Ontario eReferral – eConsult – HL7® FHIR® Implementation Guide
The Ontario eReferral – eConsult FHIR Implementation Guide provides directions for the electronic transfer of referral and consult information between healthcare providers for use in Ontario. The Implementation Guide provides the business context, use cases, and information flows that are specific to the emerging Ontario eReferral ecosystem. The Implementation Guide is expected to be generic enough to support various electronic referral and consult pathways, such as Primary Care Provider to Home and Community Care.
The Ontario eReferral – eConsult FHIR Implementation Guide covers the referral patterns for various pathways such as an EMR integration with a Home to Community Care Solution, Primary Care to Home and Community Care, Acute Care, etc. The Implementation Guide also incorporates the eConsult pathway where cases can be submitted to a managed specialty, directly to a specialist, or to a managed group.
This implementation guide describes the business considerations and implementation details for enabling interoperability between two referral systems to initiate and manage an electronic referral as well as an electronic consult.
In addition to the health care provisioning workflows associated with the eReferral and eConsult use cases, the Ontario eReferral – eConsult FHIR implementation guide includes specific recommendations in support of eReferral payload contributions to analytical repositories for health system planning purposes.
The following patterns have been provided in this release of the implementation guide to facilitate referral and consult workflows:
- SMART on FHIR messaging pattern where a Referral Management System (RMS) is directly launched in a clinician’s Point of Service (POS) system and enables users to complete the initial eReferral request, including the initial appointment date and time; or
- Direct messaging where two RMSs exchange referral messages (e.g., initial eReferral request, appointment updates, communications and notifications) via FHIR-based API interfaces.
- RESTFul FHIR API for systems wishing to conform to the RESTful FHIR API requirements. The focus is on the expected use of FHIR's RESTful API to support the exchange of information with a Referral Management System (RMS).
This implementation guide is for trial use and will go through a formal governance committee review and approval process.
The provincial open review starts September 29 and runs to November 23, 2022. Download the comment spreadsheet to provide feedback.
FHIR is an evolving trial-for-use standard, so additional changes by HL7 are expected. We will continue to monitor developments and assess any potential impacts and publish updates as they emerge.
*SIMPLIFIER.NET is a web-based FHIR registry built by Firely that serves as the hosting platform for the Canadian FHIR Registry sponsored by Canada Health Infoway