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Terminology Standards Canadian Certification
Developing clinical terminology professional certification in Canada to help address the terminology resource gap
Members: 50
Contact: Bev Knight
Type: Open
Access: Public
Developing clinical terminology professional certification in Canada to help address the terminology resource gap





  • Kelly Abrams, Vice President, Canadian College of Health Information Management
  • Beverly Knight, Standards Manager, Canada Health Infoway


Shazia Khokhar joined a group
Developing clinical terminology professional certification in Canada to help address the terminology resource gap


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  • FHIR Terminology Service API
  • HAPI v2
  • HL7 Explorer
  • InfoRMS
  • InfoScribe
  • Message Builder
  • Message ReMixer
  • Object Identifiers (OIDs)
  • SNOMED CT Browser
  • Terminology Gateway
  • Terminology Service API
  • TermWorks

FHIR web services used to access terminology data

FHIR Terminology Service APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertize in the fine details of terminology.

terminology gateway APIFHIR Terminology Service API

Open source integration tools useful for health IT integration projects

HAPI FHIR® is a simple-but-powerful library for adding FHIR messaging to applications. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.



External Solutions for API integration

Open source integration tools useful for health IT integration projects.


HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform


HAPI FHIR is a simple-but-powerful library for adding FHIR messaging to your application. It is pure Java compatible and licensed under the business-friendly Apache Software License, version 2.0.


Open source integration tool useful for health IT integration projects

HAPI for HL7 v2 messages is an open-source, object oriented HL7 v2.x parser developed for the Java platform.


Enhanced browsing of HL7 v3

Infoway HL7 Explorer is a powerful browser for HL7 v3 structures, vocabulary and references. Used in conjunction with the pan-Canadian releases, HL7 Explorer makes locating details and information more efficient.


Learn about what HL7 Explorer can do for you with this brief online presentation.

MR 02.06

HL7 Explorer applied to the MR 02.06 HL7 v3 maintenance release

CeRx 4.4.2

HL7 Explorer applied to the CeRx 4.4.2 HL7 v3 maintenance release



Standards versions available for viewing in HL7 Explorer

Standard URL 
CA MR 02.06
CA MR 02.05.01
CA MR 02.05
CA MR 02.04.03
CA CeRx 4.4.2
CA CeRx 4.4.1 
CA CeRx 4.4
BC V02R04
NS CeRx 4.3
NS R02.04.03
AB MR2007
AB R02.04.03
AB R02.04.00 SHR
AB R02.04.03 Imm

Request Management Solution

InfoRMS (Infoway Request Management System) is Infoway's Request for Change Tool for SNOMED CT, pCLOCD/LOINC, pan-Canadian Subsets and pan-Canadian HL7 artifacts. Not sure if you have access to InfoRMS? Manage your InfoRMS Access in your user profile.

Submit or follow requests to SNOMED CT


Submit or follow requests to pCLOCD/LOINC

pan-Canadian Subsets

Submit or follow requests to pan-Canadian Subsets


Follow requests to pan-Canadian HL7 messaging


infoscribeSupporting the Standards Selection Framework, InfoScribe enables teams to collaboratively create, discuss, and publish digital health solutions from clinical requirements to specifications. Featuring templates, versioning, PDF export, inline commenting and HL7 Explorer integration, InfoScribe improves productivity and accelerates the development of healthcare solutions.

Standards Selection Framework

The Standards Selection Framework provides users with the means to plan, choose and document interoperability solutions from concept through to implementation. Starting from the Clinical Requirements identified by clinicians through to business requirements, standards and technical specifications, the framework provides a comprehensive guide through the development of interoperability solutions.

The framework also provides an opportunity for the InfoCentral community to share successful implementation projects, the standards selections made at a point in time of the project and the specifications that result from the selections made. Publishing solutions in this space will help to establish a Canadian repository of references.

clinical requirements

Clinical Requirements describe the information and workflow needs of the clinician for a specific clinical context and clinical data exchange. Using the Clinical Interoperability Principles as a guide, a set of requirements expressed in the clinician’s voice will provide the foundation for a well-designed interoperability solution.

business requirements

Business Requirements are derived from clinical requirements and provide a full picture of the solution that needs to be developed. Use cases, business rules and guidance are used to fully outline the solution design.


Standards are an integral piece of the interoperability solution, covering both the terminology that defines the data sent, and the messaging structures that define how the data is transferred. The framework provides the access and consideration criteria to the international and Canadian standards to facilitate implementation.

standards selection

Standards Selection refers to the process that has been developed to help guide teams through the selection of terminology and messaging standards. Using the line of inquiry and considerations in the forms provided implementation teams may assess the standards available and determine the best option for the point in time. The process also provides an opportunity for the InfoCentral community to share successful implementation projects, promoting standardization through reuse.


Specifications provide the details for the solution to be implemented. These details include: a review of the data elements used, samples of transferred messages, the system architecture as well as the security specifications including authorization and authentication.

Solution for API integration

Infoway Message Builder allows developers to focus on the business challenges of integrating their solutions with each electronic health record implementation by abstracting the differences between different versions of pan-Canadian HL7 messaging and supporting current implementation constraints. Developers can build interfaces in a familiar development environment, using the programming language of their choice*, while the Message Builder API fosters quick and easy creation, population and access to HL7v3 requests and responses.

Infoway Message Builder v2.0 and later is enhanced to generate JAVA APIs to create, validate, marshal/unmarshal CDA documents.

 Implementation and Exchange

Key features and benefits

Message Builder offers a number of key features and benefits:

  1. Abstracts the complexity of HL7v3 messages and greatly simplifies the work of the developer when implementing them;
  2. Reduces the impact on developers from implementation variations;
  3. Enables companies to achieve Infoway product certification with greater confidence and reduced time;
  4. Enables developers to incorporate future message versions without re-writing their products;
  5. Can be embedded in software applications due to its open source distribution under a commercial-friendly Apache 2.0 license.

Out of the box support

Infoway Message Builder comes with built-in runtime APIs that support a number of pan-Canadian specifications:

  • MR2009 (R02.04.02)
  • MR2007 (V02R02)
  • MR 2007 (V02R01)
  • CeRx (V01R04.3)

In addition, while developers can easily build custom transport mechanisms without affecting the core, Message Builder includes native support for SOAP and RESTful message transports. Developers can configure and extend the transport as desired.

Detailed product features

  • Provides the capability to configure and populate message values that are common to all messages—this allows developers to reuse common message data, shortening the time to configure and create an interoperable system.
  • Uses simplified data types that are natural and familiar to the programming language (e.g. String for ST) rather than directly exposing the sometimes complicated HL7v3 data types—yet still allowing access to HL7v3 data types when necessary.
  • Allows developers to focus on the business-aspect of a request/response, avoiding many of the complexities of HL7v3.
  • Code-generation algorithms merge identical and similar classes together to simplify the generated API—meaning less confusion in the resulting code and an increased ability to write generic handlers for certain types.
  • Converts populated objects into HL7v3 XML requests, and converts HL7v3 responses into populated objects.
  • Provides flexibility in configuring and performing terminology-code lookups, including code set and database-backed lookups (can mix and match).
  • Associations and attributes are strongly typed, given business names when provided, and contain code docs directly from the MIFs (see
  • The algorithms inline most classes that only have a small number of properties, further simplifying the API.
  • Offers both permissive and strict modes—permissive allows many common errors and generates appropriate error comments in the XML or result object.
  • A separate validation tool is provided to test ad-hoc messages—this tool reuses the same validation components that are executed during message marshaling and unmarshalling, ensuring consistent processing of the message whether during processing or during conformance validation.

Forward looking

The power of the Message Builder architecture is in its MIF-based generation of the specification API. With Message Builder, any MIF is supported—whether a future release of the pan-Canadian specifications or a modified (constrained) jurisdiction-specific release of an existing specification. 

How it works

Message Builder comprises two parts:

  1. Message Builder Generator—a tool used by Infoway to take input MIFs and create Message Sets for use by Message Builder Runtime;
  2. Message Builder Runtime—an API used by developers to allow their products to support multiple Message Sets without recoding.

Message Builder Generator

Used by Infoway, Message Builder Generator takes MIFs (as the source of truth for standards specifications) and converts them into a series of Java Classes. This is done by first converting the MIFs to an XML Message Set (a simplified representation of the information present in the original MIFs), then generating Java Classes that reference standard Java data types and use business-friendly names. In the process, groups of related elements are flattened and similar message parts are placed into a single class: these steps increase ease of use and reduce the complexity of the resulting Java Classes.

MBG process

Using Message Builder Generator, Infoway is able to create multiple Message Sets, each representing the MIFs used in a single jurisdiction, but all for the same HL7v3 version.

Message Builder Runtime

Message Builder Runtime allows developers to quickly adapt to implementations in multiple Jurisdictions: incoming messages are first examined to determine the corresponding source Message Set, once identified, a series of Java Objects that represent the message are instantiated. Next, the Java Objects are turned into an HL7 message for the HL7 version corresponding to the desired destination Message Set. 

MB process

Using Message Builder Runtime developers can accept messages over the wire and on-the-fly turn them into a different HL7 message version. Given the capability of Message Builder to support future versions of HL7 messages, developers can easily future proof their products with minimal effort.

*Developer friendly

The Message Builder libraries are available for Java and Microsoft .NET. In addition, a simplified XML message format is available with REST-based services for managing mapping to/from the simplified form to the target specification XML format.

CDA Support

Message Builder CDA API supports the following CDA and data type specifications:

Message Builder provides  JAVA and .NET APIs for CDA document creation, validation, marshalling/unmarshalling of the following CDA document types:

  • Continuity of Care Document (CCD) (Release 1.1)
  • Consultation Notes (Release 1.1)
  • Discharge Summary (Release 1.1)
  • Imaging Integration, and DICOM Diagnostic Imaging Reports (DIR) (Release 1)
  • History and Physical (H&P) (Release 1.1)
  • Operative Note (Release 1.1)
  • Progress Note (Release 1.1)
  • Procedure Note (Release 1)
  • Unstructured Documents (Release 1.1)
  • CDA documents using pan Canadian CDA header template

Clinical applications in JAVA or .NET can use the Message Builder CDA APIs to create, validate or parse above listed types of CDA documents. Potential use cases are document source or document consumer actors in IHE XDS profile, content creator/content consumer in any content module/profile, or report creator/viewer in RIS/PACS/EMR systems.

Localization of pan-Canadian Standards

Infoway Message ReMixer is a web-based application that allows for the localization of pan-Canadian Standards (pCS) messages to meet jurisdictional requirements, all while maintaining the integrity of the original, standard message.

msg remixerAccess Message ReMixer Now

 Implementation and Exchange

Jurisdictional ReMixes

Pan-Canadian Standards use Object Identifiers (OIDs) to distinguish between objects by assigning a numeric string that enables other systems to understand the unique information that is being shared between various systems.

  • OIDs are intended to be globally unique and never re-used
  • OIDs in the pan-Canadian standards identify terminology code systems and are transmitted in HL7 messages
  • OIDS used to identify terminology subsets are not transmitted in HL7 messages, rather these OIDs are used for vocabulary maintenance and Terminology Services
  • OIDs are used to qualify local identifiers (e.g. patient identifiers) such that the combination of an OID (assigning authority) and a local identifier remains globally unique

Browse International and Canadian Content

SNOMED International's SNOMED CT browser allows users to browse and search the SNOMED CT International Edition to explore concepts and relationships. It also provides access to browse national extensions from SNOMED International member countries including the Canadian Edition of SNOMED CT in English and French.

snomed browser Browse SNOMED CT Now

 General Documentation

Browse, download and leverage the terminology used in Canada

Terminology Gateway is a web based solution framework that enables the distribution and sharing of terminology concepts, subsets and concept maps, making them available for web browsing, download or real time query.

terminology gatewayBrowse Terminology Gateway Now

RESTful web services used to browse terminology data

Terminology Service RESTful APIs enable automated exchange of clinical terminology content and resources. It allows developers to easily implement healthcare applications that programmatically consume codes and subsets without requiring in-depth expertise in the details of terminology.

terminology gateway APITerminology Service API

Apelon’s TermWorks is an easy-to-use data mapping solution which is provided by request for free to individuals who have Standards Access. It brings powerful terminology capabilities directly to the desktop. TermWorks combines Microsoft® Excel® spreadsheet software with web services-based terminology processing to give organizations comprehensive mapping capability to SNOMED CT and the Canadian Edition of SNOMED CT.


  • Introduction to SNOMED CT (English)
  • Introduction to SNOMED CT (French)
  • This email address is being protected from spambots. You need JavaScript enabled to view it.

Web Conference

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Bev Knight
Canada Health Infoway
Linda Monico
Canada Health Infoway
Tasha Shaw-Verbic
Canada Health Infoway
Shazia Khokhar
Adesh Maharaj
Manitoba eHealth
Vanessa Chan
Telus Health
Marguerite Fenske
Government of Yukon - Health & Social Services
Kathy Ervin
Alberta Health Services
Avneet Bhatia
Jennifer MacKinnon
Igor Sirkovich
Helen Stevens Love
Stevens Healthcare Integration
Shamhad Abdi
University of Toronto
Steven Zachary
Alberta Health Services
Shoma Dhillon

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Improving the quality of patient care through the effective sharing of clinical information among health care organizations, clinicians and their patients.

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