AU Patient Summary Implementation Guide
0.2.0-preview - Preview Australia flag

This page is part of the AU Patient Summary (v0.2.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions. This version does not produce a registered package so may only be referenced directly here.

General Guidance

Page standards status: Informative

Profiling Approach

AU PS profiles will by design:

  • ensure resource compliance with AU Core and IPS
  • support additional requirements agreed as necessary to support patient summaries in an Australian healthcare context
  • support varied stakeholder needs and use of AU Patient Summary artefacts e.g. government policy, implementers, tooling developers, testers, IG authors/maintainers etc.

AU PS profiles:

  • are based on the AU Core profile (where it exists)
  • have additional requirements inherited from IPS applied (as determined by the AU PS Profile Design Principles)
  • have additional requirements as agreed by this project applied
  • use compliesWithProfile to assert compliance with IPS

The differential view therefore shows the patient summary requirements that are additional to AU Core. In some profiles, e.g. AU PS Organization, there are no requirements additional to AU Core.

AU Patient Summary Patient current profiling approach

Figure 1: Profiling approach for AU PS Patient profile

AU PS profiles will apply Obligations in the near future. Work is underway in the AU PS Conformance Sessions on a proposal for conformance, including the definition of Obligations. Once agreed, AU PS profiles will be updated to include Obligations.

AU PS Profile Design Principles

AU PS profile design to ensure compliance with AU Core and IPS is agreed to as follows. AU PS profiles:

  • SHALL ensure resources validate against both IPS and AU Core profiles (where both profiles exist)
    • Cardinality
    • Must Support
    • Fixed values and patterns
    • Data type sub-elements and profiles
    • Data type choices
    • Invariants
  • Where both AU Core and IPS profiles do not exist, SHALL ensure resources validate against:
    • IPS profile (where only the IPS profile exists)
    • AU Core profile (where only the AU Core profile exists)
  • AU PS profiles SHALL validate reference elements against AU PS profile where defined
  • In AU PS profiles, inherited AU Core profile value sets are preferred over equivalent IPS profile value sets:
    • where an element has a required binding, the element SHALL apply the intersection of both value sets (AU Core and IPS)
    • where an element has a lesser binding, use the AU Core value set and binding strength (where AU Core is equivalent or stronger) or use the IPS value set where the binding strength is stronger

Profiling Options

When managing profile complexity and requirements in the national and international context for AU Patient Summary, the following mechanisms are available:

  1. Derived from Profiles (derive)
  2. Informal alignment (humans authoring rules in a profile)
  3. Complies With Profile (compliesWith)
  4. Dependent Profiles (imposeProfile)

These mechanisms offer differing capabilities and advantages. Typically HL7 AU profiles have used derivation to manage compliance within HL7 AU inheritance. However, AU Patient Summary will comply to both HL7 AU (AU Core) and IPS and therefore additional mechanism(s) on top of derivation from the base HL7 AU profile are required. At this time additional requirements are included in profiles via informal alignment.

For a human, the main differences with use of imposeProfile are:

  • does not rely on humans to maintain compliance rules from the target profile
  • does not visually show human reader of the source profile any rules from the target profile, i.e. a human reader must view and understand both profiles to understand the rules
  • where two or more profiles offer optional alternatives (e.g. differing preferred bindings or data type choices) does not in the profile preference one over another

Currently no AU Patient Summary profile uses imposeProfile. To support future maintenance it is under consideration that all AU Patient Summary profiles derive from AU Core, where available, and use imposeProfile to apply IPS rules. That would mean that a number of IPS-imposed requirements including cardinality, terminology, and flagging of Must Support would not be directly visible in the formal views within this guide. Or, if we chose to make the additional IPS constraints visible + use imposeProfile, those constraints would be repeated from a validation sense and be an additional validation burden.

Users of this implementation guide are encouraged to provide their feedback about the potential use of imposeProfile.