Ontario eReferral – eConsult – HL7® FHIR® Implementation Guide

Scope

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, Central Intake Hub 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.

The Implementation Guide also provides a detailed use case to support the contribution of referral information to the Provincial eReferral Repository. The eReferral Repository is a recipient system that relies on other systems (typically a referral management system) to contribute referral data (such as in the case of Central Waitlist Management system) that take place over the lifecycle of the referral.

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.
• 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).

Status

This implementation guide is for trial use and will go through a formal governance committee review and approval process. 

The provincial open review period starts December 5, 2024, and runs to February 14, 2025.  Download the comment spreadsheet to provide feedback.

View the Open Review Webinar presentation here.