Prep Work for Friday's Canadian FHIR Baseline Profiling Workstream Meeting (2-3pm EST)

Hi Finnie,

I will be removing this project shortly.

Thanks,

Joel

Hi,

Is the following project still in use simplifier.net/canadianbaseline? If not, I recommend that it be removed so as not to be confused with the CA core that being is worked on by the community.

Thanks
Finnie

I think the keys to success / adoption are to:
- to provide useful profiles,
- get the word out so folks are aware that the profiles exist, and
- put a process in place to address the gaps and issues that will surface when folks start to use them.

A good starting point - the current effort underway - is to provide basic workable profiles that are reasonably compatible with solutions that have been adopted in the US and Canada, highlighting the things that we in Canada do differently (e.g. health card numbers, provider numbers, drug codes, etc.) so:
- Canadian and US vendors can build solutions that work in both markets,
- they are aware of Canadian requirements when building solutions, and
- they have a specification to follow when addressing our requirements.

Without a mandate, yes, jurisdictions/vendors/projects all have the freedom to ignore what others are doing, define their own solutions and, in turn, make themselves islands ... it begs the question of why they would use FHIR at all.

I agree that a mandate would be great but, would it make any difference without the keys above?

I totally agree with you Derek. But it will take greater minds than I to get all of the jurisdictions to agree. In the US, we basically have ONC pushing this and the big vendors are all on board. Unfortunately, the Canadian healthcare landscape actually makes this more difficult than in the US - which is a first!

lmckenzie wrote: The US work is certainly accelerated by the national rule declaration process. The regulatory levers (and comfort level around using them) obviously vary from place to place.

Lloyd, I think this is the key to success (or the key to failure... as the case may be). My sense is that we will need the FHIR CA-Core baseline to be signed-off and adopted by our jurisdictional partners. This would be market-making for the vendors. I fear if we do not achieve this jurisdictional consensus, however, it puts our goals of care delivery network-wide interoperability in dire jeopardy.

US Core/Argonaut has now been ongoing for about 4 years. In many ways, it was EHR-vendor led. They continue to identify new targets for work, come to consensus on specifications, coordinate testing and move things through the ballot process. Several other jurisdictions are following suit (using US Core as a starting point), including Australia, Russia, and a few others. So we're not alone in this path, and it's certainly a path that's recommended by both the communities and the larger EHR vendors. It also just generally makes sense. The key commonly supported elements for allergies, conditions, labs, etc. aren't that different from place to place or implementation to implementation. The tricky parts are agreeing on terminologies. However, if there's been significant standards/regulatory work in the country already, that helps. The US work is certainly accelerated by the national rule declaration process. The regulatory levers (and comfort level around using them) obviously vary from place to place.