Releases of the PS-CA Implementation Guide may be found on a table on the Home Page of this Project.
Jurisdictional Context
Alignment to Work Underway with Jurisdictions
Some jurisdictions may already be working on their own jurisdictional content. Both PS-CA and jurisdictional content should be informed by the same high-level principles from the Pan-Canadian Coordinating Table.
Jurisdictional content is expected to meet the minimum expectations outlined in the PS-CA specification, this ensures that all implementors across the country are building from thesame foundational data model (leading to economies of scale with vendors). With this approach, customizations and differences across jurisdictions are minimized to only implementation specific details (e.g., tighter constraints on elements that support specific integration requirements from jurisdictional health assets).
In the cases where jurisdictions have begun profiling work, the PS-CA specification development team has worked collaboratively with the jurisdiction to compare the specifications, align where appropriate, and identify any areas that need to be relaxed in the national profile, or resolved further through the international specification. Jurisdictional content developed after the initial draft of the PS-CA is published is expected to align to the minimum expectations outlined in the PS-CA specification and ideally directly derive from the profiles in the PS-CA FHIR® package.
Differences between the PS-CA and Jurisdictional Content
Jurisdictional content will never break the expectations of this specification, meaning it is never expected to have looser constraints than those put forth the PS-CA. Rather any additional constraints put forth through jurisdictional content are expected to be the result of tightening of the expectations outlined in PS-CA (e.g., applying a Must Support flag to an element that is noted for tightening in future releases but is currently lacking support from a number of participating jurisdictions at the pan-Canadian level).
Additionally, some jurisdictions may also apply constraints on elements specifically needed for integration with their existing digital health assets (e.g., additional provider identity requirements to leverage an existing digital health asset integration).
Understanding the scope of the jurisdictional content also plays a critical role in understanding the differences between the two types of content. Additional expectations outlined in the jurisdictional content that has been developed to date solely reflect the expectations for systems generating, storing, and transmitting summaries produced within that jurisdiction. These additional expectations have not been scoped to apply to summaries received from other jurisdictions, and therefore should not be interpreted as such.
Additional guidance will be provided on interpreting jurisdictional constraints as jurisdictions move to support intra-jurisdictional and international exchange of patient summaries in later releases.
Jurisdictional Patient Summary Content
Jurisdictional details may be hosted in a jurisdictional guide or project space. In cases where a jurisdiction is starting to surface implementation details through derived profiles - those derived profiles can be found in their project space and have been rendered below (through packaging) for reader convenience.
Implementers are encouraged to review the additional constraints, localizations, and implementation details published by jurisdictions.
Ontario Implementation Details
The Ontario Patient Summary is based on the International Patient Summary standard and was developed in collaboration with Canada Health Infoway and other jurisdictions and with preliminary input from primary care clinicians and solution vendors.
The Ontario Patient Summary (PS-ON) Standard aligns, where applicable, to the International Patient Summary (IPS) HL7 FHIR standard, the Pan-Canadian Patient Summary (PS-CA) Standard (under concurrent development), and the Canadian Baseline (CA-Baseline).
Notably, the PS-ON Standard is scoped for patient summaries generated, stored, and transmitted within Ontario. This is in contrast to the PS-CA Standard, which is intended to support intra-jurisdictional use, cross-jurisdictional use, and cross-border use. This difference in scope is the root of most of the variances between PS-CA and PS-ON.
Implementers are encouraged to review the Ontario Patient Summary FHIR Implementation Guide to learn more about the relationship between the specifications and to review details regarding Patient Summary implementation in Ontario.
Ontario Patient Summary FHIR Implementation Guide
Alberta Implementation Details
The Alberta Patient Summary (PS-AB) is based on the Pan-Canadian Patient Summary (PS-CA) Standard, and the Canadian Baseline (CA-Baseline). It was developed in collaboration with Canada Health Infoway and with input from Alberta clinicians and solution vendors. The PS-AB attempts to profile in a way that allows the Patient Summary instances to be conformant to PS-CA, and CA-Baseline without having to formally derive from the profiles in these specifications. Alberta is in the process of developing implementation details to provide to their implementers.
Implementers are encouraged to review the Alberta Patient Summary space to read about the additional constraints, localizations, and implementation details published by jurisdictions.
Alberta Patient Summary FHIR Implementation Guide
British Columbia Implementation Details
The PS-CA: BC Implementation Guide leverages foundational artifacts from PS-CA, including BC-specific guidance tailored to provincial healthcare needs. For Release 1, national artifacts are utilized, with the potential to build on PS-CA profiles for BC-specific needs in future releases. BC Providers in community/clinic settings have not historically shared information digitally outside of their settings. As a result, the BC requirements are expected to evolve as clinicians become more comfortable with sharing of information and of the clinician requirements of a Patient Summary.
Implementers are encouraged to review the British Columbia Implementation Guide to read about the additional constraints, localizations, and implementation details published by jurisdictions.
British Columbia Patient Summary FHIR Implementation Guide
New Brunswick Implementation Details
The PS-CA: NB implementation leverages foundational artifacts from PS-CA, without creating a separate implementation guide. While there are some variances between PS-CA and NB implementation, the goal is to fully align. The initial NB Patient Summary release focuses on requirements outlined by NB clinicians, a subset of data from MyHealth Records, and the Patient Mediated Access use case using the CA:SHL profile. To read more about the PS-CA:NB implementation, visit MyHealthNB Patient Summary Overview
This guide will continue to be updated as additional jurisdictions adopt the content present in this guide.