Usage scenarios

The following are supported usage scenarios for this profile:

• Query for procedures performed on a patient
• Record or update a record of a procedure performed on a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• US Core Procedure
• and MAY be conformant to Procedure (IPS) if patient is supported as Procedure.subject.reference

No equivalent International Patient Access profile.

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

Profile specific implementation guidance

• Procedure.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.
• The use of coding can vary significantly across systems, client applications need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Servers SHOULD populate Procedure.code.text and/or Procedure.code.coding.display so that client applications can at least display the condition even if the client application does not recognise the code supplied.
• In an exchange with the My Health Record system Procedure.status is “completed”
• The Procedure resource can represent a reason as a code with Procedure.reasonCode, or a reference with Procedure.reasonReference to a Condition or other resource.
  • Although both are marked as must support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements
  • A client application SHALL support both elements
• A procedure including an implantable device should use Procedure.focalDevice with a reference to a Device resource

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]/Procedure?patient={Type/}[id] or optionallyGET [base]/Procedure?patient.identifier=[system|][code]

   Example:

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

   Implementation Notes: Fetches a bundle of all Procedure 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 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]/Procedure?patient={Type/}[id]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Procedure?patient=5678&date=ge2020-01-01T00:00:00Z
   2. GET [base]/Procedure?patient.identifier=http://example.org/fhir/mrn|12345&date=ge2020-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Procedure resources for the specified patient and date (how to search by reference 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 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]/Procedure?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

   Example:

   1. GET [base]/Procedure?patient=5678&code=http://snomed.info/sct|26782000,http://snomed.info/sct|36969009&date=ge2020-01-01T00:00:00Z
   2. GET [base]/Procedure?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|26782000,http://snomed.info/sct|36969009&date=ge2020-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all Procedure resources for the specified patient and date and procedure code(s). SHOULD support search by multiple codes. (how to search by reference and how to search by token and how to search by date)

2. SHOULD support searching using the combination of the patient 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]/Procedure?patient={Type/}[id]&status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/Procedure?patient=5678&status=completed
   2. GET [base]/Procedure?patient=5678&status=completed&_revinclude=Provenance:target

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