DRAFT - The specification is currently in development and subject to significant change. It is not ready for limited roll-out or production level use.

Updates

Specifications Updates

RELEASE VERSION No. DATE SUMMARY OF CHANGE
CA:eReC v1.0.2 DFT v1.0.2 10/30/2024 Technical Errata - Modified Bundle slicing discriminator from resource type to profile to improve validation capabilities.

Fix typos on Messaging Compliance Table (in the Actors and Transactions section) for the following transactions:

Notify data correction [eReCm-4]
- Maturity Level should be L2 for eReC Requester

Send communication from requester [eReCm-9]
- Maturity Level should be L3 for eReC Performer

Send communication from performer [eReCm-10]
- Maturity Level should be L3 for eReC Performer
CA:eReC v1.0.1 DFT v1.0.1 10/9/2024 Technical Errata - Update to the canonical url for task-code.

- Updated the profile pages to reflect the correct canonicals for each profile

- Added linkage and description to the existing BusinessStatusReason extension in the extension table.
CA:eReC v1.0.0 DFT v1.0.0 10/1/2024 - Updated overall page hierarchy from ballot feedback

Business Context

- Added Business Models page to describe the people and systems that contribute to a service record in different eReferral and eConsult models supported by the specification.

- Updated Use Cases page - Added a use case for Central Access and Triage in addition to Central Intake. Updated flow diagrams for simplicity and consistency with sequence diagrams.

- Added Business Events page to describe events supporting eReferral/eConsult workflow associated with different levels of system maturity.

Technical Context

Updated MustSupport definition from ballot feedback - highlighted 'use case support' guidance on resource profiles.

- Added Integration Patterns page to highlight the real-world architectures that support the business models to provide implementable technical specifications.

- Updated technical actors, actor options and grouping.

- Note: Addition of eReC Informer and eReC Recipient technical actors with updated eReC-m2: Notify new service record , and new eReC-m11: Notify update service record transactions.

- Updated Messaging page with new actor definitions and transactions, re-framing transactions in context of maturity levels. Added requirements for reducing message size within a message bundle.

- Updated Sequence diagrams with new/updated actors and transactions. Added a diagram to support the Central Access and Triage use case.

- Updated Conformance Requirements tables with new/updated actors and transactions. Added a table to support Central Access and Triage use case.

Resource Profile Updates

PROFILE VERSION No. DATE SUMMARY OF CHANGE
Bundle 1.0.2 10/30/2024 Technical Errata - Modified Bundle slicing discriminator from resource type to profile to improve validation capabilities
Task 1.0.1 10/9/2024 Technical Errata - Update to the canonical url for task-code
HealthcareService 1.0.0 9/18/2024 HealthcareService profile added from ballot feedback
Questionnaire 1.0.0 9/18/2024 Questionnaire profile removed from ballot feedback
Appointment, Bundle, Communication, DocumentReference, Location, MessageHeader, Organization, Patient, Practitioner, PractitionerRole, QuestionnaireResponse, ServiceRequest, and Task profiles 1.0.0 9/18/2024 Updated these profiles and version numbers based on ballot feedback
CommunicationBarrier, CopiedParticipants, DARC, DART, HCNV Code, PatientPresentLocation, PerformerIdentifier, ReasonForNoHCN, ReferralIdentifier, and RoutingOptions extensions 1.0.0 9/18/2024 Removed mustsupport and updated version numbers on these extensions
all profiles .meta element
The MustSupport flag on this element has been relaxed in this version until further confirmation of the use of meta.profile (outside of use for certain validation suites) and impact can be assessed by the working group. Please note that this relaxation is based on the IG Best Practices highlighted here of avoiding forcing the mustSupport constraint on .meta in profiles unless absolutely necessary.
all profiles .coding
Elements .coding.system and .coding.display have been relaxed, while the elements .coding and .coding.code will maintain their constraints as discussed within the eReferral interoperability working group, pending further discussion based on the mustSupport definition (TBC).

Terminology Updates

VALUE SET/CODE SYSTEM VERSION No. DATE SUMMARY OF CHANGE
All valueSets 9/18/2024 ValueSets were refined to include correct canonicals, with Canada Health Infoway owned codesystems created for each valueSet (with exception of human-language valueSet). Version numbers were removed
package/valueset-communication-barrier.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/communication-barrier until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-communication-category.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/communication-category until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-darc-dart-reasons.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/darc-dart-reason until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-ereferral-identifier-type.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes the code from http://ehealthontario.ca/fhir/CodeSystem/ereferral-identifier-type until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-human-language.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention
package/valueset-message-event-code.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/message-event-code until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-patient-contact-relationship.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from http://ehealthontario.ca/fhir/CodeSystem/patient-contact-relationship until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems. Note that these codes in particular may also evolve as part of the requirements for emergency contact relationship codes in the pan-Canadian Health Data Content Framework
package/valueset-task-business-status.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/task-business-status until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems
package/valueset-task-code.json 0.1 11/28/2023 Replaced eHealthOntario ValueSet Canonical with IGuide Canonical convention, still includes codes from https://ehealthontario.ca/fhir/CodeSystem/task-code until further feedback from the eReferral Interoperability Working Group is collected to address the impact of changing the code system on production systems

Known Issues

  1. Introduced virtualService extension derived from an R5 element within the Appointment profile. A separate extension will be created for it after balloting is completed. For now, please focus attention on the patterning and use of the Appointment resource and how virtualService fits into it.

Note: virtualService extension has been removed from the profile and this issue therefore is resolved.

Any known issues found within the guide will be documented in the section provided here in future iterations of this guide. To provide your questions or concerns please message Canada Health Infoway on: interoperability@infoway-inforoute.ca.