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 Waist Circumference

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

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This profile sets minimum expectations for an Observation resource to record, search, and fetch waist circumference observations with standard coding and units of measure. It is based on the FHIR Vital Signs Profile 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 waist circumference associated with a patient
  • Record or update an observation of waist circumference 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.
  • Observations MAY have additional codes that translate or map to the Observation code or category codes. For example:
    • providing a local code
    • providing a more specific codes such as 8306-3 - Body height - lying in addition to 8302-2 - Body height. Several additional observation codes are provided in the FHIR core specification vital signs table.
  • Observations MAY have [component] observations to qualify the vital sign observation. For example, 8478-0 - Mean blood pressure, 8887-2 - Heart rate device type, 8326-1 - Type of body temperature device. Several of these are provided in the FHIR core specification vital signs table.

Usage:

Formal Views of Profile Content

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

This structure is derived from observation-vitalsigns

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*observation-vitalsignsWaist circumference
au-core-obs-02: At least value or data absent reason shall be present
... status 1..1coderegistered | preliminary | final | amended +
Fixed Value: final
... code
.... Slices for coding 2..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincWaistCircumCode 1..1CodingLOINC Waist Circumference
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 8280-0
..... coding:snomedWaistCircumCode 1..1CodingSNOMED CT Waist Circumference
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 276361009
... subject 1..1Reference(AU Core Patient)Who and/or what the observation is about
... effective[x] C1..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
... valueQuantity C0..1QuantityWaist circumference
.... value 1..1decimalNumerical value (with implicit precision)
.... unit 1..1stringUnit representation
.... system 1..1uriSystem that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code 1..1codeCoded responses from the common UCUM units for vital signs value set.
Binding: https://healthterminologies.gov.au/fhir/ValueSet/metric-body-length-units-1 (required)
... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
... bodySite C0..1CodeableConceptObserved body part
Binding: https://healthterminologies.gov.au/fhir/ValueSet/body-site-1 (preferred)
au-core-obs-04: If a coded body site is provided, at least one code shall be from SNOMED CT

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.valueQuantity.coderequiredhttps://healthterminologies.gov.au/fhir/ValueSet/metric-body-length-units-1
Observation.bodySitepreferredhttps://healthterminologies.gov.au/fhir/ValueSet/body-site-1

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()
au-core-obs-04errorObservation.bodySiteIf a coded body site is provided, at least one code shall be from SNOMED CT
: coding.exists() implies coding.where(system='http://snomed.info/sct').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. The client SHALL support search using the 'vital-signs' category defined in each profile. The server SHALL support search using the 'vital-signs' category defined in each profile.
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. The client SHALL support search using the LOINC codes defined in each profile. The server SHALL support search using the LOINC codes defined in each profile.
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.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    3. 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=vital-signs

    Example:

    1. GET [base]/Observation?patient=5678&category=vital-signs

    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 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=vital-signs&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Observation?patient=5678&category=vital-signs&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 = vital-signs (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]/Observation?patient={Type/}[id]&code={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&code=http://snomed.info/sct|364075005,http://loinc.org|8280-0,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)

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=vital-signs&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&category=vital-signs&status=final
    2. GET [base]/Observation?patient=5678&category=vital-signs&_revinclude=Provenance:target

    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|364075005,http://loinc.org|8280-0,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|364075005,http://loinc.org|8280-0,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 observation code(s) (how to search by reference and how to search by token and how to search by date)