FHIR Implementers Community Call - Nov 2023 - Notes & Recording

Hi all!

Thanks everyone for a great quarterly call today!

Please use this link to view the recording of the call:

As well, here are some notes from the session:

Updates:

Patient Summary Updates - Working Group Status

- Demo'd patient summary experience between patient ad provider at partnership conference
- PS working group has been on infocentral for a few years, but ramping up now – 200 plus members; infocentral.infoway-inforoute.ca/en/collaboration/wg/patient-summaries
- looking to get into a more formal balloting process for patient summary going
- Sheridan working on getting CI build up and running for patient summary; PS v1.1.0 - draft and minor release, going into content freeze in December
- Working toward alignment with data domains in the IPS
- Next week: BC Albert and ON to come together to talk about their implementation plans for PS; all have limited production release (LPR) plans for end of fiscal year
- Q: what's Infoway's recommendation on how jurisdictions share their specific requirements toward the pan Canadian working group? Do they submit their requirements from a province perspective? Or just proceed with making their own profiles that extend on the Canadian Patient Summary profiles?
- Announcements on how to get more involved from an engagement perspective will be going out in the next few days; also re: what should we do, just worth checking if there are contractual requirements

Implementation efforts in Ontario

- Focus on primary care patient summary; summary from primary care physicians into a repository; limited production release (LPR) focus is data-in, and building up that store of point-in-time patient summary snapshots
- Important to uniquely identify the patient summaries, and the authority under which it was submitted (which provider, which clinic, etc); this is critical for privacy, security, and determining who's submitting what
- Scenarios like multiple providers submitting summaries for the same patient
- Use of the data: obviously for cases like a discharge summary; but also great as a way to capture allergies, patient-reported meds; so it's a question of can these resources be captured and used by other entities to provide better and safer care?
- Whole other topic on the business and adoption side of this – will doctors and clinics actually use this?
- From BC: even getting all the clinic locations into a common registry has been a huge lift; let alone which providers work in which clinics
- Objective of getting 1:1 attachment of patients to providers, to help avoid complications of multiple entity relationships and the fluidity of who patients can see as their providers
- What's going to trigger a primary care patient summary leaving an EMR? Is it required that once a night the EMR sends patient summaries to the repositories? (looking like this, based on which patients were 'seen' that day)
- Vendors would love if we standardized on our architectures across provinces – do the working groups get into this? There's likely going to be some coordination occurring coming up in the working groups; currently it's more focused on the data model
- Different provinces will have some slight variations on what's most important in the profiles and the use cases

Partnership Conference

- Outstanding discussions, in terms of how we relate to our standards, our business policies, and how we implement them; without the business policies, it actually doesn't matter if we're doing the standards work
- Everyone has a technical standard for EMR data migration – the barriers are the business factors, less so the technical ones
- In Canada, we can solve technology, it's the adoption component that's hard; typically in data exchange, the value tends to accrue to the receiver of the data, less so the submitter
- Lots of vendor attendance; great to know what these larger projects like Patient Summary mean to specific vendors and smaller groups

Workstream Updates:

Canadian FHIR Baseline Profiles

- Currently using our weekly calls to review and resolve issues logged in the community issue log on the Simplifier view of the CA Baseline IG/profiles
- Main debate currently on the canonical URL, do we need to change it or not; decided to use the URL approach that the US Core went with, but we potentially should be using a different one (infoway doesn't own the hl7.ca/com); should hl7 affiliates use a different structure?
- Friday CA Baseline Call: ways that CA Baseline group can get more engaged in the CA Core profiles and progress and updates

SMART North

- Wanting to make the group a forum for sharing discussion about SMART on FHIR (SOF) use cases; want to make a library of tools and frameworks
- Started working on an IG and to document existing implementations of SOF in Canada as well; ideally it serves as an easy reference point
- Exploring advanced integrations and improved interoperability and functionalities; raised by BC's PHSA team
- Collaborating with other frameworks as well – Viewlet frameworks, trying to figure out how SOF and these other frameworks work or don't work together
- Wanting to dive deeper into architecture – do we need a sub-working group to align on architecture between provincial implementations and also different types of FHIR frameworks?
- Next steps: looking for iGuide contributors, figure out contextual launch issues

Unfortunately we didn't have time to hear updates on the eReferral workstream. If anyone from the eReferral workstream can comment, please feel free to reply in the thread with some updates!

Thanks again everyone!