Metamodel

The metamodel is a model that describes the components of the Pan-Canadian Health Data Content Framework and the relationships between them. It defines the types of framework components, such as Business Concepts, the Semantic Common Data Model, data exchange and the Business Glossary, among others.

The Pan-Canadian Health Data Content Framework Metamodel is used to

• Help define the scope of the framework and therefore ensure framework completeness;
• Convey different stakeholder views, such as a business or technical view;
• Provide consistency and structure to architectural thinking; and
• Plan the delivery of architectural artifacts in phases or releases to support the overall framework strategy and plan.

The audiences for the metamodel are individuals with lived experience, health care providers, governing bodies, organization leaders, researchers and technical users, as well as members of the public who would like to know more about the components of the Pan‑Canadian Health Data Content Framework.

The metamodel’s components are organized into 3 sections:

• Business Concepts;
• Semantic Common Data Model Representation; and
• Fast Healthcare Interoperability Resources (FHIR) Physical Representation for Data Exchange.

The sections are connected and should be read in sequence. Readers should begin with Business Concepts, as those components and relationships are expressed in the Semantic Common Data Model Representation, which in turn provides the precise set of data model elements, attributes and model constraints required to develop the FHIR Physical Representation for Data Exchange.

Business Concepts

This section represents the business view of the data. The key components in this section are the following:

• Data element. A distinct unit of information that represents a specific attribute or characteristic in a dataset. Examples include Given Name, Person Address Type and Date of Birth.
• Value set. The finite set of permitted values (codes), drawn from one or more code systems, for a data element representing a codeable concept. Examples of value sets are Route of Administration, Health Care Provider Role and Alcohol Use Status.
• dataset. A grouping of data elements brought together into a specification for collection or analysis for specific transactions, use cases for data exchange or specific outcomes. Examples of datasets are eReferral, eConsult, International Patient Summary (IPS) and Immunization.
• Business glossary. Provides terms and their definitions, and semantic relationships describing clinical and architecture concepts used across the Pan‑Canadian Health Data Content Framework.

The remaining business components presented in this section are mostly used to classify and categorize data elements.

Semantic Common Data Model Representation

This section expresses the business view and real-life business concepts within a technology-agnostic relational data model. Key elements are as follows:

• Class. An encapsulation of data that is recognized by a domain expert as a representation of a discrete concept. A class includes clinical concepts related to health care — such as immunization — as well as supporting concepts such as metadata, code and business glossary.
• Attribute. A characteristic of a class that provides more specific information to distinguish it from other entities. Example attributes for the Immunization entity are Dose Quantity, Dose Unit of Measure Code, Immunization Reason Code and Immunization Body Site Code.
• Attribute value set. A set of codes drawn from one or more code systems, intended for use in a particular context. It is similar to the Value Set component in Business Concepts but represents its technical view.

Other elements of the Semantic Common Data Model Representation represent how entities are related to each other and how they are grouped into data categories or presented in views, such as the Canadian Core Data for Interoperability (CACDI) View, for stakeholders to consume.

FHIR Physical Representation for Data Exchange

This section takes the Business Concepts view and the Semantic Common Data Model Representation to develop a data exchange specification using the FHIR standard. The key elements of this component are the following:

• Implementation guide. A set of rules that specifies how a particular interoperability or standards problem is typically solved using FHIR resources. Business dataset concepts such as eReferral are defined in the Implementation Guide.
• Profile. A set of constraints on a resource that is represented as a structure definition, with derivation equaling constraint. Exchange constraints are informed by Semantic Common Data Model constraints to ensure semantic alignment between components in the 3 sections of the Metamodel.
• Resource element. Individual component of a resource. Examples include patient.name and patient.gender.
• Value set. Similar to the Attribute Value Set element in the Semantic Common Data Model Representation but represents its data exchange view.

The Metamodel will continue to evolve and additional components, such as privacy concepts and versioning, will be added.

The maturity of the Metamodel is currently 2: Proposed.