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1.3. Scope

1.3.1. In Scope

This implementation guide applies to systems that contribute client demographic and identifier information to the Provincial Client Registry (PCR) using HL7 FHIR R4 APIs.

The scope of this guide is limited to PCR contribution workflows where an authorized source system submits patient identity information for creation, maintenance, reconciliation, or correction within PCR.

The guide includes the functional and technical requirements for the following contribution operations:

• Patient Add
• Patient Update
• Patient Merge
• Patient Unmerge

The guide also includes:

• FHIR resource profiles and profile-specific requirements
• Contribution operation requirements
• Business rules and validation requirements
• Mandatory data elements and cardinality constraints
• Identifier requirements and policies
• Conformance rules
• Capability Statement requirements
• Privacy and security obligations applicable to contribution
• Error handling and processing outcomes
• Response and OperationOutcome handling
• Connectivity readiness considerations
• Contribution conformance requirements

The specification supports the contribution of patient demographic information, local identifiers, provincial identifiers, and record relationships required to maintain accurate patient identity information within PCR.

This guide describes how contributing systems submit new patient information, update existing patient information, and perform merge and unmerge activities when duplicate or incorrectly linked client identities are identified.

Patient query and search functionality are not within the scope of this guide.

Query capabilities, including the functional requirements for retrieving patient information from PCR, are documented separately within the PCR FHIR Query Implementation Guide. Query requirements may also be supported through alternative PCR HL7 V2 and HL7 V3 specifications.

1.3.2. Out of Scope

The following topics are outside the scope of this implementation guide:

• Patient query, search, or retrieval functionality
• Detailed PCR onboarding methodology
• Project delivery planning and implementation management activities
• Required project staffing and resourcing guidance
• Detailed conformance testing procedures
• Environment provisioning activities
• Operational support procedures
• Legacy PCR implementation approaches except where referenced for context
• Detailed mappings between PCR FHIR contribution specifications and alternative HL7 V2 or HL7 V3 contribution specifications

General PCR onboarding guidance, including implementation planning, onboarding activities, project methodology, resource requirements, and detailed conformance testing procedures, is provided through separate Ontario Health onboarding materials. Organizations seeking to establish a PCR integration should contact the Ontario Health Registries Product Management Team to obtain onboarding and implementation guidance.

Non-functional connectivity implementation details for the Ontario Health ONE Access Provider Gateway (OAG) are also outside the scope of this guide, including:

• Gateway configuration
• Network connectivity implementation
• Endpoint provisioning
• Transport-layer implementation details
• Certificate installation procedures
• Identity enrollment procedures
• Environment-specific gateway configuration

Implementers should refer to Ontario Health connectivity documentation, onboarding materials, and applicable gateway specifications for detailed connectivity implementation requirements.

This guide does not replace applicable Ontario Health agreements, privacy obligations, security requirements, onboarding direction, or legislative requirements established under PHIPA and related regulations.

1.3.3. Applying PCR FHIR IG

Ontario Health will be establishing the PCR HL7 FHIR Implementation Guide as an interoperability specification under Ontario’s Digital Health Information Exchange (DHIEX) framework.

Information in this guide is provided in accordance with O. Reg. 329/04 under Personal Health Information Protection Act (PHIPA), 2004, section 28 Application of Specifications.

Contribution from external stakeholders is voluntary; however, should they choose to contribute, then compliance with the interoperability specification is mandatory.