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

2.1. Business Model

2.1.1. Context

OCRE delivers electronic medical reports from acute care, diagnostic, and specialty care settings to community-based clinicians, including both primary care providers and specialists.

The following sections and diagrams illustrate the proposed interactions between data contributors (e.g. Hospitals, ICHSCs) and point of service systems (e.g. EMRs, and etc). As OCRE implementation will go through transition phase to the final phase, we have two sets of diagrams describing the systems in the future state, and in the transition state.

2.1.2. Future State Model

This diagram illustrates the high-level end to end flow of OCRE reports from data contributors, e.g. hospitals, Integrated Community Health Services Centres (ICHSCs), to point of service systems (e.g. EMRs, and etc).

2.1.2.1. Future State Systems

The following diagram describes the actors in the future state. In this state, point of service systems (e.g. EMRs, and etc) support FHIR R4 and subscribe to OH Pub/Sub services to receive reports.

The systems in this state include:

• Data Contributor: systems that submit clinical and medical imaging reports in either FHIR R4 (preferably), or in HL7v2, or in HRM FHIR DSTU2 format to OCRE.

• OCRE converts HL7v2 and FHIR DSTU2 formats to FHIR R4, and publishes clinical and medical imaging reports in FHIR R4 format to OH Pub/Sub services.

• Point of service systems (e.g. EMRs, and etc) are notified by OH Pub/Sub services of clinical and medical imaging reports they are subscribed to.

2.1.2.2. Attachments

• When submitting a FHIR R4 report with an attachments, data contributor SHALL follow the Upload Attachment flow.
  • This requirement doesn't apply on HL7v2 and FHIR DSTU2 submissions.
• On the receiving side, point of service systems that use OH Pub/Sub Services to receive FHIR R4 reports SHALL follow the Download Attachment flow for reports that have a link to a file rather than an attachment embedded in the report.
  • This requirement doesn't apply to point of service systems that receive reports from HRM in the Transition State described below.

2.1.3. Transition State Model - FHIR R4 Submissions

OCRE will also support a transition state where point of service systems are not yet ready to integrate with OH Pub/Sub services and to receive FHIR R4 reports. The following describes the transition state where OCRE will be used to support HRM to deliver clinical reports to point of system systems (e.g. EMRs, and etc). OCRE will convert clinical and medical imaging reports from FHIR R4 to HRM FHIR DSTU2 format and forward these to HRM. HRM will follow the existing process of converting clinical and medical imaging reports from FHIR DSTU2 to HRM XML and the point of service systems can get these reports in XML format.

2.1.3.1. Transition State Systems - FHIR R4 Submissions

The systems in this state include:

• Data Contributor: systems that submit clinical and medical imaging reports in FHIR R4 format to OCRE.

• OCRE: converts FHIR R4 to HRM FHIR DSTU2 format and passes this to HRM.

• HRM converts FHIR DSTU2 to HRM XML using the existing process.

• Data Consumers (e.g. EMRs) get reports in HRM XML format.

2.1.4. Transition State Model - HL7v2 and FHIR DSTU2 Submissions

Reports submitted by data contributors in HL7v2 or in FHIR DSTU2 format will be routed "as is" to HRM. Point of Service systems (e.g. EMRs) will keep getting these reports in HRM XML format.

2.1.4.1. Transition State Systems - HL7v2 and FHIR DSTU2 Submissions

The systems in this state include:

• Data Contributor: systems that submit clinical and medical imaging reports in HL7v2, or in HRM FHIR DSTU2 format to OCRE.

• OCRE: routes reports in HL7v2 or HRM FHIR DSTU2 formats "as is" to HRM.

• HRM converts FHIR DSTU2 (or HL7v2) to HRM XML using the existing process.

• Point of Service Systems (e.g. EMRs) that get reports in HRM XML format.