DRAFT - ESC
The current CPhA Pharmacy Claim Standard (CPhAPCS) Standard was developed to
provide orderly and efficient online processing of prescription drug claims. As drug
benefits and pharmacy services have evolved, so must the Pharmacy Claims Standard
In 2022, the PCS started a modernization and update process to ensure that it
continues to meet the needs of all users. In reaching this goal, the intent of the Standard
is to support the needs of as wide a base of potential users as possible, while being
flexible enough to change as needs and technology change and to provide simple and
easy implementation. Starting in 2023, the Canadian FHIR Pharmacy Claims Standard
(FHIR PCS) will begin to replace the existing standard.
The FHIR PCS a joint partnership by the Canadian Pharmacists Association,
Neighbourhood Pharmacies Association of Canada and Canadian Life and Health
Insurance Association and is governed by a Steering Committee comprised of
representatives from each partner organizations.
Objectives of the Canadian FHIR PCS:
- To provide a simplified and common claim format for all carriers to use. The goal is to provide real-time claims processing (data collection and payment) through a single device in the pharmacy which will link to all potential networks and carriers with which the community pharmacist may communicate, while avoiding double keying of information.
- Facilitate data/information transmission required by federal, provincial or territorial regulations related to drug and pharmacy service utilization
- Address gaps in clinical data in the current standard for the benefit of providers and payers
- Minimize the need for additional standards, reporting solutions etc.
Stakeholders -do we wish to include?
The following core members of the ESC and TSC have participated in the development of the FHIR standard: ???? do we want this??
CPHA CLHIA Neighbourhood Pharmacies Shoppers Drug Mart ESI Canada TELUS Kroll Pharmacy Systems