Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-ballot

It is based on HL7® FHIR® R4 and defines profiles, data elements, and interaction patterns to support consistent exchange of medical imaging information across provincial systems.

These requirements enable interoperability across hospitals, Integrated Community Health Services Centres (ICHSCs), clinical viewers, and other point-of-service systems, supporting long-term integration within Ontario’s enterprise imaging environment. The aim is to enable standardized submission and retrieval of medical imaging data and support consistent access to imaging information across the provincial EHR.

Scope

This implementation guide is developed to support the exchange of medical imaging data through the Ontario Medical Imaging Clinical Data Repository (miCDR).

It defines the FHIR-based requirements for submitting and retrieving imaging orders, reports, and related clinical information within Ontario’s provincial ecosystem.

It applies to Health Information Custodians (HICs), including hospitals and Integrated Community Health Services Centres, as well as clinical systems consuming imaging data through miCDR.

Status

The provincial open review period starts April 24, 2026, and runs to May 25, 2026.

The following webinar materials are available for downloading:

• Comment spreadsheet to provide feedback
• Webinar presentation
• Webinar Questions & Answers
• Link to Ontario Medical Imaging DICOM® Implementation Guide v1.0.0-ballot for reference.
• To access the specification:   Ontario Medical Imaging HL7® FHIR® Implementation Guide v1.0.0-Ballot

This implementation guide is for trial use and is subject to a formal review and approval process.

FHIR is an evolving trial-for-use standard, so additional changes by HL7 are expected. We will continue to monitor developments and assess whether there are 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.