Usage scenarios

The following are supported usage scenarios for this profile:

• Query for a specific procedure or test request such as an electrocardiogram (ECG) order or a referral to a support program
• Query for a specific service offered to a patient such as a referral to a support program
• Query for category of service request (e.g. all cardiology requests)
• Record or update a request for a service for a patient

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

• US Core ServiceRequest

No equivalent International Patient Access or International Patient Summary profile.

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

Profile specific implementation guidance

• ServiceRequest.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 ServiceRequest.code.text and/or ServiceRequest.code.coding.display so that client applications can at least display the condition even if the client application does not recognise the code supplied.
• The ServiceRequest resource can represent a reason as a code with ServiceRequest.reasonCode, or a reference with ServiceRequest.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
• The ServiceRequest resource can represent the desired performer as a code with ServiceRequest.performerType, or a reference with ServiceRequest.performer to a HealthcareService 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
• ServiceRequest.supportingInfo is broad to accommodate a wide variety of use cases by allowing a reference to any resource.
  • servers SHALL ensure references to external resources are only to resources that conform to at least an AU Core profile and the resource type is supported by the Conformance/Capability statement for that endpoint and conform
  • See guidance on the construction of identifiers in each Identifier profile and the section on Business Identifiers in AU Base.
  • Source system identifiers that identify the business process (order ids) SHOULD be included as AU Local Order Identifier to support workflow and deduplication of ServiceRequest resources.
    • See guidance on the construction of an identifier on the relevant Identifier profile page and the section on Business Identifiers in AU Base.

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

   Example:

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

   Implementation Notes: Fetches a bundle of all ServiceRequest 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]/ServiceRequest?patient={Type/}[id]&category={system|}[code]

   Example:

   1. GET [base]/ServiceRequest?patient=5678&category=http://snomed.info/sct|708175003

   Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and a category code = 708175003 (how to search by reference and how to search by token)

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

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

   Example:

   1. GET [base]/ServiceRequest?patient=5678&category=http://snomed.info/sct|708175003&authored=ge2020-01-01T00:00:00Z

   Implementation Notes: Fetches a bundle of all ServiceRequest resources for the specified patient and date and a category code = 708175003 (how to search by reference and how to search by token and how to search by date)

4. 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]/ServiceRequest?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/ServiceRequest?patient=5678&code=http://snomed.info/sct|169069000,http://snomed.info/sct|399208008

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

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

1. SHOULD support fetching a ServiceRequest using the _id search parameter:
   • SHALL support these _revinclude parameters: Provenance:target GET [base]/ServiceRequest/[id] or GET [base]/ServiceRequest?_id=[id]

   Example:

   1. GET [base]/ServiceRequest/2169591
   2. GET [base]/ServiceRequest?_id=2169591

   Implementation Notes: Fetches a single ServiceRequest (how to search by the logical id of the resource)

2. SHOULD support searching using the identifier search parameter:
   • SHALL support these _revinclude parameters: Provenance:target GET [base]/ServiceRequest?identifier={system|}[code]

   Example:

   1. GET [base]/ServiceRequest?identifier=http://gp.example.org|1032333

   Implementation Notes: Fetches a bundle containing any ServiceRequest resources matching the identifier (how to search by token)

3. 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])
   • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
   • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

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

   Example:

   1. GET [base]/ServiceRequest?patient=5678&category=http://snomed.info/sct|708175003&status=active

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

4. SHOULD support searching using the combination of the patient and code and authored 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 authored (e.g.authored=[date]&authored=[date]]&...)

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

   Example:

   1. GET [base]/ServiceRequest?patient=5678&code=http://snomed.info/sct|169069000,http://snomed.info/sct|399208008&authored=ge2020-01-01T00:00:00Z
   2. GET [base]/ServiceRequest?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|169069000,http://snomed.info/sct|399208008&authored=ge2020-01-01T00:00:00Z

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

5. 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])
   • SHOULD support multipleOr search on code (e.g.code={system|}[code],{system|}[code],...)
   • SHALL support multipleOr search on status (e.g.status={system|}[code],{system|}[code],...)

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

   Example:

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

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