# Future of AU Patient Summary - AU Patient Summary Implementation Guide v1.0.0

* [**Table of Contents**](toc.md)
* [**Guidance**](guidance.md)
* **Future of AU Patient Summary**

## Future of AU Patient Summary

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| *Page standards status:*[Informative](http://hl7.org/fhir/R4/versions.html#std-process) |

### AU Patient Summary (AU PS) R1 Target Release Time Frame

AU PS R1 (& AU Core R2) Target Release Timeline:

* Intermediate draft snapshots from December 2024 and for each HL7 AU Connectathon
* R1 Ballot for Comment in the August/September 2025 cycle
* R1 Ballot for Working Standard in the February/March 2026 cycle, published by June 2026
* Continued updates on a yearly / 18-monthly cycle from then on

**Figure 1: AU PS R1 target release time frame** 

Future updates of AU PS would reflect changes to:

* AU Base
* AUCDI (Patient summary)
* AU Core
* International Patient Summary
* requests from the AU FHIR community

### AU PS R1 Development Process

The first release of AU PS is an 18 month process from HL7 AU proposal to publication, outlined in the figure below:

**Figure 2: AU PS R1 development process** 

#### Maturing the Baseline

The approach to develop and mature AU PS is outlined in the figure below making reference to the [Australian FHIR Maturity Level (AFMM) levels](https://hl7.org.au/fhir/6.0.0/generalguidance.html#maturity-levels).

**Figure 3: Maturing the AU PS baseline** 

### Future Candidate Requirements Under Consideration

The following items are under consideration to add to AU PS.

* **Last Updated**: AUCDI element Last Updated is intended to reflect when a data group was last updated, capturing clinical relevance and currency. A known and implemented solution in other jurisdictions for similar requirements is the use of the Provenance resource. An alternative to the use of Provenance may be the definition of custom extensions or `meta.lastUpdated`. Future versions of AU Core will develop and test approaches to addressing Last Updated. When defined in AU Core, it will be inherited by AU PS.
* **DocumentReference Profile**: Future versions of AU Core will develop and test an AU Core DocumentReference profile to support sharing of clinical notes across multiple use cases to support common implementation. When defined in AU Core, the reference in AU PS Bundle will be updated to reference this profile.
* **Device Profiles**: Use of the Device resource for medical devices, and devices that perform, observe, or author clinical data, are required to support multiple downstream use cases including eRequesting and patient summary. Future versions of AU Core will develop and test profiles to support common implementation of Device information. A potential outcome of this AU Core work is either a new AU PS profile or direct reference to the defined AU Core profile.
* **Additional Diagnostic Results Profiles**: Additional AU Core profiles to support common implementation of additional aspects of diagnostic results including imaging, specimen, and reports are expected to be developed and tested in future versions of AU Core. Potential outcomes of this work in AU Core are additional AU PS profiles that describe how to comply with the AU Core and IPS requirements: AU PS Imaging Result Observation, AU PS ImagingStudy, AU PS Specimen, and AU PS DiagnosticReport.
* **Pregnancy Information Profiles**: Exchange of pregnancy information is supported in AU PS via reference to IPS profiles. Additional AU Core profiles to support common implementation of widely shared pregnancy information including pregnancy assertion (sometimes referred to as pregnancy status), last menstrual period and estimated date of delivery are under consideration for a future release and may be developed and tested in future versions of AU Core. A potential outcome of this AU Core work are additional AU PS profiles that describe how to comply with the AU Core and IPS requirements: AU PS Pregnancy Status and AU PS Pregnancy EDD.
* **Additional guidance on approaches to generation**: Additional material or references on approaches for selecting appropriate summary content, documenting algorithmic vs. human curation of data, and generating narrative representations may be a consideration for future versions of AU PS. A draft page on the various [Methods for IPS generation](https://confluence.hl7.org/spaces/PC/pages/358881792/Methods+for+IPS+Generation+DRAFT+FUTURE+DEVLOPMENT) has been drafted on HL7 Confluence, and this may be a consideration for both IPS and AU PS.
* **AU PS profile policies and governance**: Future versions of AU PS will make reference to policies and conventions for HL7 AU FHIR artefacts. Given the nature and scope of the work across all HL7 AU FHIR implementation guides, there is likely to be an HL7 AU project to develop the material and provide recommendations for enhancing HL7 AU Implementation Guides. This work will address related issues and ensure alignment with governance practices.
* **Alignment with future versions of IPS**: Future versions of AU PS are expected to continue to align to future versions IPS. For a list of items under consideration for future versions of IPS see IPS [Future Developments](https://hl7.org/fhir/uv/ips/2.0.1/Known-Issues-and-Future-Development.html#future-development).
* **Alignment with FHIR Clinical Documents**: Future versions of AU PS will consider alignment with the [FHIR Clinical Documents](https://hl7.org/fhir/uv/fhir-clinical-document/en/) for compatibility and adoption. This version of AU PS is based on IPS and AU Core, neither of which has a formal relationship with FHIR Clinical Documents. An assessment on how and when to align may be undertaken in a future release, ideally in collaboration with the IPS and/or AU Core projects. In the meantime, implementers are encouraged to consider the guidance within the FHIR Clinical Documents specification when implementing AU PS.

