AU Core Implementation Guide
0.4.1-preview - Preview Australia flag

This page is part of the AU Core (v0.4.1-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core Smoking Status

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-smokingstatus Version: 0.4.1-preview
Standards status: Draft Maturity Level: 1 Computable Name: AUCoreSmokingStatus

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 an Observation resource to record, search, and fetch observations that represent a patient’s smoking status, i.e. current behaviour for all types of tobacco smoking, with standard coding. It is based on the core FHIR Observation resource 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 smoking status associated with a patient
  • Record or update an observation of smoking status associated with a patient

Comparison with other national and international IGs

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

  • 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.
  • Additional codes that translate or map to the Observation code or category codes are allowed. For example providing both a local code and the required code.

Usage:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Smoking status
au-core-obs-02: At least value or data absent reason shall be present
... status SO 1..1 code registered | preliminary | final | amended +
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
... Slices for category SO 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
.... category:socialHistory 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: social-history
... code SO 1..1 CodeableConcept Type of observation (code / type)
Required Pattern: At least the following
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1747861000168109
.... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:code, value:system
..... coding:loincSmokingStatus 0..1 Coding LOINC Smoking Status
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 72166-2
... effective[x] SOC 1..1 dateTime Date, and optionally time, the observation was performed
au-core-obs-01: Date shall be at least to day
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
... value[x] SOC 0..1 CodeableConcept Actual result
Binding: Smoking Status . (extensible)
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester
... dataAbsentReason SOC 0..1 CodeableConcept Why the result is missing
ObligationsActor
SHALL:populate-if-known AU Core Responder
SHALL:no-error AU Core Requester

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Observation.value[x]extensibleSmokingStatus .
https://healthterminologies.gov.au/fhir/ValueSet/smoking-status-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()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined 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 requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder 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 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.
category MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
code MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.
date MAY date A requester SHALL provide a value precise to the second + time offset. A responder SHALL support a value precise to the second + time offset.
status MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder 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:
    • 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:
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history
    2. GET [base]/Observation?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history

    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:
    • 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={system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&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 = social-history (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:
    • 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|266918002

    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:
    • 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={system|}[code]&status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/Observation?patient=5678&category=http://terminology.hl7.org/CodeSystem/observation-category|social-history&status=final

    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:
    • 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|266918002&date=ge2020-01-01T00:00:00Z
    2. GET [base]/Observation?patient.identifier=http://example.org/fhir/mrn|12345&code=http://snomed.info/sct|266918002&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)