AU Patient Summary Implementation Guide
0.5.0-cibuild - CI Build Australia flag

AU Patient Summary Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 0.5.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-ps/ and changes regularly. See the Directory of published versions

AUCDI

Page standards status: Informative

Australian Clinical Data for Interoperability (AUCDI) and AU Patient Summary (AU PS) complement each other assisting in common understanding of clinical data concepts when implemented in systems and exchanged between systems.

AUCDI defines data groups comprising one or more data elements and references clinical terminology concepts, forming the foundation of a common language to allow systems to exchange semantically accurate data more efficiently. AUCDI defines clinical requirements for the data required to support the provision of care, exchange, aggregation for analysis, and to support clinical decision support. AUCDI may define requirements that are future focussed and as yet do not align with system implementation of the clinical concept.

AU PS is a technical specification that addresses constraints and obligations on data representation for generation, exchange, and consumption of patient summaries in the Australian healthcare context. AU PS enables system data to be mapped to an agreed FHIR format for systems in Australia.

AUCDI and AU Patient Summary Development Approach

Figure 1: AUCDI and AU PS development approach

An interpretation of AUCDI clinical information requirements through community consensus is undertaken to define support for the exchange of clinical and administrative data within technical constraints. Note that:

  • In any particular release, AU Core or AU PS may not cover all AUCDI data concepts, especially when AUCDI data concepts are not supported in existing systems.
  • AU PS includes exchange for concepts that are commonly implemented in systems and not included in AUCDI e.g. Patient.name, Practitioner.identifier, Procedure.encounter.
  • AU PS includes exchange for clinical concepts not yet included in AUCDI, e.g. MedicationRequest, which are included through reference to IPS or AU Core.
  • AU PS includes data elements not included in AUCDI that are required to make FHIR implementable e.g. Observation.status, MedicationRequest.intent.

AUCDI and AU PS Versions

AUCDI R2 builds upon R1, expanding on the initial “core”, introducing additional data groups to support different use cases including “Patient summary”:

AUCDI Version AU PS Version
R1 -
R2 (Patient summary) 1.0.0

AUCDI (Patient summary) Mappings Into AU PS

The table below shows the relationship between data defined in the “Patient summary” AUCDI Data Groups and Elements, AU Core profiles, and AU PS profiles.

Column attribute descriptions are as follows:

  • AUCDI Data Group: The name of the AUCDI data group.
  • AUCDI Data Element: The name of the AUCDI data element within an AUCDI data group.
  • AU PS Document Section: The AU PS Document section relevant for exchange (see Structure of the Australian Patient Summary (AU PS)).
  • AU PS Profile(s): The title of the AU PS profile relevant for exchange.
  • FHIR Path: The FHIRPath expression to the FHIR element relevant for exchange, i.e. the FHIR element that can be populated with data from a source system that represents the clinical concept expressed in the AUCDI data element.
  • Comment: Additional information about the mapping including an explanation of where an element or group is not yet mapped.
| |
AUCDI Data Group AUCDI Data Element AU PS Document Section AU PS Profile(s) FHIR Path Comment
Adverse reaction risk summary Substance name Allergies and Intolerances AU PS AllergyIntolerance AllergyIntolerance.code
Date/time of onset of first reaction AU PS AllergyIntolerance TBD There is no native FHIR element or extension available with this exact meaning. Possible options are to:
  • map to AllergyIntolerance.onsetDateTime noting that allergies and intolerances may be identified without a reaction so this may not identify a first reaction.
  • map to AllergyIntolerance.reaction.onsetDateTime and the first reaction is just understood as the earliest noting that not all reactions may be captured.
  • develop a FHIR extension to capture the date time of the first reaction - to be submitted for consideration in the FHIR Extensions Pack.
Please provide your feedback on possible mapping options on this page.
Manifestation AU PS AllergyIntolerance AllergyInterolance.reaction
Severity of reaction AU PS AllergyIntolerance AllergyIntolerance.reaction.severity
Comment AU PS AllergyIntolerance AllergyIntolerance.note
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration.
Last Menstrual Period (LMP) assertion Date of onset History of pregnancy - - This AUCDI data group is a Future Candidate Requirement Under Consideration.
Certainty - -
Date of assertion - -
Medication use statement Medication name Medication Summary AU PS MedicationStatement | AU PS Medication MedicationStatement.medication[x] | Medication.code See the Medicine Information guidance page in AU Core.
Clinical indication AU PS MedicationStatement MedicationStatement.reasonCode | MedicationStatement.reasonReference
Strength AU PS MedicationStatement | AU PS Medication MedicationStatement.medication[x] | Medication.code | Medication.ingredient
Form AU PS MedicationStatement | AU PS Medication MedicationStatement.medication[x] | Medication.form
Dose amount AU PS MedicationStatement MedicationStatement.dosage.doseAndRate
Route of administration AU PS MedicationStatement MedicationStatement.dosage.route
Dose timing AU PS MedicationStatement MedicationStatement.dosage.timing
Comment AU PS MedicationStatement MedicationStatement.note
Date of assertion AU PS MedicationStatement MedicationStatement.dateAsserted
Problem/Diagnosis summary Problem / Diagnosis name Problems | History of Past Problems AU PS Condition Condition.code
Body site AU PS Condition Condition.code
Date/time of onset AU PS Condition Condition.onsetDateTime
Date/time of resolution AU PS Condition Condition.abatementDateTime
Status AU PS Condition Condition.clinicalStatus
Comment AU PS Condition Condition.note
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration.
Procedure Procedure name History of Procedures AU PS Procedure Procedure.code
Clinical indication AU PS Procedure Procedure.reasonCode | Procedure.reasonReference[x]
Body site/laterality AU PS Procedure Procedure.code
Date/time performed AU PS Procedure Procedure.performed[x] | Procedure.performedDateTime
Comment AU PS Procedure Procedure.note
Sex and gender summary Sex assigned at birth N/A AU PS 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 PS Patient Patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-genderIdentity')
Pronoun/s AU PS Patient Patient.extension.where(url='http://hl7.org/fhir/StructureDefinition/individual-pronouns')
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration.
Vaccination Vaccine name Immunizations AU PS Immunization Immunization.vaccineCode
Sequence AU PS Immunization Immunization.protocolApplied.doseNumber[x]
Date of administration AU PS Immunization Immunization.occurenceDateTime
Comment AU PS Immunization Immunization.note
AUCDI Data Group AUCDI Data Element AU PS Document Section IPS Profile(s) FHIR Path Comment
Estimated Date of Delivery (EDD) summary EDD by menstrual cycle History of pregnancy Observation Pregnancy - Expected Delivery Date (IPS) Observation.valueDateTime This data group maps to an IPS profile; This AUCDI data group is a Future Candidate Requirement Under Consideration.
Date of ultrasound Observation Pregnancy - Expected Delivery Date (IPS) Observation.effectiveDateTime AUCDI elements Date of ultrasound and Estimated data of delivery by ultrasound would be grouped together in the same Observation, separate to Estimated data of delivery by menstrual cycle.
EDD by ultrasound Observation Pregnancy - Expected Delivery Date (IPS) Observation.valueDateTime
Last updated - - This AUCDI element is a Future Candidate Requirement Under Consideration.
Gestation by ultrasound - - This AUCDI element is a Future Candidate Requirement Under Consideration.
Pregnancy assertion Pregnancy assertion History of pregnancy Observation Pregnancy - Status (IPS) Observation.valueCodeableConcept This data group maps to an IPS profile; This AUCDI data group is a Future Candidate Requirement Under Consideration.
JustificationObservation Pregnancy - Status (IPS) Observation.note
Date of assertionObservation Pregnancy - Status (IPS) Observation.effectiveDateTime