AU Patient Summary Implementation Guide
0.5.0-cibuild - CI Build
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
Page standards status: Informative |
AU PS profiles will by design:
AU PS profiles:
The differential view therefore shows the patient summary requirements that are additional to AU Core. In some profiles, e.g. AU PS Organization, the only additional requirements from AU Core are the obligations for AU PS actors.
Figure 1: Profiling approach for AU PS Patient profile
The AU PS Bundle profile is not based on AU Core or AU Base (no resource profile exists). The approach to profiling for AU PS Bundle is to:
This approach to AU PS Bundle profiling has been taken as at this time there is a tooling limitation that prevents meeting both of the below conditions:
AU PS profile design to ensure compliance with AU Core and IPS is agreed to as follows. AU PS profiles:
Adopting the approach in both IPS and AU Core, AU PS profiles are ‘open’ and allow for additional content undefined by AU PS (and IPS) to be shared. See the section Extensibility – “Additional” Sections or Elements for information.
When managing profile complexity and requirements in the national and international context for AU PS, the following mechanisms are available:
These mechanisms offer differing capabilities and advantages. Typically HL7 AU profiles use derivation to manage compliance within HL7 AU inheritance. However, AU PS will comply to both HL7 AU (AU Core) and IPS and therefore additional mechanism(s) on top of derivation from the underlying HL7 AU profile stack are required. At this time additional requirements are included in AU PS profiles via informal alignment (i.e. human authoring, human checking, and compliesWith checks).
For a human, the main differences with use of imposeProfile are:
Currently no AU PS profile uses imposeProfile. To support future maintenance it is under consideration that all AU PS profiles derive from AU Core, where available, and use imposeProfile to apply IPS rules. That would mean that a number of IPS-imposed requirements including cardinality, terminology, and flagging of Must Support would not be directly visible in the formal views within this guide. Or, if we chose to make the additional IPS constraints visible + use imposeProfile, those constraints would be repeated from a validation sense and could be an additional validation burden.
Users of this implementation guide are encouraged to provide their feedback about the potential use of imposeProfile.
As in IPS, a producer can send:
Additional sections or elements are often required by other profiles the system may conform to, allowing local requirements, including technical and workflow context for the resource, to be reflected and extending the health information supported in exchanges. For this reason, extensibility is generally encouraged and expected in AU PS profiles. Only in some exceptionally rare use case profiles are rules tightened to limit the nature of additional information that can be sent.
Implementers intending to populate the AU PS with an unprofiled resoure type, e.g. MedicationAdministration, are recommended to consider the corresponding AU Base profile, e.g. AU Base MedicationAdministration, as guidance for that resource type in an Australian healthcare context.
Implementers need to be aware, the rules of the Composition.section:All Slices
defined in the AU PS Composition profile apply to all sections, defined or undefined:
Composition.section.title
is mandatory and has obligations defined for AU PS Producers and AU PS ConsumersComposition.section.text
is mandatory and has obligations defined for AU PS Producers and AU PS ConsumersIt is recommended that where a producing system intends to populate “additional” sections there is some definition available in a specification describing the intended contents and use of these additional sections.
Specification authors adopting AU PS are encouraged to enable greater interoperability and software re-use by avoiding reductions in an element’s cardinality.
Depending on local requirements, a consumer (i.e. client application) may ignore these “additional” elements, may treat the data as for rendering only, or be capable of recognising and using the element.
The AU PS shares the same structure as IPS and contains sections that can include coded elements in reusable “minimal” data blocks.
The AU PS identifies a number of terminologies as Must Support for AU PS consumers and producers. Primary terminologies used in this specification include SNOMED CT Australian Edition (SNOMED CT-AU) for clinical concepts (e.g. allergies, problems, procedures, medicines), LOINC for observation codes (e.g. pathology results and vital signs), UCUM for units of measure, ISO 3166 for countries, PBS Item codes for medicines, Australian Immunisation Register codes for vaccines, and FHIR defined CodeSystems.
Within the AU PS context (i.e. the Australian healthcare context), the Australian localised value sets, developed and published by the National Clinical Terminology Service (NCTS) and the HL7 AU FHIR Working Group are preferred over IPS value sets to support the consumer on their healthcare journey in the AU healthcare context.
In an IPS context, IPS proposes that to support interoperability of IPS content between organisations that use different SNOMED CT value set content, a “common proximal ancestor” strategy is used. See IPS Structuring Terminology Choices for more information.
See the guidance defined in IPS Patient Safety in IPS Context.
See the guidance defined in AU Core Medicine Information.
See the guidance defined in AU Core Representing Body Site, Which May Include Laterality.
See the guidance defined in IPS Provenance.