AU eRequesting Implementation Guide
1.0.0-ballot - Ballot Australia flag

AU eRequesting Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-erequesting/ and changes regularly. See the Directory of published versions

AU eRequesting Data for Interoperability Mappings

Page standards status: Informative

Australian eRequesting Data for Interoperability (AUeReqDI) is the product of a national clinician focussed requirements gathering project operating as part of the Sparked AU FHIR Accelerator. AUeReqDI outputs form a set of data requirements to be considered and referred to as part of the development and definition of AU eRequesting.

The primary intent of AUeReqDI is to design and govern a collection of coherent, reusable building blocks known as ‘data groups’. These data groups define what clinical information is required to support eRequests. However, they do not specify how the data is exchanged; this is the role of the FHIR standard. AUeReqDI is not required to be implemented as a whole single product. AUeReqDI builds upon and complements the foundational Australian Clinical Data for Interoperability (AUCDI) and focuses on the specific use case of eRequesting.

AUeReqDI Release 1 (R1) is focused on an agreement of the minimum data required to support standardised eRequesting within the Australian health context, and forms a common language foundation that allows systems to exchange semantically accurate data for eRequests. It incorporates and builds upon prior work from national and international programs and initiatives, including the Royal College of Pathologists of Australasia (RCPA)’s Pathology information, Terminology and Units Standardisation (PITUS) framework and the Royal Australian New Zealand College of Radiology (RANZCR’s) Radiology Referral Set.

AU eRequesting is intended to provide an implementable standard for FHIR based interfaces for diagnostic requesting in Australia, providing:

  • an exchange standard for AUeReqDI (the underpinning clinical data model)
  • data model and RESTful API interactions that set minimum expectations for a system to create, update, search, and retrieve electronic diagnostic requests
  • a foundation focused on pathology and medical imaging requests in community-based care provision, with consideration for future eRequesting use cases beyond this scope

With AUeReqDI defining clinical data requirements and FHIR AU eRequesting providing the Implementation Guide for FHIR-based electronic requesting of diagnostic imaging and pathology services, an interpretation of AUeReqDI is necessary which is undertaken through the community.

AU eRequesting, AUeReqDI and AUCDI Versions

AU eRequesting, AUeReqDI and AUCDI are updated periodically. AUeReqDI R1 contains data groups required to facilitate the exchange of a pathology test and medical imaging request, and reuses data groups from AUCDI where relevant.

AUeReqDI R1 is aligned with AUCDI R1.

AUCDI R2 was published after AUeReqDI R1, introducing additional and expanded data groups to support different use cases. These are not reflected in AUeReqDI R1.

The following table shows the version alignment between AU eRequesting, AUeReqDI and AUCDI:

AU eRequesting Version AUeReqDI Version AUCDI Version
1.0.0 R1 R1

AUeReqDI Mappings Into AU eRequesting

The table below shows the relationship between AUeReqDI and AUCDI Data Groups and Elements and AU eRequesting and AU Core profiles.
Column attribute descriptions are as follows:

  • AUeReqDI/AUCDI Data Group: Represents a grouping of one or more AUeReqDI or AUCDI Data Elements.
  • AUeReqDI/AUCDI Data Element: Represents a single, discrete clinical concept defined by AUeReqDI or AUCDI.
  • AU eRequesting Profile(s)/AU Core Profile(s): Represents the mapping of AUeReqDI or AUCDI Data Groups and Data Elements to AU eRequesting or AU Core FHIR artefacts.
  • FHIR Path: The specific path in the FHIR standards for each AUeReqDI or AUCDI Data Element within, showing where and how to implement these elements in FHIR-based systems.
  • Comment: Additional information about the mapping including an explanation of where an element or group is not yet mapped.
AUeReqDI Data Group AUeReqDI Data Element AU eRequesting Profile(s) FHIR Path Comment
Service request Service name AU eRequesting Diagnostic Request ServiceRequest.code
Clinical indication AU eRequesting Diagnostic Request ServiceRequest.reasonCode
Clinical context AU eRequesting Diagnostic Request ServiceRequest.supportingInfo:clinicalContext
Urgency AU eRequesting Diagnostic Request ServiceRequest.priority
Service timing AU eRequesting Diagnostic Request ServiceRequest.occurrence[x] This element is choice between occurrenceTiming | occurrenceDateTime | occurrencePeriod.
Comment AU eRequesting Diagnostic Request ServiceRequest.note
Distribution list AU eRequesting CommunicationRequest CopyTo CommunicationRequest.recipient
Urgent contact AU eRequesting CommunicationRequest Urgent Provider CommunicationRequest.recipient
Billing guidance AU eRequesting Diagnostic Request

AU eRequesting Coverage		 ServiceRequest.insurance

Coverage		 ServiceRequest.insurance references a Coverage resource.
Medical imaging request Test name AU eRequesting Imaging Request ServiceRequest.code
Modality AU eRequesting Imaging Request ServiceRequest.code
Target body site AU eRequesting Imaging Request ServiceRequest.code | ServiceRequest.bodySite
Contrast use AU eRequesting Imaging Request ServiceRequest.code
Clinical indication AU eRequesting Imaging Request ServiceRequest.reasonCode
Clinical context AU eRequesting Imaging Request ServiceRequest.supportingInfo:clinicalContext
Urgency AU eRequesting Imaging Request ServiceRequest.priority
Service timing AU eRequesting Imaging Request ServiceRequest.occurrence[x] This element is choice between occurrenceTiming | occurrenceDateTime | occurrencePeriod.
Comment AU eRequesting Imaging Request ServiceRequest.note
Distribution list AU eRequesting CommunicationRequest CopyTo CommunicationRequest.recipient
Urgent contact AU eRequesting CommunicationRequest Urgent Provider CommunicationRequest.recipient
Billing guidance AU eRequesting Imaging Request

AU eRequesting Coverage		 ServiceRequest.insurance

Coverage		 ServiceRequest.insurance references a Coverage resource.
Pathology test request Test name AU eRequesting Pathology Request ServiceRequest.code
Fasting status AU eRequesting Pathology Request ServiceRequest.extension:fastingPrecondition
Clinical indication AU eRequesting Pathology Request ServiceRequest.reasonCode
Clinical context AU eRequesting Pathology Request ServiceRequest.supportingInfo.clinicalContext
Urgency AU eRequesting Pathology Request ServiceRequest.priority
Service timing AU eRequesting Pathology Request ServiceRequest.occurrence[x] This element is choice between occurrenceTiming | occurrenceDateTime | occurrencePeriod.
Comment AU eRequesting Pathology Request ServiceRequest.note
Distribution list AU eRequesting CommunicationRequest CopyTo CommunicationRequest.recipient
Urgent contact AU eRequesting CommunicationRequest Urgent Provider CommunicationRequest.recipient
Billing guidance AU eRequesting Pathology Request

AU eRequesting Coverage		 ServiceRequest.insurance

Coverage		 ServiceRequest.insurance references a Coverage resource.
Implanted medical device summary Device type name Device Device.type The Device resource has not yet been profiled for use in AU eRequesting.
Current status Device Device.status The Device resource has not yet been profiled for use in AU eRequesting.
Overall comment Device Device.note The Device resource has not yet been profiled for use in AU eRequesting.
Last updated - - The Device resource has not yet been profiled for use in AU eRequesting.
Pregnancy summary (AUCDI R3+ backlog) TBD AU eRequesting Diagnostic Request ServiceRequest.supportingInfo:pregnancyStatus Proposed to correspond to a future AUCDI pregnancy summary concept (in the AUCDI R3+ backlog), which is expected to describe pregnancy status within a single pregnancy and potentially include more granular states to encompass a continuum of pregnancy states. In AU eRequesting R1, the pregnancy status is constrained to Pregnant only, as advised by AUCDI authors, to ensure future compatibility.
AUCDI Data Group AUCDI Data Element AU Core Profile(s) FHIR Path Comment
Adverse reaction risk summary Substance name AU Core AllergyIntolerance AllergyIntolerance.code
Manifestation AU Core AllergyIntolerance AllergyInterolance.reaction
Comment AU Core AllergyIntolerance AllergyIntolerance.note
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration. Future versions of AU Core will develop and test approaches to addressing Last Updated.
Problem/Diagnosis summary Problem / Diagnosis name AU Core Condition Condition.code
Body site/laterality AU Core Condition Condition.code
Status AU Core Condition Condition.clinicalStatus
Comment AU Core Condition Condition.note
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration. Future versions of AU Core will develop and test approaches to addressing Last Updated.
Sex and gender summary Sex assigned at birth AU Core Patient Patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-recordedSexOrGender') The Person Recorded Sex or Gender extension is profiled by AU Core Sex Assigned At Birth (RSG) to represent the concept of Sex assigned at birth.
Gender identity AU Core Patient Patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-genderIdentity')
Pronoun/s AU Core Patient Patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-pronouns')
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration. Future versions of AU Core will develop and test approaches to addressing Last Updated.