 FHIR®) | A standard for exhanging healthcare information electronically that defines a set of "Resources" that represent granular clinical concepts. The resources can be managed in isolation, or aggregated into complex documents. Technically, FHIR is designed for the web; the resources are based on simple Extensible Markup Language (XML) or JavaScript Object Notation (JSON) structures, with an http-based RESTful protocol where each resource has predictable Uniform Resource Locator (URL). Where possible, open internet standards are used for data representation. |
| Health Card Number (HCN) | A number assigned to every individual eligible to receive provincial health care services under the provincial/territory health insurance plan |
| Health Information Custodian (HIC) | A person or organization that has custody or control of personal health information for the purpose of health care or other health-related duties. Examples include physicians, hospitals, pharmacies, laboratories and the Ministry of Health. |
| Health Level Seven (HL7®) | A set of international standards used to move clinical and administrative health data between applications. The application layer, or "layer 7" in the Open Systems Interconnection paradigm, is the focus of the HL7 standards. |
| Hospital | Any institution, building or other premises or place that is established for the purposes of the treatment of patients and that is approved under the Public Hospitals Act, R.R.O. 1990, Reg. 965 as a public hospital. |
| Hospital Information System (HIS) | A comprehensive, knowledge-based system used in a hospital setting, capable of providing information to all who need it to make sound decisions about health. |
| Hypertext Transfer Protocol (HTTP) | A communication link protocol used by web servers and browsers to transfer/exchange HTML documents or files (text, graphic images, sound, video, and other multimedia files) over the Internet. |
| Implementation Guide (IG) | A document explaining the proper use of a standard for a specific purpose. |
| Implementer(s) | Entities responsible for carrying out the adoption of Implementation Guide (IG). |
| Informational Annotation | An informational message has been generated during the validation process, however the dispense or administration record is still valid for disclosure to clinicians (e.g., Newborn DOB detected). |
| Integrated Community Health Services Centres (ICHSCs) | An Integrated Community Health Services Centre (ICHSC), formerly known as an Independent Health Facility (IHF), is a community-based, often private clinic in Ontario that is licensed to provide specific OHIP-insured services, including diagnostic imaging (MRI/CT), surgeries (cataract, orthopedics), and other medical procedures |
| Interoperability specification | Has the meaning set out in section 26 of O. Reg. 324/04 and generally means a business or technical requirement established by the Agency that applies to a digital health asset or to a digital health asset’s interaction with other digital health assets, and that may include, without being limited to, a requirement related to, (a) the content of data or a common data set for electronic data, (b) the format or structure of messages exchanged between digital health assets, (c) the migration, translation or mapping of data from one digital health asset to another, (d) terminology, including vocabulary, code sets or classification systems, or (e) privacy or security. |
| JavaScript Object Notation (JSON) | A text format that is completely language independent but uses conventions that are familiar to programmers of the C-family of languages, including C, C++, C#, Java, JavaScript, Perl, Python, and many others. These properties make JavaScript Object Notation (JSON) an ideal data-interchange language. |
| Ministry of Health (MOH) | The Ontario government ministry in charge of overseeing the province's healthcare system. Formerly known as Ministry of Health and Long Term Care (MOHLTC). |
| Medical Record Number (MRN) | A unique number assigned by a facility (e.g. hospital, community pharmacy) to identify an individual. The medical record number is organization specific. |
| Object Identifier (OID) | An identifier mechanism standardized by the International Telecommunications Union (ITU) and International Organization for Standardization/International Electrotechnical Commission (ISO/IEC) for naming any object, concept, or "thing" with a globally unambiguous persistent name. |
| ONE Access Gateway (OAG) | A modernized platform for enabling the integration of provider facing applications with provincial clinical repositories and registries in a secure and reliable manner. |
| Ontario Clinical Imaging Network (OCINet) | The Ontario Clinical Imaging Network (OCINet) is an independent, not-for-profit corporation and a key delivery partner of Ontario Health. Formed in April 2022 to centralize diagnostic imaging, it enables the secure, province-wide storage, retrieval, and sharing of medical images between hospitals, community health centres, and clinicians to improve patient care. |
| Ontario Clinical Report Exchange (OCRE) | A digital health solution that enables clinicians to securely receive patient reports electronically from participating hospitals and specialty clinics. |
| Ontario Medical Imaging Clinical Data Repository (miCDR) | A secure, digital system in the provincial EHR for collecting, storing, and sharing diagnostic images and reports. It allows authorized clinicians at hospitals and independent health facilities to contribute and access a patient's longitudinal, cross-regional imaging history, such as X-rays, CT scans, MRIs, and mammograms. |
| Personal Health Information (PHI) | Has the meaning set out in section 4 of PHIPA. Specifically, it is “identifying information” about an individual that: • Relates to the physical or mental health of the individual; • Relates to the provision of health care to the individual; • Is a plan of service under the Home Care and Community Services Act, 1994; • Relates to payments or eligibility for health care or eligibility for coverage for health care; • Relates to the donation of any body part or bodily substance of the individual or that is derived from the testing or examination of any such body part or bodily substance; • Is the individual’s health number; and/or • Identifies an individual’s substitute decision-maker. PHI also includes identifying information about an individual that is not PHI listed above but that is contained in a record that includes PHI listed above. Information is “identifying” when it identifies an individual or when it is reasonably foreseeable in the circumstances that it could be utilized, either alone or with other information, to identify the individual. |
| Personal Health Information Protection Act (PHIPA) | The Ontario health privacy law. It establishes rules for the management of Personal Health Information and the protection of the confidentiality of that information, while facilitating the effective delivery of healthcare services. References to PHIPA include the regulation made thereunder (O. Reg. 329/04), as may be amended or replaced from time to time. |
| Point of Service (PoS) | A software application used by health information custodians for viewing or managing personal health information (PHI). Common PoS systems include, but are not limited to, provincial clinical viewers, health information system (HIS) and primary care electronic medical records (EMRs). |
| Provider Application | Provider applications include point-of-service systems supporting clinical workflow for Ontario’s healthcare providers. |
| Prescribed Organization (PO) | The organization prescribed in Ontario Regulation 329/04 as the organization for the purposes of Part V.1 of PHIPA. The Prescribed Organization has the power and the duty to develop and maintain the EHR in accordance with Part V.1 of PHIPA and the regulations made thereunder |
| Provincial Client Registry (PCR) | The definitive source for a health care client’s identity, facilitating the unique, accurate and reliable identification of individual clients and others who receive care in Ontario, across the disciplines in the health care sector. It contains demographic and identification cross-reference data for health care clients registered in one or more patient identifier domains for which eHealth Ontario, as a result of policy/program/IT decisions, has established a data sharing agreement with the respective organizations. The PCR is fed by multiple data sources, including the Ministry of Health and Long-Term Care Registered Persons Data Base, hospital sites tracking admissions, discharges, and transfers, and other systems that participate in health care services. |
| Structural validation | A process to confirm that a record being submitted meet the technical rules of the message format (e.g., Fast Healthcare Interoperability Resources JavaScript Object Notation/Extensible Markup Language (FHIR JSON/XML) structure or HL7 v.2 and the presence of mandatory fields). |
| Unique Provider Identifier number (UPI) | A unique number or code used for the purpose of identifying a healthcare provider. |
| Uniform Resource Identifier (URI) | The sequence of characters that identifies a logical or physical resource. Uniform Resource Locator (URL) is an example of a type of URI. |
| Uniform Resource Locator (URL) | A method to locate a resource on the web. It contains the name of the protocol to be used to access the resource and the resource name |
| Universal Unique Identifier (UUID) | An octet string of 16 octets (128 bits) used to reliably identifying very persistent objects across a network, particularly (but not necessarily) as part of an object identifier (OID) value, or in a Uniform Resource Name (URN). |
| Warning Annotation | A commentary generated when a validation rule determined that a message should be considered or analyzed, however the dispense or administration record is still invalid for transmission to clinicians (e.g., Date of Birth (DoB) has the day and month transposed). |
| Extensible Markup Language (XML) | A simplified subset of standard generalized markup language, capable of describing many different kinds of data. |