AU Core Implementation Guide
0.4.0-preview - Preview Australia flag

This page is part of the AU Core (v0.4.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

CapabilityStatement: AU Core Responder CapabilityStatement

Official URL: http://hl7.org.au/fhir/core/CapabilityStatement/au-core-responder Version: 0.4.0-preview
Standards status: Draft Maturity Level: 1 Computable Name: AUCoreResponderCapabilityStatement

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 CapabilityStatement describes the basic rules for the AU Core Responder actor that is responsible for providing responses to queries submitted by AU Core Requesters. The complete list of FHIR profiles, RESTful operations, and search parameters supported by AU Core Responders are defined in this CapabilityStatement.

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AU Core Responder CapabilityStatement

  • Implementation Guide Version: 0.4.0-preview
  • FHIR Version: 4.0.1
  • Supported Formats: SHALL support json, SHOULD support xml
  • Supported Patch Formats: SHOULD support application/json-patch+json
  • Published on: 2024-06-20
  • Published by: HL7 Australia - FHIR Working Group

Note to Implementers: FHIR Capabilities

Any FHIR capability may be 'allowed' by the system unless explicitly marked as "SHALL NOT". A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.

SHALL support the following Implementation Guides

SHOULD support the following Implementation Guides

FHIR RESTful Capabilities

Mode: server

The AU Core Responder SHALL:

  1. Support the AU Core Patient resource profile.

  2. Support at least one additional resource profile from the list of AU Core Profiles.

  3. Implement the RESTful behavior according to the FHIR specification.

  4. Return the following response classes:

    • (Status 400): Bad Request

    • (Status 401): Not Authorized

    • (Status 403): Forbidden

    • (Status 404): Not Found

  5. Support JSON source formats for all AU Core interactions.

  6. Declare a CapabilityStatement identifying the list of profiles, operations, and search parameters supported.

The AU Core Responder SHOULD:

  1. Support XML source formats for all AU Core interactions.
Security
  1. A responder MAY reject any unauthorized requests by returning an HTTP 401 "Unauthorized", HTTP 403 "Forbidden", or HTTP 404 "Not Found"
  2. For authentication and authorisation, systems MAY support any SMART App Launch and SMART Backend Service Authorization. When this is not avalable, basic authentication MAY be used.
Summary of System-wide interactions
  • MAY support the transaction interaction.
  • MAY support the batch interaction.
  • MAY support the search-system interaction.
  • MAY support the history-system interaction.

Capabilities by Resource/Profile

Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

  • The relevant profiles (if any)
  • The interactions supported by each resource ( R ead, S earch, U pdate, and C reate, are always shown, while VR ead, P atch, D elete, H istory on I nstance, or H istory on T ype are only present if at least one of the resources has support for them.
  • The required, recommended, and some optional search parameters (if any).
  • The linked resources enabled for _include
  • The other resources enabled for _revinclude
  • The operations on the resource (if any)
Resource Type Profile R S U C Searches _include _revinclude Operations
AllergyIntolerance http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance y y clinical-status, patient, patient.identifier, patient+clinical-status
Condition http://hl7.org.au/fhir/core/StructureDefinition/au-core-condition y y category, clinical-status, code, onset-date, patient, patient.identifier, patient+category, patient+category+clinical-status, patient+clinical-status, patient+code, patient+onset-date
Encounter http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter y y class, date, identifier, location, patient, patient.identifier, patient+class, patient+date, patient+location, patient+status, status
Immunization http://hl7.org.au/fhir/core/StructureDefinition/au-core-immunization y y date, patient, patient.identifier, patient+date, patient+status, patient+vaccine-code, status, vaccine-code
Location http://hl7.org.au/fhir/core/StructureDefinition/au-core-location y y address, address-city, address-postalcode, address-state, identifier, name
Medication http://hl7.org.au/fhir/core/StructureDefinition/au-core-medication y
MedicationRequest http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest y y _id, authoredon, intent, patient, patient.identifier, patient+intent, patient+intent+authoredon, patient+intent+status, status MedicationRequest:medication
Observation http://hl7.org.au/fhir/core/StructureDefinition/au-core-waistcircum,http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodyweight,http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodytemp,http://hl7.org.au/fhir/core/StructureDefinition/au-core-diagnosticresult,http://hl7.org.au/fhir/core/StructureDefinition/au-core-heartrate,http://hl7.org.au/fhir/core/StructureDefinition/au-core-resprate,http://hl7.org.au/fhir/core/StructureDefinition/au-core-diagnosticresult-path,http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstatus,http://hl7.org.au/fhir/core/StructureDefinition/au-core-bloodpressure,http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodyheight y y category, code, date, patient, patient.identifier, patient+category, patient+category+date, patient+category+status, patient+code, patient+code+date, status
Organization http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization y y _id, address, identifier, name
Patient http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient y y _id, birthdate, birthdate+family, birthdate+name, family, family+gender, gender, gender+name, identifier, indigenous-status, name, gender-identity
Practitioner http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner y y _id, identifier, name
PractitionerRole http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole y y _id, identifier, organization, practitioner, practitioner.identifier, specialty PractitionerRole:practitioner
Procedure http://hl7.org.au/fhir/core/StructureDefinition/au-core-procedure y y code, date, patient, patient.identifier, patient+code+date, patient+date, patient+status, status

Resource Conformance: SHOULDAllergyIntolerance

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the AllergyIntolerance resource, the responder SHALL support the AU Core profile and the conformance expectations for the AllergyIntolerance resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY clinical-status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHOULD patient+ clinical-status reference+ token

Resource Conformance: SHOULDCondition

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-condition
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Condition resource, the responder SHALL support the AU Core profile and the conformance expectations for the Condition resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY category token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY clinical-status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY code token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY onset-date date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

Combined Search Parameters
Conformance Parameters Types
SHALL patient+ clinical-status reference+ token
SHALL patient+ category reference+ token
SHOULD patient+ category+ clinical-status reference+ token+ token
SHOULD patient+ code reference+ token
SHOULD patient+ onset-date reference+ date

Resource Conformance: SHOULDEncounter

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-encounter
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Encounter resource, the responder SHALL support the AU Core profile and the conformance expectations for the Encounter resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY class token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY date date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY identifier token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY location reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
MAY status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHALL patient+ date reference+ date
SHOULD patient+ class reference+ token
SHOULD patient+ location reference+ reference
SHOULD patient+ status reference+ token

Resource Conformance: SHOULDImmunization

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-immunization
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Immunization resource, the responder SHALL support the AU Core profile and the conformance expectations for the Immunization resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY date date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY vaccine-code token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHOULD patient+ date reference+ date
SHALL patient+ status reference+ token
MAY patient+ vaccine-code reference+ token

Resource Conformance: SHOULDLocation

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-location
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Location resource, the responder SHALL support the AU Core profile and the conformance expectations for the Location resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL address string
SHALL name string
SHOULD address-city string
SHOULD address-state string
SHOULD address-postalcode string
MAY identifier token

The requester SHALL provide at least a code value and SHOULD provide both the system and code values.

The responder SHALL support both.

Resource Conformance: SHOULDMedication

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-medication
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read.
  • MAY support search-type,create,update,delete,vread,patch,history-instance.

Documentation

MedicationAdministration, MedicationDispense, MedicationRequest, and MedicationStatement resources can represent a medication, using an external reference to a Medication resource. If the responder supports the Medication resource, the responder SHALL support the AU Core profile and the conformance expectations for the Medication resource.

Resource Conformance: SHOULDMedicationRequest

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-medicationrequest
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the MedicationRequest resource, the responder SHALL support the AU Core profile and the conformance expectations for the MedicationRequest resource.

Search Parameters
Conformance Parameter Type Documentation
SHOULD _id token
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY authoredon date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY intent token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHALL patient+ intent reference+ token
SHOULD patient+ intent+ authoredon reference+ token+ date
SHALL patient+ intent+ status reference+ token+ token

Resource Conformance: SHOULDObservation

Supported Profiles
http://hl7.org.au/fhir/core/StructureDefinition/au-core-waistcircum
http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodyweight
http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodytemp
http://hl7.org.au/fhir/core/StructureDefinition/au-core-diagnosticresult
http://hl7.org.au/fhir/core/StructureDefinition/au-core-diagnosticresult-path
http://hl7.org.au/fhir/core/StructureDefinition/au-core-heartrate
http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstatus
http://hl7.org.au/fhir/core/StructureDefinition/au-core-resprate
http://hl7.org.au/fhir/core/StructureDefinition/au-core-bloodpressure
http://hl7.org.au/fhir/core/StructureDefinition/au-core-bodyheight
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Observation resource, the responder SHALL support the AU Core profile and the conformance expectations for the Observation resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY category token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY code token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY date date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHALL patient+ category reference+ token
SHALL patient+ category+ date reference+ token+ date
SHOULD patient+ category+ status reference+ token+ token
SHALL patient+ code reference+ token
SHOULD patient+ code+ date reference+ token+ date

Resource Conformance: SHOULDOrganization

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Organization resource, the responder SHALL support the AU Core profile and the conformance expectations for the Organization resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL identifier token

The requester SHALL provide at least a code value and SHOULD provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using HPI-O and ABN identifiers as defined in the profile.

The responder SHOULD support search using HPI-O and ABN identifiers as defined in the profile.
SHOULD address string
SHOULD name string
SHOULD _id token

Resource Conformance: SHALLPatient

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

The responder SHALL support the Patient resource, the AU Core profile, and the conformance expectations for the Patient resource.

responders SHALL support the capability for a requester application to access the patient record using any of the following API calls:

GET [url]/Patient/[id]

GET [url]/Patient?_id=[id]

GET [url]/Patient?identifier=[identifier]

responders are not required to support any additional search parameters, and requesters SHOULD NOT expect responders to do so.

Search Parameters
Conformance Parameter Type Documentation
SHALL _id token
SHALL identifier token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
SHOULD name string
SHOULD family string
MAY birthdate date

The requester SHALL provide a value precise to the day offset.

The responder SHALL support a value precise to the day offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY gender token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY indigenous-status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY gender-identity token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHOULD birthdate+ family date+ string
SHOULD birthdate+ name date+ string
SHOULD family+ gender string+ token
SHOULD gender+ name reference+ string

Resource Conformance: SHOULDPractitioner

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitioner
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Practitioner resource, the responder SHALL support the AU Core profile and the conformance expectations for the Practitioner resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL identifier token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using a HPI-I identifier as defined in the profile.

The responder SHOULD support search using a HPI-I identifier as defined in the profile.
SHOULD name string
SHALL _id token

Resource Conformance: SHOULDPractitionerRole

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the PractitionerRole resource, the responder SHALL support the AU Core profile and the conformance expectations for the PractitionerRole resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL identifier token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using a Medicare Provider Number identifier as defined in the profile.

The responder SHOULD support search using a Medicare Provider Number identifier as defined in the profile.
SHALL practitioner reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD practitioner.identifier reference.token

The requester SHALL provide at least a code value and SHOULD provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using a HPI-I identifier as defined in the AU Core Practitioner profile.

The responder SHOULD support search using a HPI-I identifier as defined in the AU Core Practitioner profile.
SHOULD _id token
SHOULD specialty token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY organization reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.

Resource Conformance: SHOULDProcedure

Base System Profile
http://hl7.org.au/fhir/core/StructureDefinition/au-core-procedure
Profile Conformance
SHALL
Reference Policy
resolves

Interaction summary
  • SHALL support read,search-type.
  • MAY support create,update,delete,vread,patch,history-instance.

Documentation

If the responder supports the Procedure resource, the responder SHALL support the AU Core profile and the conformance expectations for the Procedure resource.

Search Parameters
Conformance Parameter Type Documentation
SHALL patient reference

The requester SHALL provide at least an id value and MAY provide both the Type and id values.

The responder SHALL support both.
SHOULD patient.identifier reference.token

The requester SHALL provide both the system and code values.

The responder SHALL support both.

The requester SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.

The responder SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
MAY code token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
MAY date date

The requester SHALL provide a value precise to the second + time offset.

The responder SHALL support a value precise to the second + time offset.

The requester SHALL support these search comparators gt, lt, ge, le.

The responder SHALL support these search comparators gt, lt, ge, le.

MAY status token

The requester SHALL provide at least a code value and MAY provide both the system and code values.

The responder SHALL support both.
Combined Search Parameters
Conformance Parameters Types
SHALL patient+ date reference+ date
SHOULD patient+ code+ date reference+ token+ date
SHOULD patient+ status reference+ token