AU Core Implementation Guide
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AU Core Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-core/ and changes regularly. See the Directory of published versions

Resource Profile: AU Core Patient

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient Version: 1.1.0-ci-build
Standards status: Trial-use Maturity Level: 2 Computable Name: AUCorePatient

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient. It is based on the AU Base Patient profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the Patient when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

Usage scenarios

The following are supported usage scenarios for this profile:

  • Query for records associated with a patient
  • Record or update a record associated with a patient
  • Query for basic demographics and other administrative information about a patient
  • Record or update basic demographics and other administrative information about a patient
  • Read information about a patient referenced by another resource

Profile specific implementation guidance

  • An individual’s IHI SHOULD be used in Patient.identifier if available, in preference to Medicare or DVA numbers.
  • See guidance on the construction of identifiers in each Identifier profile and the section on Business Identifiers in AU Base.
  • This profile supports the sex, gender, and related concepts of: Name to Use, Gender Identity, and Individual Pronouns. See the Sex and Gender page for guidance on exchanging sex and gender related concepts conformant to AU Core.
  • See the Representing communication preferences section for guidance.
  • When constructing an address:
    • an international address can be represented using the core Address data type
    • an Australian address SHOULD be represented using the Australian Address data type profile
  • Patient names can be provided as a text representation in name.text and/or parts such as name.family and name.given.
  • name.text specifies the entire name as it is intended to be displayed. This may be provided instead of, or as well as, the specific parts. It is important to note that the presence of parts of a name, e.g. name.family and name.given, do not imply that name.text is known or needs to be supplied.
  • In this profile, the following sub-elements of name are marked as Must Support: name.use, name.text, name.family, and name.given
    • responders are required to support at least one of the following sub-elements: name.text, name.family, and name.given
    • requesters are required to support all sub-elements marked Must Support: name.use, name.text, name.family, and name.given

Usage:

Changes since version 1.0.0:

  • The resource metadata has changed (description)

    • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    This structure is derived from AUBasePatient

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Patient C 0..* AUBasePatient A patient in the context of electronic exchange of health information
    au-core-pat-01: At least one patient identifier shall be valid, or if not available, the Data Absent Reason extension shall be present
    au-core-pat-02: At least one patient name shall have a family name, or if not available, the Data Absent Reason extension shall be present
    ... Slices for extension Content/Rules for all slices
    .... extension:indigenousStatus SO 0..1 AustralianIndigenousStatus Indigenous status
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... extension:genderIdentity SO 0..* PGenderIdentity Gender identity shall be a member of the Gender Identity Response value set if any codes within that value set can apply
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... extension:individualPronouns SO 0..* Pronouns Pronouns shall be a member of the Australian Pronouns value set if any codes within that value set can apply
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... Slices for identifier SOC 1..* Identifier, AUIHI, AUMedicareCardNumber, AUDVANumber, AUHealthCareCardNumber, AUPensionerConcessionCardNumber, AUCwlthSeniorsHealthCardNumber, AUMedicalRecordNumber, AUInsuranceMemberNumber Identifies this patient across multiple systems
    Slice: Unordered, Open by pattern:type
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... identifier:ihi SO 0..1 AUIHI Identifies this patient across multiple systems
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... identifier:medicare SO 0..1 AUMedicareCardNumber Identifies this patient across multiple systems
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... identifier:dva SO 0..1 AUDVANumber Identifies this patient across multiple systems
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... name SOC 1..* HumanName A name associated with the patient
    au-core-pat-03: At least text, family name, or given name shall be present, or if neither is available, the Data Absent Reason extension shall be present
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... use SO 0..1 code usual | official | temp | nickname | anonymous | old | maiden
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... text SO 0..1 string Text representation of the full name
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... family SO 0..1 string Family name (often called 'Surname')
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... given SO 0..* string Given names (not always 'first'). Includes middle names
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... gender SO 1..1 code male | female | other | unknown
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... birthDate SO 1..1 date Date of birth extended for time and accuracy indicator
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... address SO 0..* AustralianAddress, Address An address for the individual
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... communication SO 0..* BackboneElement A language which may be used to communicate with the patient about his or her health
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... language SO 1..1 CodeableConcept The language which can be used to communicate with the patient about his or her health
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... preferred SO 0..1 boolean Language preference indicator
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Constraints

    IdGradePath(s)DetailsRequirements
    au-core-pat-01errorPatientAt least one patient identifier shall be valid, or if not available, the Data Absent Reason extension shall be present
    : (identifier.where(system.count() + value.count() >1)).exists() xor identifier.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
    au-core-pat-02errorPatientAt least one patient name shall have a family name, or if not available, the Data Absent Reason extension shall be present
    : name.family.exists() xor name.extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
    au-core-pat-03errorPatient.nameAt least text, family name, or given name shall be present, or if neither is available, the Data Absent Reason extension shall be present
    : (text.exists() or family.exists() or given.exists()) xor extension('http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

    FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

    Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

    Note: Support for _id is mandatory for a responder and optional for a requester. Where the expectation for a search parameter differs between actors, the table below will reflect the stronger conformance requirement.

    Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
    _id SHALL token
    identifier SHALL token The requester SHALL provide both the system and code values. The responder SHALL support both.

    The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the profile. The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the profile.
    birthdate+family SHOULD date+string
    birthdate+name SHOULD date+string
    family SHOULD string
    family+gender SHOULD string+token
    gender+name SHOULD token+string
    name SHOULD string
    birthdate MAY date A requester SHALL provide a value precise to the day. A responder SHALL support a value precise to the day.

    The requester SHOULD support these search comparators gt, lt, ge, le. The responder SHOULD support these search comparators gt, lt, ge, le.

    The requester SHOULD support multipleAnd, and if multipleAnd is supported, SHALL support the search comparators gt, lt, ge, le. The responder SHOULD support multipleAnd, and if multipleAnd is supported, SHALL support the search comparators gt, lt, ge, le.
    gender MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
    indigenous-status MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
    gender-identity MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.

    Mandatory Search Parameters

    1. SHALL support searching using the _id search parameter:

      GET [base]/Patient?_id=[id]

      Example:

      1. GET [base]/Patient?_id=5678

      Implementation Notes: Fetches a bundle with the requested Patient, instead of just the resource itself, and allows for the inclusion of additional search parameters such as _include, _revinclude, or _lastUpdated (how to search by id of the resource).

    2. SHALL support searching using the identifier search parameter:

      GET [base]/Patient?identifier=[system|][code]

      Example:

      1. GET [base]/Patient?identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
      2. GET [base]/Patient?identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361
      3. GET [base]/Patient?identifier=http://example.org/fhir/mrn|12345

      Implementation Notes: Fetches a bundle containing any Patient resources matching the identifier (how to search by token)

    Optional Search Parameters:

    The following search parameters and search parameter combinations SHOULD be supported:

    1. SHOULD support searching by a responder-defined search that matches any of the string fields in the HumanName, including family, given, prefix, suffix, and/or text using the name search parameter:

      GET [base]/Patient?name=[string]

      Example:

      1. GET [base]/Patient?name=Wang
      2. GET [base]/Patient?name=Wang

    2. SHOULD support searching using the combination of the gender and name search parameters:

      GET [base]/Patient?gender={system|}[code]&name=[string]

      Example:

      1. GET [base]/Patient?name=Wang&gender=female

      Implementation Notes: Fetches a bundle of all Patient resources matching the specified gender and name (how to search by string and how to search by token)

    3. SHOULD support searching using the combination of the birthdate and family search parameters:
      • SHOULD support these date comparators: gt,lt,ge,le
      • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...), and if multipleAnd is supported, SHALL support the search comparators gt,lt,ge,le

      GET [base]/Patient?birthdate=[date]&family=[string]

      Example:

      1. GET [base]/Patient?family=Wang&birthdate=2007-03-20

      Implementation Notes: Fetches a bundle of all Patient resources matching the specified birthdate and family (how to search by date and how to search by string)

    4. SHOULD support searching using the combination of the birthdate and name search parameters:
      • SHOULD support these date comparators: gt,lt,ge,le
      • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...) and if multipleAnd, and if *multipleAnd is supported, SHALL support the search comparators gt,lt,ge,le

      GET [base]/Patient?birthdate=[date]&name=[string]

      Example:

      1. GET [base]/Patient?name=Wang&birthdate=2007-03-20gt

      Implementation Notes: Fetches a bundle of all Patient resources matching the name and a birthdate greater than that specified (how to search by date and how to search by string)

    5. SHOULD support searching using the combination of the family and gender search parameters:

      GET [base]/Patient?family=[string]&gender={system|}[code]

      Example:

      1. GET [base]/Patient?family=Wang&gender=female

      Implementation Notes: Fetches a bundle of all Patient resources matching the specified family and gender (how to search by string and how to search by token)