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Clinical Interoperability Strategy
Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.
Membres: 185
Personne-ressource: Lisa Hayes
Administration: Linda Monico
Type: Ouvert
Accès: Public
Referencing strategic materials, to discuss the five perspectives and opportunities for action, and contribute viewpoints and insights.

À propos de nous


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


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current status of clinical interoperability 2018 04/12/18
Clinical interoperabiity has become a hot topic. There seems to be a growing awareness and concern about the difficulties that are a daily occurrence for providers. The frustrations related to the time and effort that is still required to exchange cl...
Looking to Estonia 04/12/18
I can see that there would be resistance as they are based on proprietary solutions and approaches. I think that the countries where this work, there is a commitment to open source and open standards. Ultimately, I don't know that there is another w...
Looking to Estonia 04/12/18
Interesting how some countries are forging ahead. Interoperabilty has become a hot topic but there seems to be a lot of resistance from the EMR vendors.
Looking to Estonia 04/05/18
I'm curious as to why there is so little about what is happening in jurisdictions like Estonia. I found this resource in your site
' 07/25/17
U.S. ONC 2016 Interoperability Standards Advisory 07/04/17
Hi Lesley, Thanks for taking the time to ask the question. Getting started in any industry is a challenge not to mention the complexity health information technology brings. You are correct, you are replying to a significantly dated post. There ar...
U.S. ONC 2016 Interoperability Standards Advisory 07/01/17
Hello All, I am obviously very late to the discussion, being that I just joined, but I'm interested to hear if any progress had been made on this front. My two cents are that this would be a fantastic resource. I'm currently an HIM student and a d...
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: - - 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: 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...



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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.



  • Object Identifier (OID)
  • WebHook Notifications
  • Canadian URI Registry
  • TermWorks
  • Registre FHIR Canadien
  • Terminology Gateway
  • HAPI v2
  • Message ReMixer
  • Terminology Service API
  • SNOMED CT Browser
  • FHIR Terminology Service API
  • HL7 Explorer
  • Message Builder
  • InfoRMS

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.

Canada Health Infoway has an arrangement in place with HL7 International that allows Infoway to submit OIDs to HL7 International on behalf of Canadian Implementers free of charge. There is a $250 USD fee per OID request if done directly with HL7 International.

To submit an OID, download the registration form that corresponds to your OID request. Email the completed form to Cette adresse courriel est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. for all Non-jurisdictional and Infoway owned subsets. All other requests must be sent to Jurisdictional Representatives for OIDs following these guidelines listed:

  1. Jurisdictional Teams will require 5-7 business days to process each request. It will be incumbent on the requestor to reply within this time frame to any questions or make any follow ups as required. Any failure to do so will result in an automatic rejection and require resubmitting the request.

  2. The Requestor must post the OID Requests on the following forums ONLY after consulting with the Jurisdiction/Infoway SME:

    a. HL7 International and FHIR Implementation WG (Jurisdictional/Non-Jurisdictional OID Requests)
    b. Public Health Surveillance and Health Terminologies (Subset OID Requests)

  3. Forum posts shall have the following format:

    Subject: New Namespace/CodeSystem/Subset OID Request
    • OID Description: “A description of the OID”
    • OID Symbolic name: Symbolic name guidelines
    • Responsible Body & Contact Information
    • Proposed FHIR URI: URI as per URI Guidelines
    • To be published: Canadian URI Registry/Terminology Gateway

  4. There will be a wait period of 5 business days for the communities to react to the forum post with comments, questions or asks for clarification.

  5. FHIR URIs must be proposed for all Jurisdictional and Non-jurisdictional OID requests according to the URI Guidelines and must be published in the Canadian URI Registry. Publishing the URI is an optional but highly recommended step. The requestor will submit a validated FHIR® NamingSystem resource object based on the NamingSystem profile to their jurisdictional representative who will then upload it.

  6. FHIR URIs must not be proposed for Subsets to be published on the Terminology Gateway as they will be generated automatically.

  7. The Forum post will be updated with the new OID.

Automated notifications of new content in Terminology Gateway

A WebHook is an HTTP callback. When new content is published in the Terminology Gateway, a publishing event will be POSTed to each registered WebHook, notifying their respective owners about the publication.

WebHook registration

Individual users can register for WebHook notifications by sending an email to: Cette adresse courriel est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. and specifying the WebHook endpoint. Upon registration, a unique api_id will be assigned to the WebHook. Each notification POSTed by the Terminology Gateway will contain the api_id, allowing the endpoint to verify that the notification was indeed issued by the Terminology Gateway. The api_id must be echoed back by the WebHook endpoint in the body of the notification response.

WebHook interface

The WebHook endpoint must serve HTTP requests conforming to the following interface:

HTTP Request

  "api_id": "cb570e5a2748f349f9119431db836b3a23fdb6571afee34c0432d87220f2431b",
  "base_url": "",
  "notification_time": "2017110711:07:00",
  "targets": [
      "id": "2.16.840.1.113883.",
      "name": "Canadian Clinical Drug Data Set (CCDD)",
      "type": "package",
      "version": "20171016",
      "effective_date": "20171016",
      "publication_time": "2017103015:20:23",
      "message": "Monthly CCDD update for October 2017"
      "id": "2.16.840.1.113883.",
      "name": "PrescribeIT",
      "type": "package",
      "version": "LPR2",
      "effective_date": "20171103",
      "publication_time": "2017110309:37:22",
      "message": "PrescriptionMedicinalCode version reflecting the October 2017 CCDD update"
  • api_id: as previously mentioned, each notification POST contains the api_id granted at registration.
  • base_url: the base URL for the native REST API endpoint of the originating system. This can be used to call back the Terminology Gateway via APIs in order to programmatically download updated content.
  • notification_time: the timestamp of the WebHook notification in yyyyMMddHH:mm:ss format.
  • targets: list of updated targets. Each entry in this array corresponds to a Terminology Gateway artifact (subset, codesystem, map, package) that was updated and is therefore subject to the notification. The target list will only include artifacts for which the user has registered to receive notifications. Users can register to receive notifications about content updates using the Terminology Gateway User Interface or by invoking the native REST APIs.

    Each of the notification targets contains the following fields:
    • id: the artifact id, typically an OID
    • name: the artifact name
    • type: the artifact type: subset, codesystem, package or map
    • version: the published version id
    • effective_date: the effective date associated to the artifact version, in yyyyMMdd format
    • publication_time: the publication time in yyyyMMddHH:mm:ss format
    • message: optional message describing the published artifact version

HTTP Request

HTTP Response code: 200 for success, any other response code will be interpreted as an error
Sample HTTP Response Body:

  "api_id": "cb570e5a2748f349f9119431db836b3a23fdb6571afee34c0432d87220f2431b",
  "result": "success",
  "message": "Successful processing of the WebHook notification"
  • api_id: as previously mentioned, each notification response must echo back the api_id granted at registration.
  • result: success if the web hook notification was successful, any other value will be interpreted as an error.
  • message: optional response message.

Error handling

When receiving an error as a result of a WebHook notification, the Terminology Gateway will retry the notification four times at 15 minutes intervals. If still unsuccessful after four notification attempts, the system will drop the notification and will notify the user by email that the WebHook couldn't be invoked.

Sample code

Demo code for a sample WebHook endpoint can be found here:

Le registre canadien d'identificateurs uniformes de ressources (URI) a été créé pour regrouper l'information concernant les espaces de noms des identificateurs et des systèmes de codes. L'utilisation des ressources NamingSystem de FHIR® rend la saisie des métadonnées propice à la consultation et au traitement informatique. Elle permet aussi le mappage bidirectionnel automatique entre les identificateurs d'objets (OID) et les URI.

Afin de rendre la recherche de ces artéfacts plus souple, le registre d'URI canadien (alpha) permet d'effectuer des recherches via du texte en clair, des OID ou des URI. Les identificateurs URI sont créés à l'aide des lignes directrices URI et affichés sur la page du groupe de travail sur l'architecture de solutions FHIR en vue d'être approuvés.

Tous les artéfacts NamingSystem sont organisés par le Canadian URI Project dans Simplifier et peuvent faire l’objet de recherches après une période de 20 minutes.

Consultez le registre d’URI canadien(alpha)

Apelon’s TermWorks is an easy-to-use data mapping solution that is provided by request (free of charge) 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.


knowing Learn More

  • Cette adresse courriel est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.
  • SNOMED CT Education
  • Apelon User Guide
  • Infoway User Installation Guide
  • How does TermWorks Work?
  • TermWorks FAQs

The Canadian FHIR® Registry supports collaborative development in an effort to accelerate sustainable growth of FHIR, locally and internationally. The registry will be the home of national FHIR profiles recommended for use in Canada, including extensions, value sets, URIs and other useful, commonly used components. It is also host to a growing number of national, jurisdictional and locally shared FHIR projects, and is open to all Canadian implementers.

The Canadian FHIR Registry offers:

  • seamless integration of profile editing using Forge (free FHIR profile editor)
  • designated project space
  • supports project teams of up to 100 individuals
  • online authoring of implementation guides
  • integration with source control tools such as GitHub
  • version controlled environment

The Canadian FHIR Registry blends software development best practices with the requirements of modelling in FHIR, essential to delivering successful project requirements while having continuous access to structure validation, rendering and publishing.

All project artifacts are backed up weekly, on Sunday nights. Each snapshot will be retained for 10 days. The project owner can request an as-is snapshot containing all the necessary artifacts such as text, xml, json, md and image files by contacting Cette adresse courriel est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser..

Organization projects can be viewed without logging in. To edit or request a new project, Cette adresse courriel est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser. with the details.

View projects in the Canadian FHIR Registry

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

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.


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

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


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

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


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.

In November 2017, the Canadian HL7 InfoCentral community determined that there was no longer any need to do further updates to the pan-Canadian Version 3 messages. As a result, the December 2012 releases of MR02.06.01 and CeRx 4.4.2 are the latest pan-Canadian publications of these standardized messages.

The HL7 Explorer, the Master Terminology Worksheet (MTW) and all other messaging related artifacts are aligned with the latest releases.


Learn about the features HL7 Explorer: search once, graphical representation, quick hints, etc.

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
CA MR 02.05.01
CA MR 02.05
CA MR 02.04.03
CA CeRx 4.4.2
CA CeRx 4.4.1 
CA CeRx 4.4
BC V02R04
NS CeRx 4.3
NS R02.04.03
AB MR2007
AB R02.04.03
AB R02.04.00 SHR
AB R02.04.03 Imm

Solution for API integration

Infoway Message Builder allows developers to focus on their business problem by providing APIs that foster quick and easy creation, population and access to HL7v3 requests and responses and CDA documents.

 Implementation and Exchange

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.



External Solutions for API integration

Open source integration tools 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 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.

Request Management Solution

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

Prior to submitting a SNOMED CT request, it is the requestor's responsibility to:

  1. Validate that the content does not exist in either the International or Canadian editions of SNOMED CT
  2. Comply with the appropriate Editorial Guidelines

Submit or follow requests to SNOMED CT


Prior to submitting a pCLOCD/LOINC request, it is the requestor's responsibility to:

  1. Validate that the content does not exist in LOINC or the pCLOCD
  2. Comply with Regenstrief Editorial Guidelines (note: login required)

Submit or follow requests to pCLOCD/LOINC

pan-Canadian Subsets

Prior to submitting a Subset request, it is the requestor's responsibility to:

  1. Validate the content against the subsets in Terminology Gateway
  2. Comply with the appropriate proper terminology Editorial Guidelines

Submit or follow requests to pan-Canadian Subsets


Conférence Web

Veuillez ouvrir une session pour accéder à la conférence web d'InfoCentral.


Lisa Hayes
Canada Health Infoway
Linda Monico
Canada Health Infoway
Monica Hazra
Oleksandra Nepyyvoda
Kathleen McCaffrey
Interior Health
Deepti Razdan
Parul Sinha
Philippe Després
Université Laval/CHU de Québec
Alvy Hou
Ryerson U
Christine Probst
Hamilton Health Sciences
Melvy Sanchez
Ken Martin
Anisha Girn
Melissa Mercier
Pratique Privée
Linda Parisien
Canada Health Infoway
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