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Clinical Interoperability Strategy
Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.
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Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.

About

LEADERS

Dr. Peter Rossos, CMIO, University Health Network & co-chair Clinical Interoperability Steering Committee
Lynne Zucker, Vice President, Clinical Systems Integration, Canada Health Infoway

Activity

Don Trotter joined a group
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Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.
Eric Savoie joined a group
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Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.
Nirav Naik joined a group
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Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.
Hi, I have created a FHIR tracker to add the following code system and value set URI for Health Canada Natural Product Number: - http://hl7.org/fhir/sid/ca-hc-npn - http://hl7.org/fhir/ValueSet/ca-hc-npn Here is the link to the tracker item: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13404: Finnie

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Forum

Health Canada - Natural Product Number (NPN) 05/12/17
Hi, I have created a FHIR tracker to add the following code system and value set URI for Health Canada Natural Product Number: - http://hl7.org/fhir/sid/ca-hc-npn - http://hl7.org/fhir/ValueSet/ca-hc-npn Here is the link to the tracker item...
U.S. ONC 2016 Interoperability Standards Advisory 01/06/16
Mike, we are completely in agreement. In fact, the vision for such a Canadian resource has been included in the Clinical Interoperability Action Plan. We are currently in the process of preparing for discovery and a plan. Input and insights are mos...
U.S. ONC 2016 Interoperability Standards Advisory 01/05/16
Cindie: Thanks for bringing the ONC Standards Advisory to our attention. The link you provided didn't work... here's the correct one: https://www.healthit.gov/standards-advisory/2016. To your question: should we do this in Canada?... I total...
U.S. ONC 2016 Interoperability Standards Advisory 01/05/16
Hi all, ONC has released a comprehensive guide of standards that might be of interest as a reference. (URL to document below) As noted in the document … “The Interoperability Standards Advisory is meant to serve at least the following purpose...
Help shape this year's Partnership program. How should clinical interoperability be featured? 07/21/15
The date is set and the Infoway Partnership Conference 2015 is planned for November 24th-25th in Vancouver, BC. Respond to this ..., or reply to this post to tell us your thoughts on how you’d like to see clinical interoperability featured at this ye...
Clinical Interoperability Action Plan Available for Public Comment 05/22/15
The Clinical Interoperability Action Plan, endorsed by the Pan-Canadian Clinical Interoperability Steering Committee, has been made available for public comment. Your feedback is needed to ensure the Action Plan captures the right elements needed...
Clinical Interoperability Action PLan 04/24/15
As co-chairs of the Clinical Interoperability Steering Committee, Peter and myself wanted to provide a quick update on the next major steps with the Clinical Interoperability Strategy that was finalized earlier this year. Over the past few month...
In the news today - WSJ 04/10/15
Dear friends: Although this process has been painfully slow at a national level we appear to be moving in the right direction. I look forward to our next meeting on April 22. Have a nice weekend, Peter Obama Administration Report Slams...
Welcome and Leader Updates 02/19/15
Thanks to all of you for committing to this important initiative to improve care and access for all Canadians. The Infoway team have done a wonderful job with InfoCentral. This is well beyond beta - congratulations! I am currently in the Infoway JOIN...
Welcome and Leader Updates 12/18/14
On behalf of Dr. Peter Rossos and myself, welcome to the Interoperability Strategy Community. We are the co-chairs of the Clinical Interoperability Steering Committee, the national group responsible for providing direction and advice for implementin...

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Video

Partnership 2014 - Accelerating Clinical Interoperability

Trevor Hodge, Executive Vice President, Canada Health Infoway, takes you on a guided tour of the clinical interoperability strategy and current implementation activities underway.

12/19/14

Solutions

  • FHIR Terminology Service API
  • HAPI FHIR
  • HAPI v2
  • HL7 Explorer
  • InfoRMS
  • InfoScribe
  • Message Builder
  • Message ReMixer
  • Object Identifiers (OIDs)
  • SNOMED CT Browser
  • Terminology Gateway
  • Terminology Service API
  • TermWorks

FHIR web services used to access terminology data

FHIR Terminology Service APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertize in the fine details of terminology.

terminology gateway APIFHIR Terminology Service API

Open source integration tools useful for health IT integration projects

HAPI FHIR® is a simple-but-powerful library for adding FHIR messaging to applications. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.

HAPI FHIR

 

External Solutions for API integration

Open source integration tools useful for health IT integration projects.

HAPI v2
 

HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform

HAPI FHIR
 

HAPI FHIR is a simple-but-powerful library for adding FHIR messaging to your application. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.

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Open source integration tool useful for health IT integration projects

HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform.

HAPI v2

Enhanced browsing of HL7 v3

Infoway HL7 Explorer is a powerful browser for HL7 v3 structures, vocabulary and references. Used in conjunction with the pan-Canadian releases, HL7 Explorer makes locating details and information more efficient.

Overview
 

Learn about what HL7 Explorer can do for you with this brief online presentation.

MR 02.06
 

HL7 Explorer applied to the MR 02.06 HL7 v3 maintenance release

CeRx 4.4.2
 

HL7 Explorer applied to the CeRx 4.4.2 HL7 v3 maintenance release

 

 

Standards versions available for viewing in HL7 Explorer

Standard URL 
CA MR 02.06 https://infocentral.infoway-inforoute.ca/extra/ca/mr0206-html/html/search.html
CA MR 02.05.01 https://infocentral.infoway-inforoute.ca/extra/ca/mr020501-html/html/start.html
CA MR 02.05 https://infocentral.infoway-inforoute.ca/extra/ca/mr0205-html/html/start.html
CA MR 02.04.03 https://infocentral.infoway-inforoute.ca/extra/ca/mr020403-html/html/start.html
CA CeRx 4.4.2 https://infocentral.infoway-inforoute.ca/extra/ca/cerx442-html/html/search.html
CA CeRx 4.4.1 https://infocentral.infoway-inforoute.ca/extra/ca/cerx441-html/html/start.html 
CA CeRx 4.4 https://infocentral.infoway-inforoute.ca/extra/ca/cerx44-html/html/start.html
BC V02R04 https://infocentral.infoway-inforoute.ca/extra/bc/v02r04-html/html/start.html
NS CeRx 4.3 https://infocentral.infoway-inforoute.ca/extra/ns/cerx43-html/html/start.html
NS R02.04.03 https://infocentral.infoway-inforoute.ca/extra/ns/r020403-html/html/start.html
AB MR2007 https://infocentral.infoway-inforoute.ca/extra/ab/mr2007-html/html/start.html
AB R02.04.03 https://infocentral.infoway-inforoute.ca/extra/ab/r020403-html/html/start.html
AB R02.04.00 SHR https://infocentral.infoway-inforoute.ca/extra/ab/r020400-shr-html/html/start.html
AB R02.04.03 Imm https://infocentral.infoway-inforoute.ca/extra/ab/r020403-imm-html/html/start.html

Request Management Solution

InfoRMS (Infoway Request Management System) is Infoway's Request for Change Tool for SNOMED CT, pCLOCD/LOINC, pan-Canadian Subsets and pan-Canadian HL7 artifacts. Not sure if you have access to InfoRMS? Manage your InfoRMS Access in your user profile.
SNOMED CT
 

Submit or follow requests to SNOMED CT

pCLOCD/LOINC
 

Submit or follow requests to pCLOCD/LOINC

pan-Canadian Subsets
 

Submit or follow requests to pan-Canadian Subsets

HL7
 

Follow requests to pan-Canadian HL7 messaging

 

infoscribeSupporting the Standards Selection Framework, InfoScribe enables teams to collaboratively create, discuss, and publish digital health solutions from clinical requirements to specifications. Featuring templates, versioning, PDF export, inline commenting and HL7 Explorer integration, InfoScribe improves productivity and accelerates the development of healthcare solutions.

Standards Selection Framework

The Standards Selection Framework provides users with the means to plan, choose and document interoperability solutions from concept through to implementation. Starting from the Clinical Requirements identified by clinicians through to business requirements, standards and technical specifications, the framework provides a comprehensive guide through the development of interoperability solutions.

The framework also provides an opportunity for the InfoCentral community to share successful implementation projects, the standards selections made at a point in time of the project and the specifications that result from the selections made. Publishing solutions in this space will help to establish a Canadian repository of references.

clinical requirements

Clinical Requirements describe the information and workflow needs of the clinician for a specific clinical context and clinical data exchange. Using the Clinical Interoperability Principles as a guide, a set of requirements expressed in the clinician’s voice will provide the foundation for a well-designed interoperability solution.

business requirements

Business Requirements are derived from clinical requirements and provide a full picture of the solution that needs to be developed. Use cases, business rules and guidance are used to fully outline the solution design.

standards selection

Standards Selection refers to the process that has been developed to help guide teams through the selection of terminology and messaging standards. Using the line of inquiry and considerations in the forms provided implementation teams may assess the standards available and determine the best option for the point in time. The process also provides an opportunity for the InfoCentral community to share successful implementation projects, promoting standardization through reuse.

standards

Standards are an integral piece of the interoperability solution, covering both the terminology that defines the data sent, and the messaging structures that define how the data is transferred. The framework provides the access and consideration criteria to the international and Canadian standards to facilitate implementation.

specifications

Specifications provide the details for the solution to be implemented. These details include: a review of the data elements used, samples of transferred messages, the system architecture as well as the security specifications including authorization and authentication.

Solution for API integration

Infoway Message Builder allows developers to focus on the business challenges of integrating their solutions with each electronic health record implementation by abstracting the differences between different versions of pan-Canadian HL7 messaging and supporting current implementation constraints. Developers can build interfaces in a familiar development environment, using the programming language of their choice*, while the Message Builder API fosters quick and easy creation, population and access to HL7v3 requests and responses.

Infoway Message Builder v2.0 and later is enhanced to generate JAVA APIs to create, validate, marshal/unmarshal CDA documents.

 Implementation and Exchange

 

Key features and benefits

Message Builder offers a number of key features and benefits:

  1. Abstracts the complexity of HL7v3 messages and greatly simplifies the work of the developer when implementing them;
  2. Reduces the impact on developers from implementation variations;
  3. Enables companies to achieve Infoway product certification with greater confidence and reduced time;
  4. Enables developers to incorporate future message versions without re-writing their products;
  5. Can be embedded in software applications due to its open source distribution under a commercial-friendly Apache 2.0 license.

Out of the box support

Infoway Message Builder comes with built-in runtime APIs that support a number of pan-Canadian specifications:

  • MR2009 (R02.04.02)
  • MR2007 (V02R02)
  • MR 2007 (V02R01)
  • CeRx (V01R04.3)

In addition, while developers can easily build custom transport mechanisms without affecting the core, Message Builder includes native support for SOAP and RESTful message transports. Developers can configure and extend the transport as desired.

Detailed product features

  • Provides the capability to configure and populate message values that are common to all messages—this allows developers to reuse common message data, shortening the time to configure and create an interoperable system.
  • Uses simplified data types that are natural and familiar to the programming language (e.g. String for ST) rather than directly exposing the sometimes complicated HL7v3 data types—yet still allowing access to HL7v3 data types when necessary.
  • Allows developers to focus on the business-aspect of a request/response, avoiding many of the complexities of HL7v3.
  • Code-generation algorithms merge identical and similar classes together to simplify the generated API—meaning less confusion in the resulting code and an increased ability to write generic handlers for certain types.
  • Converts populated objects into HL7v3 XML requests, and converts HL7v3 responses into populated objects.
  • Provides flexibility in configuring and performing terminology-code lookups, including code set and database-backed lookups (can mix and match).
  • Associations and attributes are strongly typed, given business names when provided, and contain code docs directly from the MIFs (see wiki.hl7.org/index.php?title=MIF).
  • The algorithms inline most classes that only have a small number of properties, further simplifying the API.
  • Offers both permissive and strict modes—permissive allows many common errors and generates appropriate error comments in the XML or result object.
  • A separate validation tool is provided to test ad-hoc messages—this tool reuses the same validation components that are executed during message marshaling and unmarshalling, ensuring consistent processing of the message whether during processing or during conformance validation.

Forward looking

The power of the Message Builder architecture is in its MIF-based generation of the specification API. With Message Builder, any MIF is supported—whether a future release of the pan-Canadian specifications or a modified (constrained) jurisdiction-specific release of an existing specification. 

 

How it works

Message Builder comprises two parts:

  1. Message Builder Generator—a tool used by Infoway to take input MIFs and create Message Sets for use by Message Builder Runtime;
  2. Message Builder Runtime—an API used by developers to allow their products to support multiple Message Sets without recoding.

Message Builder Generator

Used by Infoway, Message Builder Generator takes MIFs (as the source of truth for standards specifications) and converts them into a series of Java Classes. This is done by first converting the MIFs to an XML Message Set (a simplified representation of the information present in the original MIFs), then generating Java Classes that reference standard Java data types and use business-friendly names. In the process, groups of related elements are flattened and similar message parts are placed into a single class: these steps increase ease of use and reduce the complexity of the resulting Java Classes.

MBG process

Using Message Builder Generator, Infoway is able to create multiple Message Sets, each representing the MIFs used in a single jurisdiction, but all for the same HL7v3 version.

Message Builder Runtime

Message Builder Runtime allows developers to quickly adapt to implementations in multiple Jurisdictions: incoming messages are first examined to determine the corresponding source Message Set, once identified, a series of Java Objects that represent the message are instantiated. Next, the Java Objects are turned into an HL7 message for the HL7 version corresponding to the desired destination Message Set. 

MB process

Using Message Builder Runtime developers can accept messages over the wire and on-the-fly turn them into a different HL7 message version. Given the capability of Message Builder to support future versions of HL7 messages, developers can easily future proof their products with minimal effort.

*Developer friendly

The Message Builder libraries are available for Java and Microsoft .NET. In addition, a simplified XML message format is available with REST-based services for managing mapping to/from the simplified form to the target specification XML format.

 

CDA Support

Message Builder CDA API supports the following CDA and data type specifications:

Message Builder provides  JAVA and .NET APIs for CDA document creation, validation, marshalling/unmarshalling of the following CDA document types:

  • Continuity of Care Document (CCD) (Release 1.1)
  • Consultation Notes (Release 1.1)
  • Discharge Summary (Release 1.1)
  • Imaging Integration, and DICOM Diagnostic Imaging Reports (DIR) (Release 1)
  • History and Physical (H&P) (Release 1.1)
  • Operative Note (Release 1.1)
  • Progress Note (Release 1.1)
  • Procedure Note (Release 1)
  • Unstructured Documents (Release 1.1)
  • CDA documents using pan Canadian CDA header template

Clinical applications in JAVA or .NET can use the Message Builder CDA APIs to create, validate or parse above listed types of CDA documents. Potential use cases are document source or document consumer actors in IHE XDS profile, content creator/content consumer in any content module/profile, or report creator/viewer in RIS/PACS/EMR systems.

Message Builder is available for Java and .NET

Message Builder for Java

System Requirements

  • Java 1.5 or higher
  • Maven 3.0.3 or higher (can be removed after installing Message Builder if working with a non-Maven project)

Download

Message Builder is licensed under Apache License, Version 2.0. To use Message Builder, you will need

  1. Message Builder Core and
  2. one or more Message Builder API release(s)—depending on your implementation requirements.

Select a Message Builder Version:

 

Select one or more Message Builder API releases:

 

Optional Message Builder components:

Terminology Database Resolver
Message Builder Example

Message Builder pom.xml file:

 

Message Builder for .NET

System Requirements

  • .Net Framework 3.5 or higher

Download

Message Builder v2.1 for .NET

Message Builder is licensed under Apache License, Version 2.0. To use Message Builder:

  1. Download Message Builder .NET Core 2.1.0 setup
  2. Unzip and pull out the dll files that you need:
     \ → root location of required Message Builder core assemblies (Mandatory - required all)
     \releases\ → location of Message Builder release assemblies (Mandatory - choose one or more)
  3. Copy them to your .NET project 
  4. Download Message Builder .NET 3rd-Party libraries, unzip it, and copy the files to your .NET project

Message Builder v1.5.8.1 for .NET

Message Builder is licensed under Apache License, Version 2.0. To use Message Builder:

  1. Download Message Builder .NET Core 1.5.8.1 setup
  2. Unzip and pull out the dll files that you need:
     \ → root location of required Message Builder core assemblies (Mandatory - required all)
     \releases\ → location of Message Builder release assemblies (Mandatory - choose one or more)
  3. Copy them to your .NET project 
  4. Download Message Builder .NET 3rd-Party libraries, unzip it, and copy the files to your .NET project

Message Builder v1.4.6 for .NET

Message Builder is licensed under Apache License, Version 2.0. To use Message Builder, you will need

  1. Download Message Builder .NET Core 1.4.6 setup
  2. Unzip and run SetupCore.msi file
  3. Choose a installation location <install dir>.  The setup execution should place the following directories in <install dir>:
     \lib\ → location of required Message Builder core assemblies (Mandatory - required all)
      \releases\ → location of Message Builder release assemblies (Mandatory - choose one or more)
     \src\ → location of all source code and project files required to load them into visual studios
     \debug\ → location of debug symbol files
  4. Pull out files the dll files from the \lib\ and \releases\ folders, and copy them to your .NET project 
  5. Download Message Builder .NET 3rd-Party libraries, unzip it, and copy the files to your .NET project

Localization of pan-Canadian Standards

Infoway Message ReMixer is a web-based application that allows for the localization of pan-Canadian Standards (pCS) messages to meet jurisdictional requirements, all while maintaining the integrity of the original, standard message.

msg remixerAccess Message ReMixer Now

 Implementation and Exchange

Jurisdictional ReMixes

Pan-Canadian Standards use Object Identifiers (OIDs) to distinguish between objects by assigning a numeric string that enables other systems to understand the unique information that is being shared between various systems.

  • OIDs are intended to be globally unique and never re-used
  • OIDs in the pan-Canadian standards identify terminology code systems and are transmitted in HL7 messages
  • OIDS used to identify terminology subsets are not transmitted in HL7 messages, rather these OIDs are used for vocabulary maintenance and Terminology Services
  • OIDs are used to qualify local identifiers (e.g. patient identifiers) such that the combination of an OID (assigning authority) and a local identifier remains globally unique

Browse International and Canadian Content

SNOMED International's SNOMED CT browser allows users to browse and search the SNOMED CT International Edition to explore concepts and relationships. It also provides access to browse national extensions from SNOMED International member countries including the Canadian Edition of SNOMED CT in English and French.

snomed browser Browse SNOMED CT Now

 General Documentation

Browse, download and leverage the terminology used in Canada

Terminology Gateway is a web based solution framework that enables the distribution and sharing of terminology concepts, subsets and concept maps, making them available for web browsing, download or real time query.

terminology gatewayBrowse Terminology Gateway Now

RESTful web services used to browse terminology data

Terminology Service RESTful APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertise in the details of terminology.

terminology gateway APITerminology Service API

Apelon’s TermWorks is an easy-to-use data mapping solution which is provided by request for free to individuals who have Standards Access. It brings powerful terminology capabilities directly to the desktop. TermWorks combines Microsoft® Excel® spreadsheet software with web services-based terminology processing to give organizations comprehensive mapping capability to SNOMED CT and the Canadian Edition of SNOMED CT.

 Education

  • Introduction to SNOMED CT (English)
  • Introduction to SNOMED CT (French)
  • This email address is being protected from spambots. You need JavaScript enabled to view it.

Web Conference

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Members

Gina DeBenedetti
Canada Health Infoway
OFFLINE
Contact
Linda Monico
Canada Health Infoway
OFFLINE
Admin
Tasha Shaw-Verbic
Canada Health Infoway
ONLINE
Admin
Don Trotter
Mobia Innovation Technologies
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Member
Eric Savoie
xrad technologie / Ministère de la santé et services sociaux du Québec
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Nirav Naik
William Osler Health System
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Lucinda Brown
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Douglas Kingsford
Interior Health Authority
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Dennis Cabel
Providence Healthcare
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CECIL SNYDER
N/A
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Cindy Cornish
Canada Health Infoway
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Kathryn Hannah
Canadian Nurses Association
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Ré Keams
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Michelle Mula
eHealth Saskatchewan
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Jennifer MacKinnon
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