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Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-Final
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  • Index
  • Home
    • Home
    • Introduction
    • Relationship to Other Specifications
    • Scope
    • Glossary
  • Business Context
    • Business Context
    • Business Model
    • Business Data
    • Use Cases
    • Business Rules
  • Technical Context
    • Technical Context
    • Implementer Responsibility
    • Conformance Rules
    • Connectivity Summary
  • FHIR Artifacts
    • FHIR Artifacts
    • Interactions
    • Profiles
    • Extensions
    • Terminology
    • System URIs
    • Examples
    • Capability Statement
    • Response Handling
    • Downloads
  • Change Log
    • Change Log
    • Known Issues & Future Developments
    • Revision History
    1. Index
    2. Change Log
    3. Revision History

For a full list of available versions, see the Directory of published versions

5.2. Revision History

This section tracks changes made across releases of this Implementation Guide (IG).

5.2.1. IG Updates

VERSION NO. DATE SUMMARY OF CHANGE Changed By
v 1.0.0-Draft1 2026-02-03 Initial draft OH DHS Team
v 1.0.0-Draft2 2026-06-11 Addressed open review, OH Privacy, and CA Core+ / ON‑EHR harmonization comments OH DHS Team
v 1.0.0-Final 2026-06-24 DHISC Approval received OH DHS Team

5.2.1.1. Summary of Updates in Version 1.0.0 – Draft 2


Item No. IG Page IG Section IG Subsection Summary of change Change description Source of Change
1 All All All Fixed typos, formatting and style DETAILS: Corrected typos, formatting, and editorial inconsistencies. RATIONALE: To improve clarity, readability, and overall consistency of the document. Open review comment
2 All All All Indigenous governance language updates DETAILS: Replaced “stakeholder(s)” with “partners” across the IG. RATIONALE: To follow enterprise guidance and use appropriate language. Open review comment
3 Business Context Business Model 2.1.1. Context Removed Patient access from use cases DETAILS: Updated the IG to remove Patient access. RATIONALE: Addresses OH Privacy comments and clarifies provider-only query scope. OH Privacy comment
4 Business Context Business Data 2.2.2. Medical Imaging Subject Area Added clarification that ImagingStudy is not part of the MI FHIR submission and will be supported by the MI DICOM IG DETAILS: Added context on how the ImagingStudy resource is generated. RATIONALE: Addresses confusion about ImagingStudy scope in the IG. Open review comment
5 Business Context Use Cases 2.3.1. Actors Aligned PCR description with OH Digital Playbook terminology for consistency and clarity DETAILS: Aligned PCR description with OH Digital Playbook terminology. RATIONALE: Ensures consistency and clarity within OH. Open review comment
6 Business Context Use Cases Data Consumption Use Cases - Provincial Clinical Viewer Queries Clarified that the initial query use cases are in scope for Provincial Clinical Viewer only DETAILS: Removed duplicate query use case, clarified scope for consuming systems, and included alternate consent block scenarios. RATIONALE: Aligns with Provincial Clinical Viewer context; third-party integrations are out of scope and deferred to future phases. Open review comment; OH Privacy comment
7 FHIR Artifacts Interactions 4.1.1. Section Contents Removed the “Submit MI Bundle” interaction to clarify the scope of the asynchronous MI data submission flow DETAILS: Removed Submit MI Bundle interaction and added asynchronous-related details in the other submission pages. RATIONALE: Batch submission for miCDR contribution is out of scope. Open review comment
8 FHIR Artifacts Interactions Submit Interactions > 4.1.2.1.2. Transaction Response Clarified asynchronous submission behavior DETAILS: Submissions return HTTP 202 and are queued for validation; valid data is stored in miCDR, and errors are captured in DQS (out of scope). RATIONALE: Provides high-level clarity on processing flow and error handling scope. Open review comment
9 FHIR Artifacts Interactions All Search Interactions Clarification on the patient identifier in search parameters DETAILS: Updated usage notes for mandatory patient search identifiers. RATIONALE: Clarifies that only one identifier needs to be sent (MRN is preferred). Open review comment
10 FHIR Artifacts Interactions Interaction: Search MI ImagingStudy Removed duplicate procedure code parameter DETAILS: Removed “procedure code” as an optional search parameter for basedOn:ServiceRequest.category in ImagingStudy search. RATIONALE: Avoids duplication, as procedure code is already captured in basedOn:ServiceRequest.code. Open review comment
11 FHIR Artifacts Profiles Profile: DiagnosticReport (Submission) Added guidance for DiagnosticReport submission DETAILS: Added guidance for populating DiagnosticReport narrative fields (result, presentedForm, conclusion), including expected use and required vs optional elements. RATIONALE: Ensures consistent and conformant reporting. Open review comment
12 FHIR Artifacts Profiles Profile: ImagingStudy Updated ImagingStudy accession identifier cardinality to 1..1 DETAILS: Updated cardinality of ImagingStudy.identifier:accession.type to 1..1 (required). RATIONALE: Ensures identifier type is always defined and clear to consumers. Open review comment
13 FHIR Artifacts Profiles Profile: Patient (Submission) Provided additional guidance on the scope of jurisdictional health card numbers in the data submission DETAILS: Updated usage notes and clarified that Ontario health card number must be sent if available; unsupported identifiers are not permitted. RATIONALE: Provides clear submission expectations. Open review comment
14 FHIR Artifacts Profiles Profile: DiagnosticReport (Submission) Updated conformance notes for accession identifier system DETAILS: Updated conformance notes for identifier:accession.system. RATIONALE: Clarifies OH expectations for accession (OID) and placer order (URI) systems. Open review comment
15 FHIR Artifacts Profiles Profile: Patient (Submission) Aligned Patient.identifier:MRN.type and Patient.identifier:JHN.type with ON‑EHR identifiers DETAILS: Aligned Patient.identifier:MRN.type and Patient.identifier:JHN.type with ON‑EHR identifiers. RATIONALE: Ensures consistency with ON‑EHR identifier definitions. CA Core+ and ON-EHR Harmonization
16 FHIR Artifacts Profiles Profile: Encounter (Submission) Removed duplicate guidance on .type DETAILS: Removed duplicate guidance on .type. RATIONALE: Eliminates redundancy and improves clarity within the IG. OH Privacy comment
17 FHIR Artifacts Profiles Profile: Endpoint Added usage note for .address clarifying base service URL format with QIDO and WADO examples DETAILS: Added examples to Endpoint.address to show that it SHALL contain the base service URL (e.g., QIDO or WADO). RATIONALE: Defines a consistent format so submitters and consumers use and interpret endpoint values the same way. Open review comment

5.2.2. Terminology Updates

This section lists updates to ValueSets and CodeSystems used in this IG.

VALUE SET/CODE SYSTEM VERSION No. Date SUMMARY OF CHANGE
DocumentReferenceTypeEHR v1.0.0 June 15, 2026 Updated value set binding for DocumentReference.type to DocumentReferenceTypeEHR.
DiagnosticReportCodeEHR v1.1.0 June 15, 2026 Updated value set binding for DiagnosticReport.code to DiagnosticReportCodeEHR.
LocalImagingProcedureCodeEHR v2.0.0 June 15, 2026 Updated value set binding for DiagnosticReport.code to LocalImagingProcedureCodeEHR.
HealthCareProviderRoleCode v1.0.0 June 15, 2026 Updated value set binding for PractitionerRole.code to HealthCareProviderRoleCode.
HealthCareProviderRoleType v1.0.0 June 15, 2026 Updated value set binding for PractitionerRole.code to HealthCareProviderRoleType.
Version: v1.0.0-Final FHIR Version: R4.0.1

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