ACT-NOW Implementation Guide
0.5.0 - ci-build

ACT-NOW Implementation Guide, published by Te aho o te kahu - Cancer Control Agency. This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/actnow/ and changes regularly. See the Directory of published versions

## Home

Official URL: http://canshare.co.nz/fhir/ImplementationGuide/actnow.canshare.co.nz | Version: 0.5.0
Draft as of 2026-06-15 | Computable Name: Actnow

### Description

The ACT-NOW specification describes the data collection for oncology treatment in New Zealand, particularly medication administration.

This Guide describes how this data could be represented as FHIR resources, and collected from care delivery systems into a FHIR server for subsequent use such as Analytics and Care delivery.

As such it describes an actual implementation based around a generic FHIR server, rather than a definition of how interoperability works between systems in a particular domain. It is accompanied by a Reference Implementation - an example solution intended to validate the design and make the design more approachable to system implementers.

Details of the server requirements are found in the CapabilityStatement - though note that there are some details - like the requirement for transaction updates using conditional update - that are not reflected here.

It is intended that the guide will help inform the choice of architectural components needed for a production grade deployment, as well as the requirements for vendors supplying data to the system.

### Tabs in the guide

There are a number of sections to the Guide, represented as tabs at the top of the guide.

- The Resource graph section describes how the clinical information is represented as a graph of FHIR resources
- The Architecture section describes the high level architecture of the proposed solution. This is intended to provide the requirements for the implementers of the system. and may be adapted as the project progresses. However, it will remain a high level description - the implementation details will not be represented in this guide.
- The API section has 2 sub sections.
  - The Input API describes how data is sent from the client to the server via the RESTful API using FHIR transactions.
  - The Query API describes what queries the system needs to support.
- Examples contains a list of example resources
- Extensions is a summary of extensions
- Profiles lists the profiles defined here
- Terminology contains ValueSets needed by the profiles & extensions
- The Reference Implementation describes applications that have been created to assist with development and demonstrate the kinds of interface that could be built with the ACT-NOW data
- And finally the Support tab allows downloading of this guide and all the artifacts defined as computable resources in a number of formats, as well as a link to the main FHIR specification.

### Version

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (actnow.canshare.co.nz.r4) and R4B (actnow.canshare.co.nz.r4b) are available.

### Dependencies

IG | Package | FHIR | Comment
--- | --- | --- | ---
ACT-NOW Implementation Guide | actnow.canshare.co.nz#0.5.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.2.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.3.0 | R4 |
minimal Common Oncology Data Elements (mCODE) Implementation Guide | hl7.fhir.us.mcode#4.0.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.2.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
Genomics Reporting Implementation Guide | hl7.fhir.uv.genomics-reporting#2.0.0 | R4 |
US Core Implementation Guide | hl7.fhir.us.core#6.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#1.0.0 | R4 |
Bulk Data Access IG | hl7.fhir.uv.bulkdata#2.0.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.1.0 | R4 |
VSAC | us.nlm.vsac#0.11.0 | R4 |
Structured Data Capture | hl7.fhir.uv.sdc#3.0.0 | R4 |
PHINVads | us.cdc.phinvads#0.12.0 | R4 |
IHE FormatCode Vocabulary | ihe.formatcode.fhir#1.1.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.3.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, May 16, 2026 18:32+1000+10:00)

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.genomics-reporting#2.0.0 Guidelines for reporting of clinical genomics results using HL7 FHIR. (built Mon, May 9, 2022 16:52+0000+00:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.bulkdata#2.0.0 FHIR based approach for exporting large data sets from a FHIR server to a client application (built Fri, Nov 26, 2021 05:56+1100+11:00)

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package ihe.formatcode.fhir#1.1.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Package hl7.fhir.us.core#6.1.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Fri, Jun 30, 2023 14:02+0000+00:00)

Package hl7.fhir.us.mcode#4.0.0 mCODE™ (short for Minimal Common Oncology Data Elements) is an initiative intended to assemble a core set of structured data elements for oncology electronic health records. (built Sun, Feb 16, 2025 19:03+0000+00:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

### IP Statement

This publication includes IP covered under the following statements.

- ISO maintains the copyright on the country codes, and controls its use carefully. For further details see the ISO 3166 web page: https://www.iso.org/iso-3166-country-codes.html
  Show Usage
  - ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code: Actnow, AnCM... Show 59 more, AnCN, AnCT, AnCondition, AnHistology, AnMedicationAdministration, AnMedicationRequest, AnPatient, CanShareCapabilityStatement, CareplanCycle, CareplanRegimen, ClinTNMGroup, ClinicalTrial, CourseNumber, CycleCount, CycleDay, CycleNumber, CyclePlannedLength, DoseAdjustmentReason, DxBasis, ERStatus, EcogStatus, FacilityAdministered, HER2Status, IOT, LastAdminDate, ObservationBSA, ObservationCM, ObservationCN, ObservationCT, ObservationClinTNMGroup, ObservationCreatClear, ObservationEcog, ObservationErStatus, ObservationGleason, ObservationHeight, ObservationHer2Status, ObservationHistology, ObservationPM, ObservationPN, ObservationPT, ObservationPathTNMGroup, ObservationPrStatus, ObservationWeight, PRStatus, PathM, PathN, PathT, PathTNMGroup, PrescribedDose, RecurrenceType, RegimenDiscontinued, RegimenDiscontinuedPatientFactors, RegimenDiscontinuedReason, RegimenDiscontinuedToxicity, RegimenIOT, RegimenOTU, RegimenOutcome, RegimenType and cp-supporting-info
- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  - Unified Code for Units of Measure (UCUM): Observation/CreatinineClearance, Observation/ExObservationHeight and Observation/ExObservationWeight
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: Observation/ExObservationECOG, Observation/ExObservationHeight and Observation/ExObservationWeight
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - Observation Category Codes: Observation/ExObservationHeight and Observation/ExObservationWeight

### Globals

There are no Global profiles defined