# Change Log - AU Patient Summary Implementation Guide v1.0.0-ci-build

* [**Table of Contents**](toc.md)
* **Change Log**

## Change Log

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| *Page standards status:*[Informative](http://hl7.org/fhir/R4/versions.html#std-process) |

### Release TBD

* Publication date: TBD
* Publication status: TBD
* Based on FHIR version: 4.0.1

This change log documents the significant updates and resolutions implemented from version [1.0.0-ballot](https://hl7.org.au/fhir/ps/1.0.0-ballot/index.html) to TBD.

#### Changes in this version

* added guidance clarifying expectations for Must Support obligations on elements with multiple cardinality in [General Requirements](general-requirements.md) page [AU PS: FHIR-53114](https://jira.hl7.org/browse/FHIR-53114)
* [AU PS MedicationStatement](StructureDefinition-au-ps-medicationstatement.md): 
* changed MedicationStatement.medicationCodeableConcept binding to Australian Medication Use (preferred) [AU Base: FHIR-53469](https://jira.hl7.org/browse/FHIR-53469)
* changed guidance for representing no known medications using SNOMED CT 787481004 |No known medications|, aligned with IPS guidance [AU PS: FHIR-52274](https://jira.hl7.org/browse/FHIR-52274)
 
* [AU PS RelatedPerson](StructureDefinition-au-ps-relatedperson.md): 
* applied technical correction to remove SHOULD:display obligation on RelatedPerson.patient.reference for the AU PS Consumer [AU PS: FHIR-56175](https://jira.hl7.org/browse/FHIR-56175)
 

### Release 1.0.0-ballot

* Publication date: 2026-02-16
* Publication status: Ballot for Working Standard
* Based on FHIR version: 4.0.1

This change log documents the significant updates and resolutions implemented from version [0.3.0-ballot](https://hl7.org.au/fhir/ps/0.3.0-ballot/index.html) to [1.0.0-ballot](https://hl7.org.au/fhir/ps/1.0.0-ballot/index.html). The changes in this update are for ballot.

#### Changes in this version

* changed AU PS Consumer guidance to align wording with the handle obligation (replace "consume resources" with "handle") in [General Requirements](https://hl7.org.au/fhir/ps/1.0.0-ballot/general-requirements.html) page [AU PS: FHIR-52616](https://jira.hl7.org/browse/FHIR-52616).
* added plain language text clarifying the meaning of SHALL:handle obligation for AU PS Consumers in [General Requirements](https://hl7.org.au/fhir/ps/1.0.0-ballot/general-requirements.html) page [AU PS: FHIR-53033](https://jira.hl7.org/browse/FHIR-53033).
* changed [Generation and Access](https://hl7.org.au/fhir/ps/1.0.0-ballot/generation-and-access.html) page to retain only options in line with current community interest [au-fhir-ps #91](https://github.com/hl7au/au-fhir-ps/issues/91).
* updated mapping of AUCDI element Date/time of onset of first reaction in the Adverse reaction risk summary data group to be AllergyIntolerance.onset[x] [AU PS: FHIR-53631](https://jira.hl7.org/browse/FHIR-53631).
* [AU PS AllergyIntolerance](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-allergyintolerance.html): 
* changed AllergyIntolerance.reaction.manifestation binding to Adverse Reaction Clinical Manifestation (preferred) [AU Base: FHIR-47076](https://jira.hl7.org/browse/FHIR-47076)
* removed SHOULD:display obligation on AllergyIntolerance.patient.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed AllergyIntolerance.code obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed AllergyIntolerance.patient obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed AllergyIntolerance.patient.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
 
* [AU PS Bundle](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-bundle.html): 
* changed obligations for all mandatory elements for the AU PS Producer from SHALL:able-to-populate to SHALL:populate [AU PS: FHIR-51440](https://jira.hl7.org/browse/FHIR-51440)
 
* [AU PS Composition](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-composition.html): 
* changed Composition.section[all slices].code cardinality from 0..1 to 1..1, and added Must Support and obligation SHALL:handle for the AU PS Consumer [IPS: FHIR-51231](https://jira.hl7.org/browse/FHIR-51231)
* changed Composition.section.code to remove use of the CodeableConceptIPS [IPS: FHIR-51231](https://jira.hl7.org/browse/FHIR-51231)
* removed the cardinality constraint on Composition.section[all slices].extension:section-note, changing it from 0..1 to 0..* [IPS: FHIR-50271](https://jira.hl7.org/browse/FHIR-50271)
* removed SHOULD:display obligation on Composition.identifier, Composition.type, and Composition.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Composition.section[all slices].title and Composition.section[all slices].text obligations from SHALL:populate-if-known to SHALL:populate for the AU PS Producer [IPS: FHIR-51259](https://jira.hl7.org/browse/FHIR-51259)
* added Composition.section.title and Composition.section.text with associated Must Support and obligations in each section slice [AU PS: FHIR-51871](https://jira.hl7.org/browse/FHIR-51871)
* changed Composition.section.entry obligation for the AU PS Producer from SHOULD:populate-if-known to SHOULD:populate in the following sections [AU PS: FHIR-51834](https://jira.hl7.org/browse/FHIR-51834): 
* Patient Summary Immunizations Section (Composition.section:sectionImmunizations)
* Patient Summary Results Section (Composition.section:sectionResults)
* Patient Summary History of Procedures Section (Composition.section:sectionProceduresHx)
* Patient Summary Medical Devices Section (Composition.section:sectionMedicalDevices)
 
* changed obligations for the following elements for the AU PS Producer from SHALL:able-to-populate to SHALL:populate [IPS: FHIR-51972](https://jira.hl7.org/browse/FHIR-51972): 
* Composition.author
* Composition.title
* Composition.event:careProvisioningEvent.code
 
* changed the following elements to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953): 
* Composition.event:careProvisioningEvent.code
* Composition.section[all slices].code
* Composition.section:sectionProblems.emptyReason
* Composition.section:sectionAllergies.emptyReason
* Composition.section:sectionMedications.emptyReason
 
 
* [AU PS Condition](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-condition.html): 
* changed Condition.bodySite to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on Condition.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Condition.code obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Condition.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Condition.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
 
* [AU PS Consumer ActorDefinition](https://hl7.org.au/fhir/ps/1.0.0-ballot/ActorDefinition-au-ps-actor-consumer.html): 
* changed requirement for recommended AU PS Composition sections from SHOULD to SHALL to implement the profiles referenced by Composition.section.entry [AU PS: FHIR-52345](https://jira.hl7.org/browse/FHIR-52345)
 
* [AU PS Encounter](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-encounter.html): 
* changed Encounter.serviceType to use CodeableConceptIPS [AU PS: FHIR-51872](https://jira.hl7.org/browse/FHIR-51872)
* changed Encounter.participant.type to use CodeableConceptIPS [AU PS: FHIR-51872](https://jira.hl7.org/browse/FHIR-51872)
* changed Encounter.reasonCode to use CodeableConceptIPS [AU PS: FHIR-51872](https://jira.hl7.org/browse/FHIR-51872)
 
* [AU PS Immunization](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-immunization.html): 
* changed Immunization.site and Immunization.route to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on Immunization.patient.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Immunization.vaccineCode obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Immunization.patient obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Immunization.patient.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
* removed SHOULD:display obligation on Immunization.vaccineCode coding slices amtVaccineCode and airVaccineCode for the AU PS Consumer [AU PS: FHIR-53077](https://jira.hl7.org/browse/FHIR-53077)
* changed Immunization.status obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53116](https://jira.hl7.org/browse/FHIR-53116)
 
* [AU PS Medication](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-medication.html): 
* changed Medication to add a comment that the IPS guidance preferencing the use of Medication resource is not adopted by AU PS at this time [AU PS: FHIR-51876](https://jira.hl7.org/browse/FHIR-51876)
* added profile specific implementation guidance that this resource SHALL NOT be used to represent no known current medications for a patient and MedicationStatement SHOULD be used instead [AU PS: FHIR-52274](https://jira.hl7.org/browse/FHIR-52274)
* applied technical correction to add obligations SHALL:populate-if-known for the AU PS Producer, and SHALL:handle for the AU PS Consumer to Medication.code coding slices pbs and amt [AU PS: FHIR-53374](https://jira.hl7.org/browse/FHIR-53374)
* changed Medication.ingredient.item[x] binding to Medication Ingredient (preferred) [AU Base: FHIR-44781](https://jira.hl7.org/browse/FHIR-44781)
 
* [AU PS MedicationRequest](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-medicationrequest.html): 
* changed MedicationRequest.dosageInstruction.route to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* changed MedicationRequest.doNotPerform to constrain out 'true' [IPS: FHIR-51483](https://jira.hl7.org/browse/FHIR-51483)
* removed SHOULD:display obligation on MedicationRequest.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed MedicationRequest.medication:medicationCodeableConcept to use CodeableConceptIPS [IPS: FHIR-51970](https://jira.hl7.org/browse/FHIR-51970)
* changed MedicationRequest.medication[x] to add a comment that the IPS guidance preferencing the use of Medication resources, with use of medicationCodeableConcept only when no other information than a simple code is available, is not adopted by AU PS at this time [AU PS: FHIR-51876](https://jira.hl7.org/browse/FHIR-51876)
* changed MedicationRequest.medication[x] obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate (change applied to MedicationRequest.medication[x]:medicationCodeableConcept and MedicationRequest.medication[x]:medicationReference) [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed MedicationRequest.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed MedicationRequest.reasonCode to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953)
* changed MedicationRequest.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
* added profile specific implementation guidance that this resource SHALL NOT be used to represent no known current medications for a patient and MedicationStatement SHOULD be used instead [AU PS: FHIR-52274](https://jira.hl7.org/browse/FHIR-52274)
* removed SHOULD:display obligation on MedicationRequest.medication[x]:medicationCodeableConcept coding slices pbs and amt for the AU PS Consumer [AU PS: FHIR-53077](https://jira.hl7.org/browse/FHIR-53077)
* changed MedicationRequest.status obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53116](https://jira.hl7.org/browse/FHIR-53116)
* changed MedicationRequest.intent obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53116](https://jira.hl7.org/browse/FHIR-53116)
 
* [AU PS MedicationStatement](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-medicationstatement.html): 
* changed MedicationStatement.dosage.route to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on MedicationStatement.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed MedicationStatement.medication[x] to add a comment that the IPS guidance preferencing the use of Medication resources, with use of medicationCodeableConcept only when no other information than a simple code is available, is not adopted by AU PS at this time [AU PS: FHIR-51876](https://jira.hl7.org/browse/FHIR-51876)
* changed MedicationStatement.medication[x] obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate (change applied to MedicationStatement.medication[x]:medicationCodeableConcept and MedicationStatement.medication[x]:medicationReference) [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed MedicationStatement.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed MedicationStatement.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
* removed SHOULD:display obligation on MedicationStatement.medication[x]:medicationCodeableConcept coding slices pbs and amt for the AU PS Consumer [AU PS: FHIR-53077](https://jira.hl7.org/browse/FHIR-53077)
* changed MedicationStatement.reasonCode to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953)
* added profile specific implementation guidance for representing no known current medications for a patient [AU PS: FHIR-52274](https://jira.hl7.org/browse/FHIR-52274)
* changed MedicationStatement.status obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53116](https://jira.hl7.org/browse/FHIR-53116)
 
* [AU PS Organization](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-organization.html): 
* applied technical correction to add obligations SHALL:populate-if-known for the AU PS Producer, and SHALL:handle and SHOULD:display for the AU PS Consumer to Organization.telecom.system [AU PS: FHIR-52835](https://jira.hl7.org/browse/FHIR-52835)
* applied technical correction to add obligations SHALL:populate-if-known for the AU PS Producer, and SHALL:handle and SHOULD:display for the AU PS Consumer to Organization.telecom.value [AU PS: FHIR-52835](https://jira.hl7.org/browse/FHIR-52835)
* changed Organization.type to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953)
* removed SHOULD:display obligation on the following elements for the AU PS Consumer [AU PS: FHIR-52836](https://jira.hl7.org/browse/FHIR-52836): 
* Organization.telecom.system
* Organization.telecom.value
 
 
* [AU PS Pathology Result Observation](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-diagnosticresult-path.html): 
* changed Observation.interpretation to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on Observation.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Observation.code obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Observation.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed the following elements to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953): 
* Observation.category:lab
* Observation.category:specificDiscipline
* Observation.dataAbsentReason
* Observation.interpretation
* Observation.referenceRange.type
* Observation.component.code
* Observation.value[x]:valueCodeableConcept
* Observation.component.dataAbsentReason
 
* changed Observation.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
 
* [AU PS Patient](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-patient.html): 
* changed Patient.contact.relationship to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* added SHOULD:able-to-populate obligation on Patient.name.text for the AU PS Producer [AU PS: FHIR-51877](https://jira.hl7.org/browse/FHIR-51877)
* added a comment to Patient.name.text strongly recommending population of this element based on IPS guidance [AU PS: FHIR-51877](https://jira.hl7.org/browse/FHIR-51877)
* changed Patient.communication.language to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953)
* applied technical correction to invariants inv-pat-1 and inv-pat-2 to ensure terminology validation applies to the correct sub-extension values when multiple extension instances are present [AU Base: FHIR-53536](https://jira.hl7.org/browse/FHIR-53536)
* removed SHOULD:display obligation on the following elements for the AU PS Consumer [AU PS: FHIR-52836](https://jira.hl7.org/browse/FHIR-52836): 
* Patient.telecom.system
* Patient.telecom.value
* Patient.telecom.use
 
 
* [AU PS PractitionerRole](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-practitionerrole.html): 
* applied technical correction to add obligations SHALL:populate-if-known for the AU PS Producer, and SHALL:handle and SHOULD:display for the AU PS Consumer to PractitionerRole.telecom.system [AU PS: FHIR-52837](https://jira.hl7.org/browse/FHIR-52837)
* applied technical correction to add obligations SHALL:populate-if-known for the AU PS Producer, and SHALL:handle and SHOULD:display for the AU PS Consumer to PractitionerRole.telecom.value [AU PS: FHIR-52837](https://jira.hl7.org/browse/FHIR-52837)
* removed SHOULD:display obligation on the following elements for the AU PS Consumer [AU PS: FHIR-52836](https://jira.hl7.org/browse/FHIR-52836): 
* PractitionerRole.telecom.system
* PractitionerRole.telecom.value
 
 
* [AU PS Procedure](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-procedure.html): 
* changed Procedure.bodySite to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on Procedure.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Procedure.code obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Procedure.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Procedure.reasonCode to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953)
* changed Procedure.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
* changed Procedure.status obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53116](https://jira.hl7.org/browse/FHIR-53116)
 
* [AU PS RelatedPerson](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-relatedperson.html): 
* removed SHOULD:display obligation on the following elements for the AU PS Consumer [AU PS: FHIR-52836](https://jira.hl7.org/browse/FHIR-52836): 
* RelatedPerson.name.use
* RelatedPerson.name.family
* RelatedPerson.name.given
 
 
* [AU PS Smoking Status](https://hl7.org.au/fhir/ps/1.0.0-ballot/StructureDefinition-au-ps-smokingstatus.html): 
* changed Observation.valueCodeableConcept to remove use of the CodeableConceptIPS [IPS: FHIR-51257](https://jira.hl7.org/browse/FHIR-51257)
* removed SHOULD:display obligation on Observation.subject.reference for the AU PS Consumer [IPS: FHIR-51258](https://jira.hl7.org/browse/FHIR-51258)
* changed Observation.code obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed Observation.subject obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-52411](https://jira.hl7.org/browse/FHIR-52411)
* changed the following elements to use CodeableConceptIPS [AU PS: FHIR-52953](https://jira.hl7.org/browse/FHIR-52953): 
* Observation.category
* Observation.category:socialHistory
* Observation.value[x]
* Observation.dataAbsentReason
 
* changed Observation.subject.reference obligation for the AU PS Producer from SHALL:populate-if-known to SHALL:populate [AU PS: FHIR-53115](https://jira.hl7.org/browse/FHIR-53115)
 

