AU Core Implementation Guide
0.2.2-preview - Preview Australia flag

This page is part of the Australian Core IG (v0.2.2-preview: AU Core) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core Last Menstrual Period

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-lastmenstrualperiod Version: 0.2.2-preview
Standards status: Draft Maturity Level: 0 Computable Name: AUCoreLastMenstrualPeriod

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This profile sets minimum expectations for an Observation resource to record, search, and fetch observations that represent the date of a patient’s last known menstrual period at a point in time with standard coding and value. It is based on the core FHIR Observation resource and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the Observation resource when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

Usage scenarios

The following are supported usage scenarios for this profile:

  • Query for observations of date of last known menstrual period associated with a patient
  • Record or update an observation of date of last known menstrual period associated with a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

No equivalent International Patient Summary profile.

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access or US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

  • Observation.category provides an efficient way of supporting system interactions, e.g. restricting searches. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.
  • Additional codes that translate or map to the Observation code or category codes are allowed. For example providing both a local code and the required code.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationDate of last menstrual period
au-core-obs-02: At least value or data absent reason shall be present
... status S1..1coderegistered | preliminary | final | amended +
Fixed Value: final
... category S1..*CodeableConceptClassification of type of observation
Slice: Unordered, Open by pattern:$this
... code S1..1CodeableConceptType of observation (code / type)
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 21840007
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincLastMenstrualPeriod 0..1CodingLOINC Last Menstrual Period
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8665-2
... encounter S0..1Reference(AU Core Encounter)Healthcare event during which this observation is made
... effective[x] SC1..1dateTimeDate, and optionally time, the observation was performed
au-core-obs-01: Date shall be at least to day
... performer S0..*Reference(AU Core Practitioner | AU Core PractitionerRole | AU Core Organization | AU Core Patient | AU Core RelatedPerson)Who is responsible for the observation
... value[x] SC0..1dateTimeActual result
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-obs-01errorObservation.effective[x]Date shall be at least to day
: $this is DateTime implies $this.toString().length() >= 10
au-core-obs-02errorObservationAt least value or data absent reason shall be present
: dataAbsentReason.exists() or value.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
patient SHALL reference The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both.
patient+category SHALL reference+token
patient+category+date SHALL reference+token+date
patient+code SHALL reference+token
patient+category+status SHOULD reference+token+token
patient+code+date SHOULD reference+token+date
patient.identifier SHOULD reference.token The client SHALL provide both the system and code values. The server SHALL support both. The client SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
category MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.
code MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.
date MAY date A client SHALL provide a value precise to the second + time offset. A server SHALL support a value precise to the second + time offset.
status MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching using the patient search parameter:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/Observation?patient={Type/}[id] or optionally GET [base]/Observation?patient.identifier=[system|][code]

    Example:

    1. GET [base]/Observation?patient=5678
    2. GET [base]/Observation?patient=5678&_revinclude=Provenance:target
    3. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    4. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient (how to search by reference and how to search by token)

  2. SHALL support searching using the combination of the patient and category search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category (how to search by reference and how to search by token)

  3. SHALL support searching using the combination of the patient and code search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)

    GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&code=http://snomed.info/sct|21840007,http://loinc.org|9279-1,http://loinc.org|85354-9

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code(s). The Observation code parameter searches Observation.code only. (how to search by reference and how to search by token)

  4. SHALL support searching using the combination of the patient and category and date search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHALL support these date comparators: gt,lt,ge,le
    • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&date=ge2020-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and a category code = survey (how to search by reference and how to search by token and how to search by date)

Optional Search Parameters:

The following search parameters and search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the combination of the patient and category and status search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])
    • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final
    2. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|survey&status=final

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and category and status (how to search by reference and how to search by token)

  2. SHOULD support searching using the combination of the patient and code and date search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code]
    • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
    • SHALL support these date comparators: gt,lt,ge,le
    • SHOULD support multipleAnd search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Observation?patient=5678&code=http://snomed.info/sct|21840007,http://loinc.org|9279-1,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z
    2. GET [base]/Observation?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|21840007,http://loinc.org|9279-1,http://loinc.org|85354-9&date=ge2020-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and report code(s) (how to search by reference and how to search by token and how to search by date)