CA Core+ v1.1.0 DFT-preBallot
DFT-preBallot - The specification is a DFT-preBallot version of CA Core+ for collecting community feedback. For a full list of available versions, see the Directory of published versions
code, clinicalStatus.coding, patient, verificationStatus.coding, reaction, reaction.manifestation, reaction.manifestation.coding.code.mustSupport on onsetDateTime, patient.reference, reaction.manifestation.coding.code, reaction, reaction.manifestation.recorder/asserter references to allow base RelatedPerson.AppointmentClass (instance class), AppointmentVirtualService.basedOn to reference ServiceRequest (CA-Core) only.basedOn, basedOn.identifier{.system,.value}, inResponseTo, payload{,.content[x]}, received, sender{,.identifier{.system,.value},.reference}, sent, status, subject{,.identifier{.system,.value},.reference}.recipient/sender references to allow base RelatedPerson.clinicalStatus 0..1, onset[x] 0..1, onsetDateTime 0..1.clinicalStatus.coding 1..* and code 1..1 MS.clinicalStatus, code, onset[x].code (absent/unknown, ICD-10-CA, ICD-9-CM).performer, effective[x].result, subject.subject to PatientCACore | Group | Device | LocationCACore).author, author.reference, content, content.attachment, date, identifier{,.system,.value}, subject, type.context.*.author reference to allow base RelatedPerson.type, type.coding, type.coding.code, period{,.start}, identifier{,.system,.value}, and from subject (cardinality remains constrained via reference).status, subject.RelatedPerson.condition.note.text, note{,.text}, patient{,.reference}, relationship, status.reasonReference constraints; no MS.$ext-delivery-method (deliveryMethod) and UsageLicense.identifier, name.identifier.system, identifier.value.specialty to HealthcareProviderSpecialtyCode.identifier, procedureCode, series, series.instance, series.instance.sopClass, series.uid, started, subject, subject.reference.procedureCode to radiologyProcedureCodeIPS2.encounter, referrer (under review); kept location reference and subject.reference required.vaccineCode, vaccineCode.coding, status.vaccineCode, lotNumber.occurrence[x]; occurrence no longer MS.patient.reference to 1..1 (no MS).address{,.city,.country,.postalCode,.text}, identifier{,.system,.value}, name, status, telecom{,.system,.value}, type.managingOrganization / partOf references.ext-medication-strength-description (instance strength) with obligations.code from 1.. MS → 1.. and added obligations.ingredient.itemCodeableConcept from extensible → preferred; added obligations to form.text.code.coding{,.system,.code,.display}, code.text, form.MedicationRenderedDosage.medication[x], reasonCode, reasonReference, dosageInstruction, dosageInstruction.text.reasonCode: PrescriptionIndicationForUse, HealthConditionCode.authoredOn, dosageInstruction, statusReason, subject; kept subject.reference 1..1 (no MS).MedicationRenderedDosage.medication[x], status, subject, effective[x], reasonCode, reasonReference, dosage, dosage.text.reasonCode now prefers MedicationReasonCode (adds PrescriptionIndicationForUse and HealthConditionCode as additional bindings).Observation-SexualOrientation (CA-Core)
status, category, subject, effective[x], valueCodeableConcept.code to LOINC#76690-7; clarified display is not fixed (multilingual contexts).Observation-AlcoholUse (CA-Core)
code 1..1 (not MS); clarified LOINC display not fixed.effective[x], status, subject, subject.reference.valueQuantity.Observation-Laboratory-Pathology-Result (CA-Core)
code, effective[x], performer, status, subject, subject.reference.valueString, valueQuantity, and mandatory valueCodeableConcept; includes interpretation and hasMember.Observation-RadiologyResults (CA-Core)
component.code binds to $results-radiology-component-uv-ips (preferred).category allows 1.. (imaging) with obligations.code to resultsRadObsIPS2.subject 1..1 MS (preadopted from IPS); allowed hasMember to same profile.Observation-SocialHistory (CA-Core)
category, code, note, note.text, status, subject, subject.reference, value[x] (elements remain MS where indicated).code, effective[x].subject, status, value[x] (now guided by obligations).Observation-TobaccoUse (CA-Core)
code 1..1 (not MS); clarified LOINC display not fixed.value[x] from 1..1 MS → 0..1 MS; added obligations to value[x], valueCodeableConcept.effective[x], status, subject.reference; added obligations to subject.$AD-Preferred address extension (instance preferred).name and address.{line,postalCode,country,city,state}.ExtensionBirthSex 0..1; CommunicationBarrier no longer MS.identifier.{type,system,value} (prior 1.. dropped).communication.language → ISO6393.identifier[JHN].type.coding.display (“Jurisdictional Health Number”) and identifier[MRN].type.coding.display (“Medical Record Number”); example binding for identifier[JHN].system → SharedPatientJHNTypeCode (example).birthDate, gender, deceased[x], deceasedDateTime, contact.name).communication to languages (preferred) and additional candidate binding to ISO6393.contact.relationship to PersonalRelationshipCodes (extensible).$AD-Preferred extension instance to preferred.name, identifier{,.system,.value}.qualification.code to $v2-2.7-0360.communication to languages.ca-core-practrole-1.practitioner, organization, code, specialty, telecom.identifier.location.identifier{,.system,.value}, location.reference, organization.identifier{,.system,.value}, organization.reference, practitioner.identifier{,.system,.value}, practitioner.reference, telecom{,.system,.use}, notAvailable.description.code (HealthcareProviderRoleCode) and specialty (HealthcareProviderSpecialtyCode).performed[x] (no longer required).absentorUnknownProcedure.code; added obligations to code.RelatedPersion (CA-Core)
RelatedPerson.authoredOn, category, code, identifier{,.system,.value}, intent, note, reasonCode, requester{,.reference,.identifier{.system,.value}}, status, subject{,.reference}, replaces.reference.code to ProcedureCode (extensible) and for reasonCode to HealthConditionCode (preferred).task-ca-core-e-rec (“Task (CA-Core eReC)”); retitled profile.identifier.*, output, basedOn, businessStatus.extension[StatusReason], code, intent.code to TaskCode (extensible) and for businessStatus to ReferralBusinessStatus (extensible).Person and RelatedPerson were evaluated and had minimal constraints and use in the Pan-Canadian context. They will be considered for future use when updated requirements are gathered.
trial-use; updated canonical URL.Patient (whole resource); inserted FMM(2); constrained value[x] to CodeableConcept; added producer/consumer obligations; updated canonical URL.task-patientNeedsToBeSeen; inserted FMM(2).value[x] to CodeableConcept; updated canonical URL.value[x] constrained to url.value[x] is string (min 1, max 5000) with MS; guidance for textual SIG.$AD-Preferred – Added as instance preferred on Organization and Practitioner address.**New / Updated Value Sets **
Binding / Date Refresh
MustSupport Definition on the Technical Context page.MustSupport.Changes influenced by Gap Analysis done across different jurisidictional and Pan Canadian specifications.
Detailed changes by profile:
AllergyIntolerance.code: updated binding and added type profileAllergyIntolerance.code.coding.code: min cardinality changed from 1 to optional, mustSupport removedAllergyIntolerance.reaction.manifestation: updated bindingCondition.code.coding.code: mustSupport removedCondition.code: updated type to reference CA Core+ terminology profileEncounter.type.coding.code: mustSupport removedEncounter.type: updated binding and type referenceImmunization.reportOrigin.coding.code: min relaxed (1 → 0)Immunization.reportOrigin.coding.system: min relaxed (1 → 0)medication.ingredient: removed (out of scope for CACDI v1)MedicationRequest.reasonCode.coding.system: min relaxed (1 → 0)MedicationRequest.reasonCode.coding.code: min relaxed (1 → 0)MedicationRequest.dosageInstruction.route.coding.system: min relaxed (1 → 0)MedicationRequest.dosageInstruction.route.coding.code: min relaxed (1 → 0)MedicationRequest.doseQuantity.value: min relaxed (1 → 0)MedicationStatement.reasonCode.coding.system: min relaxed (1 → 0)MedicationStatement.reasonCode.coding.code: min relaxed (1 → 0)MedicationStatement.dosage.timing.code.coding.system: min relaxed (1 → 0)MedicationStatement.dosage.timing.code.coding.code: min relaxed (1 → 0)doseQuantity.unit or doseQuantity.code must existPatient.name: added MustSupportPatient.telecom: added type referencePatient.identifier: removed obligation flagsUpdated extensions:
These ValueSets existed as placeholders before and now have codes attached to them. These codes are subject to change as the PCHDCF continues to evolve.
Examples were created for every profile, including an example profile deriving from CA Core+ Patient.
Complete list of examples in this release:
Profile Changes
Narrative Page Updates
Profile Changes (to align with CACDI Package 1 Ballot Release)
Updated the the profiles and pages to temporarily remove obligations from this release in order to align the approach to the forthcoming CACDI artefact in the pCHDCF
Updated the profile pages to remove the duplicative rendering of additionalBinding details now that they are rendering in the Simplifier profile views
Updated select mapping concept names and descriptions across all the Profile pages
Removed select mapping concepts from Patient (CA-Core) due to pCHDCF refinements:
Removed select mapping concepts from Condition (CA-Core) due to pCHDCF refinements:
Removed select mapping concepts from Immunization (CA-Core) due to pCHDCF refinements:
Removed select mapping concepts from Medication (CA-Core) due to pCHDCF refinements:
Removed select mapping concepts from MedicationRequest (CA-Core) due to pCHDCF refinements:
Updated Known Issues & Future Development to close issues related to additionalBinding and Extension Registry extensions, added an issue regarding extensions for cross-version concepts (e.g., Immunization.supportingInformation)
Refined re-profiled individual-pronouns extensions to include full valueSet from LOINC answer list (https://loinc.org/90778-2/)
Added General Guidance page to provide guidance around handling of Additional Elements not currently part of CA-Core+.