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 Patient

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

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for a Patient resource to record, search, and fetch basic demographics and other administrative information about an individual patient. It is based on the AU Base Patient profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the Patient 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 records associated with a patient
  • Record or update a record associated with a patient
  • Query for basic demographics and other administrative information about a patient
  • Record or update basic demographics and other administrative information about a patient
  • Read information about a patient referenced by another resource

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

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

Profile specific implementation guidance

AU Core TDG held a discussion on preferred identifiers to support where an individual is ineligible for an IHI, e.g. tourist or other temporary stay in Australia. Passport was proposed for use (see example Patient/italia-sofia).

AU Core TDG decided this is not a priority for AU Core and will not be addressed in AU Core release 1.

AU Core TDG discussed whether MRN is to be a supported identifier for patients.

AU Core TDG decided that MRN will not be added to the profile as a supported identifier, noting that MRN is still permitted.

AU Core Patient currently supports Administrative Gender as Patient.gender.

Specific feedback is sought on the case for inclusion of specific gender and sex use-data elements in AU Core Patient in release 1:

  1. Gender Identity
  2. Sex Parameter for Clinical Use (SPCU)
  3. Recorder Sex or Gender (RSG)

Please comment on au-fhir-core/issues/66.

Usage:

Formal Views of Profile Content

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

This structure is derived from AUBasePatient

NameFlagsCard.TypeDescription & Constraintsdoco
.. Patient C0..*AUBasePatientA patient in the context of electronic exchange of health information
au-core-pat-01: At least one patient identifier shall be valid
au-core-pat-02: At least one patient name shall have a family name
... extension:birthPlace S0..1birthPlacePlace of Birth for patient
... extension:indigenousStatus S0..1AustralianIndigenousStatusIndigenous status
... extension:interpreterRequired S0..1interpreterRequiredWhether the patient needs an interpreter
.... identifier:ihi S0..1AUIHIIndividual Healthcare Identifier (IHI)
.... identifier:medicare S0..1AUMedicareCardNumberMedicare Card Number
.... identifier:dva S0..1AUDVANumberDepartment of Veterans' Affairs (DVA) Number
... name SC1..*HumanNameA name associated with the patient
au-core-pat-04: At least text, family name, or given name shall be present
... telecom S0..*ContactPointA contact detail for the individual
... gender S1..1codemale | female | other | unknown
... birthDate S1..1dateDate of birth extended for time and accuracy indicator
.... extension:accuracyIndicator S0..1DateAccuracyIndicatorDate accuracy indicator
.... extension:birthTime S0..1birthTimeTime of day of birth
... address S0..*AustralianAddress, AddressAn address for the individual
... communication S0..*BackboneElementA language which may be used to communicate with the patient about his or her health
.... language S1..1CodeableConceptThe language which can be used to communicate with the patient about his or her health
.... preferred S0..1booleanLanguage preference indicator

doco Documentation for this format

Constraints

IdGradePath(s)DetailsRequirements
au-core-pat-01errorPatientAt least one patient identifier shall be valid
: identifier.where(system.count() + value.count() >1).exists()
au-core-pat-02errorPatientAt least one patient name shall have a family name
: name.family.exists()
au-core-pat-04errorPatient.nameAt least text, family name, or given name shall be present
: text.exists() or family.exists() or given.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)
_id SHALL token
identifier SHALL 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 profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the profile.
birthdate+family SHOULD date+string
birthdate+name SHOULD date+string
family SHOULD string
family+gender SHOULD string+token
gender+name SHOULD token+string
name SHOULD string
birthdate MAY date A client SHALL provide a value precise to the day. A server SHALL support a value precise to the day offset.
gender 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.
indigenous-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.
patient-gender-identity 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

  1. SHALL support fetching a Patient using the _id search parameter:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient/[id] or GET [base]/Patient?_id=[id]

    Example:

    1. GET [base]/Patient/5678
    2. GET [base]/Patient?_id=5678

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

  2. SHALL support searching a patient by an identifier using the identifier search parameter:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?identifier=[system|][code]

    Example:

    1. GET [base]/Patient?identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    2. GET [base]/Patient?identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361
    3. GET [base]/Patient?identifier=http://example.org/fhir/mrn|12345

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

Optional Search Parameters:

The following search parameters and search parameter combinations SHOULD be supported:

  1. SHOULD support searching for a patient by a server-defined search that matches any of the string fields in the HumanName, including family, given, prefix, suffix, and/or text using the name search parameter:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?name=[string]

    Example:

    1. GET [base]/Patient?name=Wang
    2. GET [base]/Patient?name=Wang&_revinclude=Provenance:target
  2. SHOULD support searching using the combination of the gender and name search parameters:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?gender={system|}[code]&name=[string]

    Example:

    1. GET [base]/Patient?name=Wang&gender=female

    Implementation Notes: Fetches a bundle of all Patient resources matching the specified gender and name (how to search by string and how to search by token)

  3. SHOULD support searching using the combination of the birthdate and family search parameters:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?birthdate=[date]&family=[string]

    Example:

    1. GET [base]/Patient?family=Wang&birthdate=2007-03-20

    Implementation Notes: Fetches a bundle of all Patient resources matching the specified birthdate and family (how to search by date and how to search by string)

  4. SHOULD support searching using the combination of the birthdate and name search parameters:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?birthdate=[date]&name=[string]

    Example:

    1. GET [base]/Patient?name=Wang&birthdate=2007-03-20

    Implementation Notes: Fetches a bundle of all Patient resources matching the specified birthdate and name (how to search by date and how to search by string)

  5. SHOULD support searching using the combination of the family and gender search parameters:
    • SHALL support these _revinclude parameters: Provenance:target

    GET [base]/Patient?family=[string]&gender={system|}[code]

    Example:

    1. GET [base]/Patient?family=Wang&gender=female

    Implementation Notes: Fetches a bundle of all Patient resources matching the specified family and gender (how to search by string and how to search by token)