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2.1. Business Model

2.1.0.1. Context

Healthcare organizations across Ontario collect, maintain, and manage patient demographic and identifier information within their local systems as part of care delivery. As trusted contributors to the Provincial Client Registry (PCR), these organizations are responsible for submitting accurate and timely patient identity information to support a shared provincial view of patient identity.

The PCR serves as Ontario's enterprise patient identity service that supports the accurate identification of individuals across the healthcare system. PCR maintains core patient demographic information, identifiers, and identifier cross-references aggregated from the Ontario Registered Persons Database (RPDB) and participating healthcare organizations. As patients receive care from multiple organizations across the healthcare ecosystem, different identifiers may be assigned, and demographic information may exist in multiple locations. PCR provides a provincial identity management service that supports the linkage of these records and cross-referenced identifiers across organizational boundaries, enabling digital health services and authorized healthcare providers to associate health information with the correct individual and access a more complete patient record.

2.1.0.2. Model

Participating organizations contribute patient demographic and identifier information to PCR through approved integration services. PCR validates, reconciles, and maintains these submissions to establish and preserve a unique provincial identity record for each patient.

Contributed information supports:

• Accurate Patient Identification: Enables precise identification of patients across diverse care settings.
• Health Record Association: Ensures accurate linking of patient health information with the correct individual across services.
• Cross-Reference Maintenance: Establishes and maintains cross-reference identifiers between contributing source systems.
• Data Quality & Consistency: Enhances the quality, completeness, and consistency of patient demographic data across Ontario's digital health ecosystem.
• Downstream Support: Supports downstream provincial EHR services and authorized healthcare providers.

2.1.0.3. Ecosystem Roles and Responsibilities

The PCR data contribution ecosystem consists of three core participant groups:

• Data Contributors: Organizations such as hospitals, Health Information Custodians (HICs), community providers, laboratories, public health agencies, and other authorized custodians. Contributors submit patient demographic and identifier information to PCR, maintain local data quality, perform updates/corrections/merges/unmerges, and ensure compliance with provincial standards and business rules.
• Provincial Client Registry (PCR): The authoritative provincial source that receives and validates submitted patient information, maintains provincial identity records and identifier cross-references, reconciles multi-source data, preserves lineage and audit history, applies data stewardship/governance rules, and provides trusted identity information.
• Consumers: Authorized healthcare facilities, EMRs, EHR viewers, clinical applications, and repositories that query, access, and utilize identity information maintained within PCR to support patient care and health information exchange.

2.1.0.4. Available Capabilities and Functions

The following contribution and identity management functions are supported across integration standards for maintaining patient identity information within PCR:

*Interactions corresponding to the HL7 FHIR Contribution service are specified in this implementation guide.