Question

Thanks for mentioning the Standards Knowledge Management Tool, Peter. That is a great resource for definitions and also as a reference for many standards in digital health and health informatics. And it demonstrates the challenges we have with definitions and terms. It is accessible here - www.skmtglossary.org/

Fortunately for us, the SKMT narrows it down to 21 terms, 49 definitions and 30 parts.

I recall on being on a committee with Peter Schloeffel and Sam Heard back in 2003 with ISO TC 215 where we came up with a definition of the EHR. In our discussions there were different ideas expressed as to what an EHR should be. After a while it was realized that when looking up definitions of words in any good dictionary in many cases there will be multiple definitions that vary depending on the context of where that word is to be used.

docplayer.net/1226080-Ehr-definition-scope-context-sam-heard-for-peter-schloeffel-iso-tc-215-wg1-aarhus-denmark-3-oct-2003.html

Ray

Thank you for this information! Would you have a link to some information regarding why Canada does not exchange PHI internationally that I could cite in my research paper?

Hi Stephanie,

As far as we know, Canada currently does not share EHR-related data outside of Canada. However, enablers, particularly, standards are available for this to happen. Some examples of standards (which have varying levels of implementations within Canada) that would enable these are:

• HL7 data exchange standards including its various flavours (e.g. V2, V3, FHIR)
• Terminologies/code systems (e.g. SNOMED CT, ICD, LOINC, etc.)
• ISO/TC215 IPS/International Patient Summary
• ISO/HL7 Electronic Health Records-System Functional Model, Release 2 (EHR FM)
• ISO/TC215 IDMP/Identification of Medicinal Products
• Other ISO standards including country codes, language codes, etc.

While standards are great enablers of data sharing outside Canada, other enablers need to be in place for this to happen including legislation, policy, regulations and technical infrastructure.

For info on what standards are in used in Canada, please see the following:
• infocentral.infoway-inforoute.ca/en/standards/standards-in-canada
• infocentral.infoway-inforoute.ca/en/standards/canadian

Additionally, you may also want to look at:

• recently published whitepaper (2020) on interoperability in various countries including Canada from the Global Digital Health Partnership (GHDP) gdhp.org/assets/pdf/WhitePapers2020/GDHP-Interop-Final.pdf
• recently published document (2020) by JIC (Joint Initiative Council comprising several SDO (standards development organizations)) on setting the stage for the future – enabling the digital transformation of healthcare www.jointinitiativecouncil.org/images/pdf/jic.setting.the.stage.for.the.future.pdf
• report published by Infoway on benefits of connected health information in Canada (2018) www.infoway-inforoute.ca/en/component/edocman/resources/reports/benefits-evaluation/3510-connected-health-information-in-canada-a-benefits-evaluation-study-document?Itemid=101

Hope this helps.

PS: We’ll be happy to speak with you should you be interested.

ISO TC 215 Canadian Leadership:
Elizabeth
Finnie
Bev
Don

Hi Iryna,

It just means that different organizations, communities, etc. use different definitions of "EHR".

Cheers,
Katie