Install instructions
To install the command line tool, download Firely Terminal
For using npm with FHIR packages, read more here
Release notes

Change requests and updates to support jurisdictions undergoing limited production roll-outs of patient summary in Canada:

  • IGuide version clean up to host all current and historical versions of PS-CA as a table on the home page
  • Introduce emptyReason into Composition in alignment with choice in IPS to offer an alternative to psuedo resources
  • Updated Terminology Approach to call out new conventions for emptyReason and the use of AdditionalBinding extension (replacing previous terminology slicing approach)
  • Introduced new stub valueSet for HC-CCDD indicating new canonical URI for the preferred code system (, Updated Stub ValueSet for NPN to include new canonical URI for the preferred code system (
  • Introduced new stub valueSet for pCLOCD with notation on new lab profiles regarding future development of constrained valueSets Added Observation Results (Laboratory), Observation Results (Pathology), Observation Results (Radiology), DiagnosticReport profiles
  • Corrected cardinality on Composition.subject to a minimum of 1. Technical correction added into IPS and PS-CA that aligned to existing expectations
  • Relaxed cardinality on Patient.Gender to align with IPS and jurisdictional needs
  • Relaxed cardinality on Condition.clinicalStatus (maintaining MS flag) to accomodate R4 deficiency in valueSet not allowing an unknown option to accomodate legacy date
  • Updated Exchanging Patient Summaries to call out new CA:FeX version that can be leveraged
  • Updated the Known Issues & Future Development page to introduce temporary issue rendering additionalBinding extensions, as well as to reflect changes made to close known issues and provide to provide linkage to closed issues in previous PS-CA guides

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