AU Core Profiles for Observation

The following core profiles for the Observation resource have been defined. If implementations use an Observation resource when expressing profile-specific concepts as structured data, they SHOULD conform to the following profiles:

• AU Core Assertion of No Relevant Finding.
• AU Core Biological Sex Assigned at Birth.
• Diagnostics: AU Core Diagnostic Imaging Result Observation, AU Core Diagnostic Result Observation, AU Core Lipid Result, AU Core Pathology Result Observation.
• Pregnancy: AU Core Estimated Date of Delivery, AU Core Gestational Age, AU Core Gravidity, AU Core Last Menstrual Period, AU Core Parity, AU Core Pregnancy Status.
• Social history: AU Core Alcohol Status, AU Core Health Program Participation Summary, AU Core Smoking Cease Date, AU Core Smoking Start Date, AU Core Smoking Status.
• Vital signs: AU Core Blood Pressure, AU Core BMI, AU Core Body Height, AU Core Body Temperature, AU Core Body Weight, AU Core Head Circumference, AU Core Heart Rate, AU Core Oxygen Saturation, AU Core Respiration Rate, AU Core Vitals Panel, AU Core Waist Circumference.

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• IPA-Observation
• US Core Simple Observation

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.

Usage scenarios

The following are supported usage scenarios for this profile:

• Query for observations about a associated with a patient
• Record or update an observation about a patient

Profile specific implementation guidance

• Codes SHOULD be drawn from SNOMED CT-AU or LOINC. Additional codes that translate or map to the code are allowed. For example providing both a local code and the SNOMED CT-AU code.
• Observation.category provides an efficient way of supporting system interactions, e.g. restricting searches, to a defined context such as social history or laboratory. Implementers need to understand that data categorisation is somewhat subjective. The categorisation applied by the source may not align with a receiver’s expectations.
  • An observation representing questions and responses to surveys and screening and assessment tools SHALL have one Observation.category as “survey”.

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.

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|160573003,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|160573003,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|160573003,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)