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Overview

Technical Background

This section provides guidance on how to apply specific IHE Integration Profiles and pan-Canadian Interoperability Specifications to address interoperability needs pertaining to the Patient Summary-CA use cases. It defines the interoperability landscape and outlines the rules of engagement to support the development of interconnected solutions to safely exchange Patient Summaries.

For more information on core IHE Profiles and specific Canadian implementation guidance, refer to the Reference Architecture available here.

The main patterns leveraged for implementing the Patient Summary-CA use cases, that are further described in detail throughout the technical sections, are:

• Mobile Access to Health Documents (MHD)
  • IHE Integration Profile Document Sharing using FHIR, that leverages the document content and format-agnostic metadata concepts
• Canadian FHIR Exchange (CA:FeX)
  • Pan-Canadian FHIR Data and Document Exchange Specification, that serves as the primary entry point for the standard exchange of FHIR data and documents.
• Pan-Canadian Shareable Health Links (CA:SHL)
  • Canadian Interoperability Specification, that leverages shareable links often converted in a QR code format, enabling patient-mediated sharing of heath data.

In addition to the primary implementation patterns described above, there is also relevant international guidance that focuses on how Patient Summary documents may be handled by receiving systems once they have been retrieved.

• IHE Sharing of IPS (sIPS) Profile : The sIPS Profile describes three options a Content Consumer actor may implement:

  • View Option: Render and display the document for clinical use

  • Document Import Option: Provide access and import the entire document and manage it as part of the patient record

  • Discrete Data Import Option: Provide access and import discrete data from selected sections of the document and manage them as part of the patient record

This guidance is complementary to CA:FeX. CA:FeX defines how the Patient Summary is generated and exchanged using FHIR APIs, while sIPS provides guidance on how a received Patient Summary document may be processed and used by consuming systems, addressing an area where this specification does not currently provide detailed guidance. sIPS does not replace CA:FeX; rather, it offers an emerging international baseline for consumer processing capabilities. Use of sIPS is not required for conformance to this specification, and content and conformance requirements for the PS-CA are defined by this specification. As the PS-CA specification continues to evolve, this guidance may be reviewed to reflect changes in consumer capability requirements and international alignment.

The transactions patterns presented above represent initial options to implement the Patient Summary use cases and are expected to evolve as we hear from the implementer community, and use cases are refined and added.