Canada’s Collaborative CA Core+ FHIR®: Delivering Immediate Healthcare Interoperability Value

Canada revolutionized healthcare data standards by adopting a ground-up, collaborative approach to Fast Healthcare Interoperability Resources (FHIR®) profile development. Rather than imposing top-down mandates, Canada partnered with three major health authorities—Ontario, Alberta and British Columbia—to co-develop CA Core+ profiles that reflect real-world production environments. This pragmatic strategy harmonized 27 disparate jurisdictional and pan-Canadian specifications into unified data element definitions and FHIR Core profiles. The initiative created a comprehensive, reusable data foundation that leverages standard FHIR capabilities while preserving crucial jurisdictional flexibility through specification development best practices. CA Core+ delivers immediate business value by providing a robust foundation for national specifications while accommodating local implementation needs. This collaborative model demonstrates how healthcare systems can achieve true interoperability without sacrificing autonomy, offering a replicable framework for other nations pursuing similar digital health transformation goals. The framework also enables centralized information sharing, allowing jurisdictions to build on one another’s work and accelerate the adoption of standards across the federation.