AU Core Implementation Guide
2.0.0-ballot - Ballot

AU Core Implementation Guide - Downloaded Version 2.0.0-ballot See the Directory of published versions

## Change Log

Page standards status: Informative

### 2.0.0-ballot

- Publication date: 2025-07-31
- Publication status: Ballot for Working Standard
- Based on FHIR version: 4.0.1

This change log documents the significant updates and resolutions implemented from version 1.0.0 to 2.0.0-ballot. The changes in this update are for ballot.

Changes Not Applied

- AU Core AllergyIntolerance:
  - change AllergyIntolerance.reaction.manifestation binding to an NCTS Clinical Manifestation value set AU Base: FHIR-47076
- AU Core Medication:
  - Change Medication.ingredient.item[x] binding to update when the AU Base AMT Medicinal Product and Substances value set moves to be an NCTS managed value set AU Base: FHIR-44781

#### Changes in This Version

- moved general guidance on representing communication preferences for a patient or related person to AU Base FHIR-46877.
- added to general guidance, reference to AU Base guidance on SNOMED CT Australian Edition FHIR-51473.
- added Recorded Sex or Gender and Sex Parameter for Clinical Use to the Sex and Gender page AU Base: 51408.
- updated AUCDI mapping Date of assertion to be MedicationStatement.dateAsserted FHIR-49960.
- updated dependency on SMART App Launch from version 2.1.0 to 2.2.0 FHIR-46398.
- AU Core AllergyIntolerance:
  - added Must Support to AllergyIntolerance.note FHIR-46940
  - added Must Support and obligation SHOULD:populate to AllergyIntolerance.onsetDateTime for the AU Core Responder FHIR-45187
- AU Core Blood Pressure:
  - added guidance on more specific blood pressure specific concepts for sitting, lying, and standing measurements FHIR-49951.
- AU Core Condition:
  - added Must Support and obligation SHOULD:populate to Condition.onsetDateTime for the AU Core Responder FHIR-45040
- AU Core Diagnostic Result Observation:
  - clarified that this profile is for specialist and other (non imaging or pathology) results, and added profile-specific implementation guidance to see AU Core Pathology Result Observation profile for pathology results FHIR-46889.
- AU Core Encounter
  - changed Encounter.reasonCode binding to Reason for Encounter (preferred) AU Base: FHIR-50996
- AU Core HealthcareService:
  - added new profile, including interaction support to the AU Core CapabilityStatements FHIR-49934, FHIR-50406, FHIR-50405, AU Base: FHIR-46322.
- AU Core Immunization:
  - added Must Support to Immunization.lotNumber FHIR-47331
  - added Must Support and obligation SHOULD:populate to Immunization.occurrenceDateTime for the AU Core Responder FHIR-45216
- AU Core MedicationRequest:
  - added Must Support to MedicationRequest.dosageInstruction.text FHIR-50101
  - removed duplication of obligation flag added by error to MedicationRequest.medicationReference FHIR-50800
  - applied technical correction to add Must Support and obligation flag to slices medicationCodeableConcept and medicationReference on MedicationRequest.medication[x] to align with Must Support on the sliced element FHIR-51083
- AU Core MedicationStatement:
  - added the new profile, including interaction support and adding the DiagnosticReport resource to AU Core CapabilityStatements FHIR-45091, FHIR-49954, FHIR-49955, FHIR-49956, FHIR-49957, FHIR-49958, FHIR-49959.
  - added Must Support to MedicationStatement.dosage.text FHIR-50101
  - applied technical correction to add Must Support and obligation flag to slices medicationCodeableConcept and medicationReference on MedicationStatement.medication[x] to align with Must Support on the sliced element FHIR-51083
  - removed duplication of obligation flag added by error to MedicationRequest.medicationReference FHIR-50800
- AU Core Organization:
  - added Must Support on Organization.telecom.system FHIR-51042
  - added Must Support on Organization.telecom.value FHIR-51042
- AU Core Pathology Result Observation:
  - added profile-specific implementation guidance to see AU Core Diagnostic Result Observation profile for non imaging or pathology results FHIR-46889
  - changed Observation.effective[x] type to remove type constraint AU Base: FHIR-49189
  - applied technical correction to add Must Support and obligation flag to slices lab and specificDiscipline on Observation.category to align with Must Support on the sliced element FHIR-51083
- AU Core Patient:
  - removed the cardinality constraint on AU Medicare Card Number identifier, changing it from 0..1 to 0..* FHIR-46268
  - added AU Patient Internal Identifier as an allowed type for Patient.identifier AU Base: FHIR-48671
  - added Must Support on Patient.telecom.system FHIR-51033
  - added Must Support on Patient.telecom.value FHIR-51033
  - added Must Support on Patient.telecom.use FHIR-51033
- AU Core PractitionerRole:
  - added Must Support on PractitionerRole.telecom.system FHIR-51034
  - added Must Support on PractitionerRole.telecom.value FHIR-51034
- AU Core Procedure:
  - added Must Support and obligation SHOULD:populate to Procedure.performedDateTime for the AU Core Responder FHIR-45145
- AU Core RelatedPerson:
  - added the new profile, including interaction support and replacing references to AU Base Related Person with AU Core RelatedPerson FHIR-49745, FHIR-49746, FHIR-44600, FHIR-49747.
- AU Core Smoking Status:
  - applied technical correction to add Must Support and obligation flag to slice socialHistory on Observation.category to align with Must Support on the sliced element FHIR-51083

### Release 1.0.0

- Publication date: 2025-01-29
- Publication status: Working Standard (Trial Use)
- Based on FHIR version: 4.0.1

This change log documents the significant updates and resolutions implemented from version 1.0.0-ballot to 1.0.0.

#### Changes in this version

- Added Sex and Gender page to consolidate implementation guidance on sex and gender concepts in AU Core. Duplicate guidance already defined in AU Base is removed, and replaced with reference to AU Base guidance FHIR-47176, FHIR-47178, FHIR-47182, FHIR-47183, FHIR-46892, FHIR-46896.
- AU Core Diagnostic Result Observation:
  - corrected base profile to AU Base Diagnostic Observation FHIR-47116
  - removed constraints from Observation.hasMember.reference FHIR-46728, FHIR-48331
  - removed Must Support and Obligations from Observation.identifier, Observation.interpretation, Observation.note, Observation.method, Observation.referenceRange, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type and Observation.referenceRange.text FHIR-46737
- AU Core Location: removed Must Support flag and associated Obligation extensions from Location.identifier FHIR-47105 and Location.mode FHIR-47104
- AU Core MedicationRequest: updated invariant au-core-medreq-01 to allow for a Data Absent Reason extension in order to meet AU Core Missing Data and Suppressed Data requirements FHIR-46417
- AU Core Pathology Result Observation:
  - removed constraints from Observation.hasMember.reference and Observation.specimen.reference FHIR-46728, FHIR-46731
  - removed Must Support and Obligations from Observation.identifier, Observation.method and Observation.note FHIR-46732
- AU Core search parameters and search parameter combinations:
  - Observation search parameters: changed 'patient' from SHALL to MAY FHIR-47171
  - Patient search parameters: removed the requirement for including an offset for 'birthdate' FHIR-47150
  - Organization search parameters: changed 'name' search parameter from SHOULD to SHALL FHIR-47109
  - Location search parameters:
    - changed 'address' search parameter from SHALL to SHOULD FHIR-47107
    - removed 'identifier' FHIR-48927
  - PractitionerRole search parameters: added 'role' as a SHOULD FHIR-47115
  - MedicationRequest search parameters: changed 'patient+intent' and 'patient+intent+status' from SHALL to SHOULD, and added a new MedicationRequest search parameter 'patient+status' as a SHALL FHIR-47073
  - updated requirement to mandate both system and code values for identifier search parameters on Organization, Practitioner and PractitionerRole FHIR-46782
- AU Core Requester CapabilityStatement:
  - removed all instances of MAY support create, update, delete, vread, patch, history-instance FHIR-46060
  - removed MAY support search-system and history-system FHIR-46059
  - _id Patient search parameter changed to SHOULD from SHALL FHIR-46390
  - added missing entries for DocumentReference and RelatedPerson resources FHIR-46546
- AU Core Responder CapabilityStatement:
  - removed all instances of MAY support create, update, delete, vread, patch, history-instance FHIR-46060
  - corrected narrative of PractitionerRole practitioner.identifier search parameter from Medicare Provider Number to HPI-I FHIR-47013
  - corrected support for Practitioner _id search parameter to SHOULD instead of SHALL FHIR-46777
  - added missing entries for DocumentReference and RelatedPerson resources FHIR-46546

### Release 1.0.0-ballot

- Publication date: 2024-08-05
- Publication status: Ballot
- Based on FHIR version: 4.0.1

This change log documents the significant updates and resolutions implemented from version 0.3.0-ballot to 1.0.0-ballot.

#### Changes in this version

- In the AU Core Data for Interoperability page, to align to the published AUCDI Release 1 (R1):
  - added AUCDI element mapping Date/Time of Measurement and Date/Time of Observation, and added future consideration note for Last Updated
  - updated mapping of AUCDI Procedure Completed Event to be represented by Procedure only au-fhir-core #147.
  - updated mapping of AUCDI Medication Use Statement to be represented by MedicationStatement only au-fhir-core #145.
- dependency to Smart App Launch changed to 2.1.0 instead of latest (2.2.0) due to missing dependency issue that causes failure to load in NPM Package registry FHIR-46398
- Throughout the specification made significant clarifications to FHIR Obligations, Actors, and Capabilities:
  - changed the default obligation behaviour in AU Core for Responders from 'be capable of populate' to 'populate if known' FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45095, FHIR-45073
  - introduced FHIR Obligations & ActorDefinitions to clarify system actors and associated obligations FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45073
  - clarified the documentation on Must Support and Mandatory elements using the language of Obligation FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45073, FHIR-43852
  - clarified capabilities in AU Core R1 by:
    - renamed AU Core Server to AU Core Responder FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45073, FHIR-43852
    - renamed AU Core Client to AU Core Requester FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45073, FHIR-43852
  - added Actor Definitions page under FHIR Artefacts FHIR-45231, FHIR-45195, FHIR-45163, FHIR-45073.
- Added Security and Privacy page FHIR-45067, and added requirements on supporting TLS 1.2 and TLS 1.3 FHIR-46068.
- Added AU Variance Statement page FHIR-46034.
- Added additional guidance for body site / laterality implementation to General Guidance page FHIR-45176.
- Moved the Medicine Information section from the General Guidance page to a new Medicine Information page FHIR-45165.
- Changes to the following AU Core search parameters and search parameter combinations:
  - clarified multipleAnd comparator support for AU Core date search parameters FHIR-46309
  - Encounter search parameters: removed discharge-disposition, identifier, type, patient+discharge-disposition, patient+type FHIR-45954, FHIR-45603, FHIR-46057
  - MedicationRequest search parameters: removed identifier and category FHIR-45991
  - Patient search parameters:
    - birthdate search parameter support for comparators gt, le, lt, ge to SHOULD from SHALL and multipleAnd support introduced as SHOULD FHIR-45410
    - corrected the search parameter for gender identity to `gender-identity` not `patient-gender-identity` FHIR-45057.
  - Organization search parameters:
    - address search parameter to SHOULD instead of SHALL FHIR-45133
    - name search parameter to SHOULD instead of SHALL FHIR-45133
- Changes to AU Core Immunization:
  - removed Must Support from Immunization.encounter FHIR-45218
  - removed Must Support from Immunization.performer, Immunization.performer.function, Immunization.performer.actor FHIR-44653
  - removed Must Support from Immunization.protocolApplied, Immunization.protocolApplied.series, Immunization.protocolApplied.targetDisease, Immunization.protocolApplied.doseNumber[x] FHIR-44674, FHIR-44656, FHIR-44654
  - removed Must Support from Immunization.reasonCode FHIR-44654, FHIR-45968
  - added Must Support to Immunization.primarySource FHIR-44659
  - changed Immunization.vaccineCode slicing rule from slicing by system to slice by value set FHIR-46391
  - support for AIR codes and AMT Vaccine codes in Immunization.vaccineCode changed to define the slices in AU Core (no longer inherited from AU Base as per FHIR-44821). Slicing discriminator changed from slicing by value:system to slicing by value set and AMT value set binding strength has been corrected to required. FHIR-46391
- Changes to AU Core Encounter:
  - removed Must Support from Encounter.identifier FHIR-45212
  - removed Must Support from Encounter.type FHIR-44580
  - removed Must Support from Encounter.hospitalization, Encounter.hospitalization.dischargeDisposition FHIR-45210
  - changed Encounter.participant.individual type from RelatedPerson to AU Base RelatedPerson FHIR-45228
- Changes to AU Core Location: removed Must Support from Location.description in FHIR-45029.
- Changes to AU Core MedicationRequest:
  - changed MedicationRequest.requester type from RelatedPerson to AU Base RelatedPerson FHIR-45228
  - removed Must Support from MedicationRequest.identifier FHIR-45208
  - removed Must Support from MedicationRequest.category FHIR-45207
  - removed Must Support from MedicationRequest.note FHIR-45209
  - removed Must Support from MedicationRequest.dispenseRequest, MedicationRequest.dispenseRequest.validityPeriod, MedicationRequest.dispenseRequest.numberOfRepeatsAllowed, MedicationRequest.dispenseRequest.quantity FHIR-45088
  - removed Must Support from MedicationRequest.substitution, MedicationRequest.substitution.allowed[x] FHIR-45088
  - added Must Support to MedicationRequest.reasonReference FHIR-45090
  - support for AMT codes and PBS Item Codes in MedicationRequest.medicationCodeableConcept changed to define slicing in AU Core (no longer inherited from AU Base as per FHIR-44821). Slicing discriminator changed from slicing by value:system to slicing by value set and the binding strength has been corrected to required. FHIR-46391
- Changes to AU Core Medication:
  - removal of Must Support from Medication.manufacturer FHIR-45130
  - removed Must Support from Medication.form FHIR-45221
  - removed Must Support from Medication.ingredient FHIR-45220
  - removed Must Support from Medication.ingredient.item[x] FHIR-45220
  - removed Must Support from Medication.ingredient.isActive FHIR-45220, FHIR-45130, FHIR-45049
  - removed Must Support from Medication.ingredient.strength FHIR-45220
  - removed Must Support from Medication.amount FHIR-45219
  - support for AMT codes and PBS Item Codes in Medication.code changed to define slicing in AU Core (no longer inherited from AU Base as per FHIR-44821). Slicing discriminator changed from slicing by value:system to value set and the binding strength has been corrected to required. FHIR-46391
- Changes to AU Core Organizaton:
  - removed Must Support from Organization.alias FHIR-44585
  - corrected the invariant au-core-org-01 FHIRPath expression FHIR-46103
- Changes to AU Core Patient:
  - removed Must Support from Patient.extension:birthPlace FHIR-45018
  - removed Must Support from Patient.extension:interpreterRequired FHIR-45186
  - removed Must Support from Patient.birthDate.extension:birthTime FHIR-45028
  - removed Must Support from Patient.birthDate.extension:accuracyIndicator FHIR-45028
  - added Must Support on Patient.name.text FHIR-44818
  - added Must Support on Patient.name.family FHIR-44818
  - added Must Support on Patient.name.given FHIR-44818
  - updated invariants au-core-pat-01, au-core-pat-02, and au-core-pat-04 to allow for a Data Absent Reason extension in order to meet AU Core Missing Data and Suppressed Data requirements FHIR-46406
- Changes to AU Core Practitioner:
  - removed Must Support from Practitioner.communication FHIR-44588
  - removed Must Support from Practitioner.qualification, Practitioner.qualification.identifier, Practitioner.qualification.code, Practitioner.qualification.period, Practitioner.qualification.issuer: FHIR-45118, FHIR-44587
  - removed Must Support from Practitioner.address FHIR-43860
  - removed Must Support from Practitioner.telecom FHIR-43860
  - added Must Support on Practitioner.name.family FHIR-44819
  - added Must Support on Practitioner.name.given FHIR-44819
  - replaced constraint au-core-prac-01: At least text or family name shall be present with making Practitioner.name.family mandatory (1..1) FHIR-44819
- Changes to AU Core PractitionerRole:
  - removed Must Support from PractitionerRole.location FHIR-43841
  - updated invariant au-core-prarol-01 to allow for a Data Absent Reason extension in order to meet AU Core Missing Data and Suppressed Data requirements FHIR-46419
- Changes to AU Core Procedure:
  - removed Must Support from Procedure.statusReason FHIR-45013
  - removed Must Support from Procedure.category FHIR-45014
  - removed Must Support from Procedure.recorder FHIR-45015, FHIR-45082
  - removed Must Support from Procedure.asserter FHIR-45016, FHIR-45083
  - removed Must Support from Procedure.bodySite and added profile-specific implementation guidance on including body site information FHIR-45017, FHIR-45114
  - removed Must Support from Procedure.note FHIR-45114
  - removed the cardinality constraint on Procedure.performed[x], changing it from 1..1 to 0..1 FHIR-45109
  - removed Obligations on Procedure.bodySite FHIR-46728
- Removed AU Core Provenance FHIR-45191.
- Removed AU Core MedicationStatement in accordance with the agreement to move work on this profile from AU Core R1 to R2. This decision is noted in the AU Core Future Candidate Requirements Under Consideration FHIR-45052.
- Changes to AU Core Condition:
  - removed Must Support from Condition.asserter FHIR-45019, FHIR-45127, FHIR-45083
  - removed Must Support from Condition.recorder FHIR-45019, FHIR-45082
  - removed Must Support from Condition.encounter FHIR-45189
  - added profile-specific implementation guidance on representing no known problems FHIR-45058
  - removed invariant au-core-cond-05 FHIR-46165
- Changes to AU Core AllergyIntolerance:
  - removed profile-specific implementation guidance "`AllergyIntolerance.verificationStatus` is "unconfirmed" where a sending system does not clearly have this element or "confirmed" depending on the level of certainty" FHIR-45039
  - removed Must Support from AllergyIntolerance.asserter FHIR-44699, FHIR-45083
  - removed Must Support from AllergyIntolerance.recorder FHIR-45082, FHIR-45066
  - removed Must Support from AllergyIntolerance.encounter FHIR-45123
  - removed Must Support from AllergyIntolerance.note FHIR-45188
  - in AllergyIntolerance.code
    - changed Indicator of Hypersensitivity or Intolerance to Substance value set binding strength from preferred to extensible FHIR-44713
    - added Additional Binding, Adverse Reaction Substances and Negated Findings value set as candidate FHIR-44713
- Changes to AU Core Smoking Status:
  - removed Must Support from Observation.encounter FHIR-45222
  - removed Must Support from Observation.performer FHIR-45223
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - replaced Observation.code patternCodeableConcept constraint of 266918002 |Tobacco smoking consumption| with 1747861000168109 |Smoking status| FHIR-45124
  - corrected invariant au-core-obs-01 to change the length check from >= 10 to >= 8 to match required precision to the day FHIR-46407
- Changes to AU Core Immunization:
  - removed Must Support from Immunization.encounter FHIR-45218
  - removed Must Support from Immunization.performer FHIR-44653
  - removed Must Support from Immunization.performer.function FHIR-44653
  - removed Must Support from Immunization.performer.actor FHIR-44653
- Changes to AU Core Blood Pressure:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Body Height:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed fixed value constraint 'final' on Observation.status FHIR-45120
  - removed the required binding to Metric Body Length Units value set from Observation.value[x]:valueQuantity to allow the FHIR standard profile binding, and added the Metric Body Length Units value set as a candidate additional binding FHIR-44787
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Body Temperature:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - removed the required binding to Metric Body Temperature Units value set from Observation.value[x]:valueQuantity to allow the FHIR standard profile binding, and added the Metric Body Temperature Units value set as a candidate additional binding FHIR-44787
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Body Weight:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - removed the required binding to Metric Body Weight Units value set from Observation.value[x]:valueQuantity to allow the FHIR standard profile binding, and added the Metric Body Weight Units value set as a candidate additional binding FHIR-44787
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Heart Rate:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - added profile-specific implementation guidance on representing pulse rate observations FHIR-44861
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Respiration Rate:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Waist Circumference:
  - removed Must Support from Observation.encounter FHIR-45134
  - removed Must Support from Observation.performer FHIR-44786
  - removed the fixed value constraint 'final' on Observation.status FHIR-45120
  - removed the required binding to Metric Body Length Units value set from Observation.valueQuantity.code to allow the FHIR standard profile binding, and added the Metric Body Length Units value set as a candidate additional binding FHIR-44787
  - removed invariant au-core-obs-01 (duplicates invariant vs-1) FHIR-46486
- Changes to AU Core Diagnostic Result Observation:
  - changed Observation.performer type from RelatedPerson to AU Base RelatedPerson FHIR-45228
  - removed the required binding to ObservationStatus Result Available value set from Observation.status FHIR-45125
  - updated invariant au-core-obs-01 to change the length check from >= 10 to >= 8 to match required precision to the day FHIR-46407
- Changes to AU Core Pathology Result Observation:
  - changed Observation.performer type from RelatedPerson to AU Base RelatedPerson FHIR-45228
  - removed the required binding to ObservationStatus Result Available value set from Observation.status FHIR-45125
  - updated invariant au-core-obs-01 to change the length check from >= 10 to >= 8 to match required precision to the day FHIR-46407
- Changes in AU Core Requester CapabilityStatement:
  - removed reference to Bulk Data Access implementation guide FHIR-45113
  - corrected the Observation combined search parameter 'patient+category+status' from SHALL to SHOULD FHIR-45390
  - corrected narrative of Location identifier parameter requester requirements on providing both the system and code values from SHOULD to MAY FHIR-46209
  - replaced security and authorization requirements with pointer to Security and Privacy page FHIR-46067
- Changes in AU Core Responder CapabilityStatement:
  - removed reference to Bulk Data Access implementation guide FHIR-45113
  - corrected the Observation combined search parameter 'patient+category+status' from SHALL to SHOULD FHIR-45390
  - corrected MedicationRequest combined search parameter 'patient+intent+authoredon' from SHALL to SHOULD FHIR-46167
  - corrected narrative of Location identifier parameter requester requirements on providing both the system and code values from SHOULD to MAY FHIR-46209
  - replaced security and authorization requirements with pointer to Security and Privacy page FHIR-46067