Canadian FHIR Baseline Profiles - Draft Vision, Scope, Principles - for Review and Feedback

The US Core profiles aren't targeted to any specific clinical use-cases beyond "share information". They're designed to be generally use-case agnostic. I was expecting the CA Core profiles would be similarly generic. Specific use-cases would likely introduce needs for additional elements and/or impose expectations on what operations would be supported. This can and should be done through additional implementation guides that build on the foundation of the CA Core (just as numerous IGs are now beginning to depend on the US and AU Core profiles). The clinical scope tends to be driven by a combination of "what can we expect pretty much all systems to be able to expose?" and "what's the minimum needed to do anything clinically and computably useful with this resource?".

Thanks Lloyd. I believe that the use cases you cited are more technical in nature: I am asking about the actual clinical use cases that are in scope for this specification.

I brought this work item to the Health Terminologies community this morning (April 16) and there was a great deal of interest in finding ways to have that community provide some support and guidance as it relates to standardized data elements and definitions, the selection of the most appropriate code systems and value set members as they pertain to the clinical use cases.

Let’s keep this in mind so we can figure out the best way and the right time to leverage these terminology experts to support this work.

Everyone agrees that this is really important work.

Have a great evening everyone.

Regards,

Andrea

The biggest difference between healthcare in the U.S. and Canada is who pays - and US Core and the draft CA Core profiles don't really get into that at all.

Key use-cases for these profiles:

• common baseline to support SMART on FHIR, CDS Hooks and Apple interface implementations in Canada
• lowest common denominator that developers of other types of apps and other FHIR clients should be able to count on when accessing data from EHRs, HISs and jurisdictional repositories that provide FHIR interfaces
• standardize common, key/high value clinical data that is relevant for most patients, including standardizing terminologies where possible
• expectation is that it should be 'reasonable' for all systems and jurisdictions to expose their data in a manner that complies with the profiles, though timelines for doing so (and willingness to do so) may vary

Michael this is a great discussion document. Lots of great comments from eHealth Ontario (Ken and Sue), Derek (our IHE Canada Liaison) , Lloyd and Tibi.

As discussed on the teleconference last Friday, I think it would be great to add to the scope statement the actual problem we are trying to solve, and really understand the clinical and business requirements of that use case. I agree that we do not want to deviate from the US Core if we can avoid it, as their vendors are our vendors, but their use cases and health system are so different from ours, so I think keeping our core clinical and business use cases front of mind is really important.

As Ken pointed out, there is lots of material now in the Canadian FHIR registry to review and leverage that gives us a pretty good idea of what people are using in their specifications now and they are all publicly available: simplifier.net/organization/canadianfhirregistry

Ron Parker had some of the folks at HL7 International present to the HL7 Canada Community about this earlier this year and they are using FHIR for this as well. (hl7.org/fhir/uv/ips/2018May/index.html), and of course, there is the work that Australia recently published.

No shortage of materials to inform the way.

Great work everyone and Michael thanks for the leadership to date. This is a really important discussion.

It is my hope that by responding to your post, more people will weigh in and express their point of view.

Thank you.

Regards,

Andrea

Hi all,

Based on discussion from the previous meeting, I've put together a short document which is intended to represent the vision, scope (particulars still TBD), and principles for the profiling work going forward. If time permits, please review; and any comments/feedback you can offer is greatly appreciated! Some time has been set aside for Friday's meeting to discuss if needed.

docs.google.com/presentation/d/1w98EOZh1ZDfyJfF6V6Jav7xyIXQ25NgyJQNZjTGTsuQ/edit?usp=sharing

Thank you!