AU Core Implementation Guide
2.0.0-draft - Draft

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## Comparison with other national and international IGs

Page standards status: Informative

AU Core aligns to, and leverages, international standards and other national standards, in particular:

- International Patient Access 1.1.0
- International Patient Summary Implementation Guide 2.0.0-ballot
- US Core Implementation Guide 7.0.0

Relationships between AU Core, AUCDI, and the above key implementation guides is described in Relationship with other IGs.

International Patient Access (IPA) and International Patient Summary (IPS) are specifically referenced, as many of the profiles defined in AU Core are expected in future to be adopted in Australian localisations of these international standards.

Corresponding profiles, conformance requirements, and capability statements included in the key FHIR implementation guides were reviewed and considered during AU Core’s development to ensure alignment, and to facilitate adoption of, this standard.

The below comparison evaluates AU Core conformance requirements with the key implementation guides identifying where compliance with AU Core satisfies the expectations established by the referenced implementation guide.

At this time only profile comparison is available. Future versions of AU Core will compare capability statements.

### Profile comparison

As part of profile comparison, the requirements, constraints, and standards specified in a particular FHIR profile are evaluated. These requirements can include mandatory elements, Must Support elements, cardinality constraints, data types, terminology bindings, usage rules, extensions, rules on missing or suppressed data.

The table below provides a profile only comparison from AU Core to profiles in key implementation guides. Compliance in the reverse direction is not guaranteed, i.e. a resource that is compliant with an International Patient Access profile MAY NOT be compliant with AU Core.

Legend:

Compliant: An AU Core compliant resource meets all requirements of the compared profile.

Additional requirements: An AU Core compliant resource is compatible, but additional changes may be needed to meet all requirements of the compared profile. Where additional requirements are identified, more information is provided in the sections below.

Incompatible: An AU Core compliant resource is incompatible with the compared profile. A resource cannot be compliant to both. Where incompatible requirements are identified, more information is provided in the sections below.

No equivalent profile: No equivalent profile for comparison.

AU Core | International Patient Access 1.1.0 | International Patient Summary 2.0.0-ballot | US Core 7.0.0
--- | --- | --- | ---
AU Core AllergyIntolerance |  |  |
AU Core Blood Pressure |  |  |
AU Core Body Height |  |  |
AU Core Body Temperature |  |  |
AU Core Body Weight |  |  |
AU Core Condition |  |  |
AU Core Diagnostic Result Observation |  |  |
AU Core Encounter |  |  |
AU Core HealthcareService |  |  |
AU Core Heart Rate |  |  |
AU Core Immunization |  |  |
AU Core Location |  |  |
AU Core Medication |  |  |
AU Core MedicationRequest |  |  |
AU Core MedicationStatement |  |  |
AU Core Organization |  |  |
AU Core Pathology Result Observation |  |  |
AU Core Patient |  |  |
AU Core Practitioner |  |  |
AU Core PractitionerRole |  |  |
AU Core Procedure |  |  |
AU Core RelatedPerson |  |  |
AU Core Respiration Rate |  |  |
AU Core Smoking Status |  |  |
AU Core Waist Circumference |  |  |

#### International Patient Access

International Patient Access 1.1.0 describes how an application acting on behalf of a patient can access patient information from a clinical records system using a FHIR-based API.

##### Additional requirements

The following IPA profile(s) contain additional requirements. Implementers are advised to note that some code changes may be required to support these profiles.

AU Core | International Patient Access 1.1.0 | Element | Additional requirements
--- | --- | --- | ---
AU Core MedicationRequest | IPA-MedicationRequest | MedicationRequest.reported[x] | Element flagged as Must Support in IPA.
AU Core MedicationStatement | IPA-MedicationStatement | MedicationStatement.statusReason | Element flagged as Must Support in IPA.
MedicationStatement.context | Element flagged as Must Support in IPA.
MedicationStatement.informationSource | Element flagged as Must Support in IPA.
AU Core Patient | IPA-Patient | Patient.identifier | IPA requires all identifiers to have system, type or assigner (ipa-pat-1).
Patient.identifier.value | Element flagged as Must Support in IPA.
Patient.name.text | Element SHOULD be present (ipa-pat-3).
Patient.active | Element flagged as Must Support in IPA.
Patient.link | Element flagged as Must Support in IPA.

##### Missing Data

AU Core compliant resources are compliant with IPA requirements for Missing Data.

##### Suppressed Data

IPA does not include requirements for Suppressed Data.

##### Additional profiles

This version of AU Core has no equivalent profile for the following IPA profiles:

- IPA-DocumentReference

#### International Patient Summary

International Patient Summary Implementation Guide 2.0.0-ballot describes how to represent the International Patient Summary (IPS) using HL7 FHIR. An International Patient Summary document is an electronic health record extract containing essential healthcare information about a subject of care.

##### Additional requirements

The following IPS profile(s) contain additional requirements. Implementers are advised to note that some code changes may be required to support these profiles.

AU Core | International Patient Summary 2.0.0-ballot | Element | Additional requirements
--- | --- | --- | ---
AU Core AllergyIntolerance | Allergy Intolerance (IPS) | AllergyIntolerance.patient.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
AllergyIntolerance.type | Element flagged as Must Support in IPS.
AllergyIntolerance.clinicalStatus | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AllergyIntolerance.verificationStatus | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AllergyIntolerance.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AllergyIntolerance.reaction.manifestation | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AllergyIntolerance.onset[x] | Type choice dateTime is flagged as Must Support in IPS.
AU Core Condition | Condition (IPS) | Condition.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
Condition.onset[x] | Type choice dateTime is flagged as Must Support in IPS.
Condition.clinicalStatus | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Condition.verificationStatus | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Condition.category | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Condition.severity | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Condition.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AU Core Immunization | Immunization (IPS) | Immunization.vaccineCode | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Immunization.patient.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
Immunization.site | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Immunization.route | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AU Core Medication | Medication (IPS) | Medication.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Medication.form | Sub-elements of CodeableConceptIPS are flagged as Must Support. Element flagged as Must Support in IPS.
Medication.ingredient | Element flagged as Must Support in IPS.
Medication.ingredient.item[x] | Sub-elements of CodeableConceptIPS are flagged as Must Support. Element flagged as Must Support in IPS.
Medication.ingredient.strength | Sub-elements of Ratio (IPS) are flagged as Must Support. IPS requires UCUM for coded quantity units. Element flagged as Must Support in IPS.
AU Core MedicationRequest | Medication Request (IPS) | MedicationRequest.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
MedicationRequest.dosageInstruction.timing | Element flagged as Must Support in IPS.
MedicationRequest.route | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AU Core MedicationStatement | Medication Statement (IPS) | MedicationStatement.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
MedicationStatement.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
MedicationStatement.dosage.timing | Element flagged as Must Support in IPS.
AU Core Pathology Result Observation | Observation Results: laboratory/pathology (IPS) | Observation.status | IPS requires value from Results Status Codes - IPS.
Observation.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
Observation.performer | IPS requires minimum of 1.
Observation.category | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Observation.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Observation.value[x] | Types string, Quantity and CodeableConceptIPS are flagged as Must Support in IPS.
Observation.valueCodeableConcept | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AU Core Patient | Patient (IPS) | Patient.name | IPS does not allow Data Absent Reason extension (ips-pat-1).
Patient.contact.relationship | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Patient.generalPractitioner | Element flagged as Must Support in IPS.
AU Core Practitioner | Practitioner (IPS) | Practitioner.telecom | Element flagged as Must Support in IPS.
Practitioner.address | Element flagged as Must Support in IPS.
AU Core PractitionerRole | PractitionerRole (IPS) | PractitionerRole.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
AU Core Procedure | Procedure (IPS) | Procedure.code | Sub-elements of CodeableConceptIPS are flagged as Must Support.
Procedure.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
Procedure.performed[x] | IPS requires minimum of 1.
AU Core Smoking Status | Observation - SH: tobacco use | Observation.subject.reference | IPS requires minimum of 1. Element flagged as Must Support in IPS.
Observation.code | IPS requires LOINC code 72166-2. Sub-elements of CodeableConceptIPS are flagged as Must Support.

##### Missing Data

AU Core compliant resources are compliant with IPS requirements for Missing Data.

##### Suppressed Data

IPS does not include requirements for Suppressed Data.

##### Additional profiles

This version of AU Core has no equivalent profile for the following IPS profiles:

- Bundle - IPS
- Composition (IPS)
- Device (IPS)
- Device - performer, observer
- Device Use Statement (IPS)
- Flag - Alert (IPS)
- DiagnosticReport (IPS)
- Imaging Study (IPS)
- Media observation (Results: laboratory, media)
- Observation - Pregnancy: EDD
- Observation - Pregnancy: outcome
- Observation - Pregnancy: status
- Observation - SH: alcohol use
- Observation Results: radiology (IPS)
- Specimen (IPS)

#### US Core

US Core Implementation Guide 7.0.0 serves as the foundation for FHIR implementation guides in the US Realm. It establishes the minimum constraints on FHIR resources to define US Core Profiles, specifying the required elements, extensions, vocabularies, and value sets, as well as their usage. It also outlines the minimum FHIR RESTful interactions needed to access patient data for each US Core Profile.

##### Additional requirements

The following US Core profile(s) contain additional requirements. Implementers are advised to note that some code changes may be required to support these profiles.

AU Core | US Core 7.0.0 | Element | Additional requirements
--- | --- | --- | ---
AU Core Condition | US Core Condition Problems and Health Concerns Profile | Condition.category | US Core requires category of 'problem-list-item' or 'health-concern'.
Condition.meta | Element flagged as Must Support in US Core.
Condition.meta.lastUpdated | Element flagged as Must Support in US Core.
Condition.assertedDate | Element flagged as Must Support in US Core.
Condition.recordedDate | Element flagged as Must Support in US Core.
US Core Condition Encounter Diagnosis Profile | Condition.assertedDate | Element flagged as Must Support in US Core.
Condition.encounter | Element flagged as Must Support in US Core.
Condition.recordedDate | Element flagged as Must Support in US Core.
AU Core Diagnostic Result Observation | US Core Observation Clinical Result Profile | Observation.code | US Core extensible binding to LOINC Codes.
Observation.value[x] | US Core requires UCUM for coded quantity units.
Observation.encounter | Element flagged as Must Support in US Core.
AU Core Encounter | US Core Encounter Profile | Encounter.type | US Core requires minimum of 1. Element flagged as Must Support in US Core.
Encounter.meta | Element flagged as Must Support in US Core.
Encounter.meta.lastUpdated | Element flagged as Must Support in US Core.
Encounter.identifier | Element flagged as Must Support in US Core.
Encounter.identifier.system | Element flagged as Must Support in US Core.
Encounter.identifier.value | Element flagged as Must Support in US Core.
Encounter.participant.period | Element flagged as Must Support in US Core.
Encounter.hospitalization | Element flagged as Must Support in US Core.
Encounter.hospitalization.dischargeDisposition | Element flagged as Must Support in US Core.
AU Core Immunization | US Core Immunization Profile | Immunization.vaccineCode | US Core extensible binding to CVX Vaccines Administered Vaccine Set.
Immunization.statusReason | Element flagged as Must Support in US Core.
Immunization.encounter | Element flagged as Must Support in US Core.
Immunization.location | Element flagged as Must Support in US Core.
AU Core Location | US Core Location Profile | Location.name | US Core requires minimum of 1.
Location.identifier | Element flagged as Must Support in US Core.
Location.status | Element flagged as Must Support in US Core.
Location.telecom | Element flagged as Must Support in US Core.
Location.address.line | Element flagged as Must Support in US Core.
Location.address.city | Element flagged as Must Support in US Core.
Location.address.state | Element flagged as Must Support in US Core.
Location.address.postalCode | Element flagged as Must Support in US Core.
AU Core Medication | US Core Medication Profile | Medication.code | US Core extensible binding to Medication Clinical Drug.
AU Core MedicationRequest | US Core MedicationRequest Profile | MedicationRequest.medicationCodeableConcept | US Core extensible binding to Medication Clinical Drug.
MedicationRequest.category | Element flagged as Must Support in US Core.
MedicationRequest.reported[x] | Element flagged as Must Support in US Core.
MedicationRequest.dosageInstruction.timing | Element flagged as Must Support in US Core.
MedicationRequest.dosageInstruction.doseAndRate | Element flagged as Must Support in US Core.
MedicationRequest.dosageInstruction.doseAndRate.dose[x] | Element flagged as Must Support in US Core.
MedicationRequest.dispenseRequest | Element flagged as Must Support in US Core.
MedicationRequest.dispenseRequest.numberOfRepeatsAllowed | Element flagged as Must Support in US Core.
MedicationRequest.dispenseRequest.quantity | Element flagged as Must Support in US Core.
AU Core Organization | US Core Organization Profile | Organization.active | US Core requires minimum of 1. Element flagged as Must Support in US Core.
Organization.telecom.system | Element flagged as Must Support in US Core.
Organization.telecom.value | Element flagged as Must Support in US Core.
Organization.address.line | Element flagged as Must Support in US Core.
Organization.address.city | Element flagged as Must Support in US Core.
Organization.address.state | Element flagged as Must Support in US Core.
Organization.address.postalCode | Element flagged as Must Support in US Core.
Organization.address.country | Element flagged as Must Support in US Core.
AU Core Pathology Result Observation | US Core Laboratory Result Observation Profile | Observation.code | US Core extensible binding to US Core Laboratory Test Codes.
Observation.referenceRange | US Core requires UCUM for coded quantity units.
Observation.meta | Element flagged as Must Support in US Core.
Observation.meta.lastUpdated | Element flagged as Must Support in US Core.
Observation.encounter | Element flagged as Must Support in US Core.
AU Core Patient | US Core Patient Profile | Patient.identifier | US Core requires all identifiers to have system and value.
Patient.identifier.system | Element flagged as Must Support in US Core.
Patient.identifier.value | Element flagged as Must Support in US Core.
Patient.name | US Core requires all name to have family or given or Data Absent Reason extension.
Gender identity | US Core requires US Core Gender Identity extension.
Patient.telecom | US Core requires all telecom to have system and value.
Patient.address.line | Element flagged as Must Support in US Core.
Patient.address.city | Element flagged as Must Support in US Core.
Patient.address.state | Element flagged as Must Support in US Core.
Patient.address.postalCode | Element flagged as Must Support in US Core.
AU Core Practitioner | US Core Practitioner Profile | Practitioner.identifier | US Core requires minimum of 1, and all identifiers to have system and value.
Practitioner.identifier.system | Element flagged as Must Support in US Core.
Practitioner.identifier.value | Element flagged as Must Support in US Core.
Practitioner.telecom | Element flagged as Must Support in US Core.
Practitioner.telecom.system | Element flagged as Must Support in US Core.
Practitioner.telecom.value | Element flagged as Must Support in US Core.
Practitioner.address | Element flagged as Must Support in US Core.
Practitioner.address.line | Element flagged as Must Support in US Core.
Practitioner.address.city | Element flagged as Must Support in US Core.
Practitioner.address.state | Element flagged as Must Support in US Core.
Practitioner.address.postalCode | Element flagged as Must Support in US Core.
Practitioner.address.country | Element flagged as Must Support in US Core.
AU Core PractitionerRole | US Core PractitionerRole Profile | PractitionerRole.telecom, PractitionerRole.endpoint | US Core requires telecom or endpoint to be present (pd-1).
PractitionerRole.location | Element flagged as Must Support in US Core.
PractitionerRole.telecom | US Core requires all telecom to have system and value.
PractitionerRole.telecom.system | Element flagged as Must Support in US Core.
PractitionerRole.telecom.value | Element flagged as Must Support in US Core.
PractitionerRole.endpoint | Element flagged as Must Support in US Core.
AU Core RelatedPerson | US Core RelatedPerson Profile | RelatedPerson.active | Element flagged as Must Support in US Core and requires minimum of 1.
AU Core Smoking Status | US Core Smoking Status Observation Profile | Observation.status | US Core requires status of 'final' or 'entered-in-error'.
Observation.code | US Core extensible binding to Smoking Status Type.
Observation.value[x]:valueCodeableConcept | Element flagged as Must Support in US Core. US Core extensible binding to Smoking status comprehensive.
Observation.value[x]:valueQuantity | Element flagged as Must Support in US Core.
AU Core Waist Circumference | US Core Simple Observation Profile | Observation.performer | Element flagged as Must Support in US Core.

##### Missing Data

AU Core compliant resources are compliant with US Core requirements for Missing Data.

##### Suppressed Data

AU Core compliant resources are compliant with US Core requirements for Suppressed Data.

##### Additional profiles

This version of AU Core has no equivalent profile for the following US Core profiles:

- US Core CarePlan Profile
- US Core CareTeam Profile
- US Core Coverage Profile
- US Core Implantable Device Profile
- US Core DiagnosticReport Profile for Laboratory Results Reporting Profile
- US Core DiagnosticReport Profile for Report and Note Exchange Profile
- US Core DocumentReference Profile
- US Core Goal Profile
- US Core MedicationDispense Profile
- US Core Average Blood Pressure Profile
- US Core Care Experience Preference Profile
- US Core Observation Occupation Profile
- US Core Observation Pregnancy Intent Profile
- US Core Observation Pregnancy Status Profile
- US Core Observation Screening Assessment Profile
- US Core Observation Sexual Orientation Profile
- US Core Simple Observation Profile
- US Core Treatment Intervention Preference Profile
- US Core Provenance Profile
- US Core QuestionnaireResponse Profile
- US Core ServiceRequest Profile
- US Core Specimen Profile