Ballot Response: HL7AUIG-STU-FHIR-BASE Australian Base Profiles Implementation Guide v1.0.0 (Standard for Trial Use)

Working Groups (WG): pa - Patient Administration WG; meds - Medication WG; oo - Orders and Observations WG; if - Infrastructure/Terminology (across all working groups)

ID

WG

Priority

Voting

WG Disposition

Summary

Detail

FHIRIG-97

meds

High

Affirmative + Suggestion

Under Review

Semantics not clear for ETP Vendor Identifier

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-prescription.html



The semantics around this data element are not clear. Specifically, the barcodes associated with current electronic prescription exchange services are a mechanism for obtaining and decrypting a prescription or dispense payload. It is not clear whether this is necessarily an identifier for the prescription.

Suggestion:
Suggest clarifying the semantics (including removal of the suggestion that it is the barcode in ETP solutions) or removing the data element.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-96

meds

Medium

Affirmative + Suggestion

Under Review

AU Prescription StructureDefinition name

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-prescription.html



The name refers to prescription and not the name of the resource (i.e. medication request) which is inconsistent with the other profiles in AU Base

Suggestion:
Rename the profile to StructureDefinition-au-medicationrequest

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-95

meds

Medium

Affirmative + Suggestion

Under Review

Multiple PBS sponsors

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medication.html



I believe it is possible for the PBS sponsor of a medication to change if the sponsor goes out of business, is acquired, or for other reasons.

Suggestion:
Suggest supporting multiple PBS Sponsors

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-94

pa

High

Negative

Under Review

Reference to Medicare Number is ambiguous

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-relatedperson.html



The reference to Medicare Number refers to either:

a 10-digit medicare card number + checksum and issue number AND
an 11-digit number which includes medicare card number + checksum + issue number + individual reference number.



If this is to be considered a patient/consumer identifier, this needs to be the 11-digit form and this should be made clear.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-93

pa

High

Negative

Under Review

Unclear what the requirement for the au device profile is

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-device.html



This profile appears to only specify support for the PAI-D identifier which is not in widespread use in Australia. The description of the profile is pretty broad too: "A device in an Australian healthcare context" and this does not agree with the use of the PAI-D identifier which is specific to devices which generate My Health Record documents on behalf of an organisation.

I think it might be too early to include this profile in the IG and it may be misunderstood or cause confusion.

Suggestion:
Recommend removing this profile, or updating the description to align with the intended use of the PAI-D identifier.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-92

pa

High

Affirmative + Suggestion

Under Review

Clarification required around HPI-O being an identifier for both HealthcareService and Organisation

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-healthcareservice.html



The HPI-O identifier listed is also an organisational identifier. It would this be helpful to describe to readers of this specification how a healthcare service is different to an organisation in this specification. By allowing the same identifier to be used in both might create confusion.

Suggestion:
Add clarification and guidance.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-91

pa

High

Affirmative + Suggestion

Under Review

Clarification required around concurrent use of HPI-O, CSP, and PAI-O identifiers for a single organisation

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-organisation.html



The profile allows a single organisation to have any combination of CSP, HPI-O, and PAI-O identifiers concurrently. It is extremely unlikely that an organisation would be eligible for (and have) an HPI-O and then also have a CSP number and/or PAI-O.

Suggestion:
Add constraints disallowing this, or clarification/guidance for correct use.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-90

pa

High

Affirmative + Suggestion

Under Review

Clarification required around use of multiple HPI-Os single a single organisation

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-organisation.html



The profile allows multiple HPI-Os for a single individual organisation which is unusual. However, if the IG is recognising that an organisation can be part of a network and associated with multiple HPI-Os, then perhaps this might make sense. However, that would require explanation and guidance on correct use.

Suggestion:
Describe intent and correct use.


Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-89

pa

High

Negative

Under Review

"Provider Number" is ambiguous

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-practitionerrole-definitions.html



"Provider Number" is ambiguous and might be mistaken to refer to an identifier other than the Medicare Prescriber Number.

Suggestion:
Rename "Provider Number" as "Medicare Provider Number"

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-88

pa

High

Affirmative + Suggestion

Under Review

Multiple HPI-I identifiers should not be allowed for a single practitioner.

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-practitioner.html



According to the HI Service, a practitioner individual can only have a single HPI-I regardless of changing names or healthcare provider professions/specialties.

Suggestion:
Either change cardinality to 0..1 or explain why multiple HPI-Is are allowed and explain how to safely do so.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-87

pa

High

Negative

Under Review

"Prescriber Number" is ambiguous

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-practitioner.html



"Prescriber Number" is ambiguous and might be mistaken to refer to an identifier other than the Medicare Prescriber Number

Suggestion:
Rename "Prescriber Number" as "Medicare Prescriber Number"

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-86

pa

High

Negative

Under Review

AHPRA Registration Number is not a qualification identifier

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-practitioner.html



The AHPRA Registration Number is an identifier associated with practitioners registration (not their qualifications)

Suggestion:
Include AHPRA Registration Number as practitioner identifier.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-85

pa

High

Affirmative + Suggestion

Under Review

Guidance should be provided the value of assigner for the IHI

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient-definitions.html#Patient.identifier:ihiNumber.assigner



Specifically, which organisation is the assigner? Is it the HI Service Operator or a different organisation?

Suggestion:
Address with guidance and examples.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-84

pa

High

Affirmative + Suggestion

Under Review

Guidance should be provided on use of the period value.

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient-definitions.html#Patient.identifier:ihiNumber.period



Specifically, how is this populated for a verified IHI, and how is it populated for IHIs which have different number and record status values.

Suggestion:
Addressing with guidance and examples to address all cases.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-83

pa

High

Negative

Under Review

Multiplicity of Patient.identifier(ihiNumber) should be clarified.

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



The specification states that a patient may have multiple Individual Healthcare Identifiers (IHIs). This is unusual (though not impossible e.g. replicas). The specification should be clear on how multiplicity should be used, or otherwise ensure that a patient may only have a zero or 1 (0..1) IHI values.

Suggestion:
Support multiple IHIs values AND provide clear rules/constraints on how this should be used by implementers.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-82

pa

Low

Affirmative + Suggestion

Under Review

Inclusion of NDIS patient identifier

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



The implementation of the National Disability Insurance Scheme by the National Disability Insurance Agency (NDIA) may include a unique identifier for individuals. It may be worth including this in the IG

Suggestion:
Investigate inclusion of the identifier.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-81

pa

High

Negative

Under Review

Medicare Number should only be the 11-digit form which includes the IRN

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



The reference to Medicare Number seemingly refers to both:

the 10-digit medicare card number + checksum and issue number AND
an 11-digit number which includes medicare card number + checksum + issue number + individual reference number.



If this is to be considered a patient/consumer identifier, this needs to be the 11-digit form.

Suggestion:
Mandate that only the 11-digit Medicare Card Number can be used

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-80

if

Low

Affirmative + Suggestion

Under Review

Description of levels FMM 1 - FMM 5 could be clearer.

url:

http://hl7.org.au/fhir/base2018Oct/guidance.html



The use of the word "PLUS" is in these descriptions is ambiguous. I expect that it means the previous level and the following additional requirements. But it reads as if the level might be named "FMM X PLUS"

Suggestion:
Include the previous level in the description e.g. :FMM1: DRAFT 0 PLUS …."

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-79

meds

Low

Affirmative + Query

Under Review

Clarification required

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-allergyintolerance.html



Note: The value set Indicator of Hypersensitivity or Intolerance to Substance is part of a staged approach to offering meaningful localised coding and that redesign occurring in SNOMED CT content relating to allergies, adverse reactions and intolerances. What work is being done in relation to data standards more broadly in the health context that will be impacted. Current data standards will not align to the terminology.



Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-78

pa

High

Negative

Under Review

Contemporary gender and sex data elements should be included in the profile

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient-definitions.html



It is not clear why the sex data element is not included and this is relevant in a clinical context. Permissible values for the sex data element are not limited to male and female.

Suggestion:
Address contemporary requirements for gender and sex data elements. Perhaps adoption of extensions for elements like biological sex could be considered in consultation with health providers.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-77

pa

Low

Affirmative + Query

Under Review

PBS Safety Net Card Identifier

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



Should the PBS Safety Net Card identifier be included?

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-76

if

High

Affirmative + Suggestion

Under Review

StructureDefinition URLs should include the version

url:

http://hl7.org.au/fhir/base2018Oct/downloads.html



The StructureDefinitions for profiles and extensions do not include the version in the URL. This has the implication that when referencing them, you can't reference a specific version. This is unlike the NCTS StructureDefinitions which DO include the version in the URL.

Suggest including the x.y.z version in the StructureDefinition.url value e.g.

http://hl7.org.au/fhir/StructureDefinition/au-practitionerrole/1.0.0



Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-75

pa

High

Affirmative + Suggestion

Under Review

It is not always clear which identifier or extension parts of the specification refer to

url:

http://hl7.org.au/fhir/base2018Oct/profiles.html



When components of the identifier are specified, some elements have the identifier it refers to provided e.g. "(ihiNumber)" in "Patient.identifier(ihiNumber)". However, for others the specific identifier is omitted e.g. "Patient.identifier.extension.valueCoding(valueCoding)" refers to the IHI Record Status but it is not clear that this element refers to the ihiNumber instance of Patient.identifier. Similar issues applied to DVA and Medicare number

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-74

if

High

Affirmative + Suggestion

Under Review

All ValueSet and CodeSystem instances defined in this Implementation Guide should conform and assert conformance with their associated NCTS profiles

url:

http://hl7.org.au/fhir/base2018Oct/terminology.html



Not all of the ValueSet or CodeSystem resources assert conformance with the "NCTS Composed Value Set" and "NCTS Complete Code System" profiles. This is desirable as it would ensure best practice in the construction of these resources and also ensure national alignment with the NCTS ecosystem (including support in NCTS conformant server applications including the Conformant Terminology Server Application spec).

Lastly, many of these resources are probably not far off conforming and this should be a largely non-technical/content exercise.


Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-73

if

High

Affirmative + Suggestion

Under Review

An Indication of whether system URLs have been provided or endorsed by the owners of the IP would be good to include.

url:

http://hl7.org.au/fhir/base2018Oct/index.html



The IG includes System URLs for a number of identifiers and coding systems. It would be good to know whether these were provided by or endorsed by the respective IP owners for use as described in this IG.

Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-72

if

High

Affirmative + Suggestion

Under Review

All ValueSet and CodeSystem instances defined in this Implementation Guide should conform and assert conformance with their associated NCTS profiles

url:

http://hl7.org.au/fhir/base2018Oct/terminology.html




Reporter: Reuben Daniels
E-mail: reuben.daniels at health dot qld dot gov dot au

FHIRIG-71

pa

Medium

Negative

Under Review

FHIRpath query - needs absolute element reference relative to root?

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-patient-definitions.html



Many of the invariant FHIRpath expressions are written on the basis of orientation from the element within which they reside. For example, the IHI identifier slice has an invariant to force that the value is prefixed with "800360" which is found on the value element within the IHI identifier slice. The relevant FHIRpath is "startsWith('800360')".

My understanding is that the FHIRpath should rather be written from the perspective of the root element within the profile including a determination of which slice should have the rule fired off with. Ie, only when a slice has the system namespace for IHI, then apply this test.

I have figured out the correct expression syntax but I am away from my main PC at the moment.

Anyways; I gather that is what is required, although am happy to be corrected by others who understand FHIRpath & validation against profiles better.

Note that, if this is an issue, then it affects most profiles that have invariants added.

thanks
Rob

Reporter: Rob Eastwood
E-mail: rob.eastwood at digitalhealth dot gov dot au

FHIRIG-70

meds

High

Negative

Under Review

No approval on pbs dot gov dot au system url

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-pbs-sponsor.html



can't use this without approval

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-69

meds

Low

Affirmative + Suggestion

Under Review

Improve usage of brand / generic extensions

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medication.html




Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-68

pa

Medium

Affirmative + Suggestion

Under Review

Medicare Number length

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-relatedperson.html


http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-patient.html



should set a minimum length on medicare number to 9

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-67

pa

Medium

Negative

Under Review

See

https://github.com/hl7au/au-fhir-base/issues/211


url:

http://hl7.org.au/fhir/base2018Oct/ValueSet-service-provision-conditions.html



missed update



Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-66

pa

Medium

Affirmative + Query

Under Review

Example NATA accreditation number

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-organisation.html



Example NATA accreditation number - check this is really a good example

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-65

if

Low

Negative

Under Review

Invisible link presentation only shows on hover

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient-definitions.html#Patient.identifier:ihiNumber.extension:ihiStatus



css fix needed so link text is visible - all over specification

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-64

if

Medium

Negative

Under Review

Narrative to explain sources of terminologies

url:

http://hl7.org.au/fhir/base2018Oct/terminology.html



Note hl7.org.au and healthterminologies dot gov dot au sourced terminologies

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-63

pa

Low

Negative

Under Review

Clarify usage of MRN

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



links to abn scoped; HIPI-O scope system urls are listed; need some words to explain these are options or that another domain may be supplied for MRN

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-62

meds

Medium

Negative

Under Review

Form is a listed under Physical Product Manufacturer Organisation

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medication.html



Form is a listed under Physical Product Manufacturer Organisation, but it isn’t and base spec already has cardinality of 1. Seems like a typo.

Reporter: Tarek Assad (Cerner)
E-mail: tarek.assad at cerner dot com

FHIRIG-61

pa

Medium

Negative

Under Review

Binding of country code

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-address.html



The binding for country code is AU. This seems to prevent addresses from outside the country to be documented.


Reporter: Tarek Assad (Cerner)
E-mail: tarek.assad at cerner dot com

FHIRIG-60

meds

Medium

Affirmative + Query

Under Review

SNOMED CT Vaccine Codes

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-immunisation.html



Why not use SNOMED CT codes for vaccine code too? Would it be very different?

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-59

pa

Medium

Affirmative + Suggestion

Under Review

HPI-O for Healthcare Service

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-healthcareservice.html



HPI-O should not be tied to a Healthcare Service but rather to a Healthcare Oranganisation which is already present. Not clear reason on why HPI-O to identify 2 different FHIR resources.

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-58

meds

Medium

Affirmative + Query

Under Review

Medication Administration not in the "AU Base"

url:

http://hl7.org.au/fhir/base2018Oct/index.html



Note the lack of an Australian Medications Profile for the "MedicationAdministration" resource. Is the intention to use this resource without Australian localisation or is this a future piece of work? Further clarity will assist implementation of this resource in required healthcare sectors (e.g. hospitals and aged care homes). Additional concepts may need to be created to facilitiate NSW Health policy and legislation; for example, additional witness with Schedule 8 medication and parenteral route administrations.

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-57

meds

Medium

Affirmative + Suggestion

Under Review

AU Base Medication Statement enhancement to accommodate medication reconciliation

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medicationstatement.html



The Medication Statement resource has the capacity to relect "current state of the practitioner’s instructions to the patient whether the consumption of the medication should continue or not". It is suggested that the AU Base Medication Statement profile be enhanced to accomodate standardised requirements for medication reconciliation per the Australian Commission on Safety and Quality in Health Care (

https://www.safetyandquality

dot gov dot au/our-work/Medication-safety/Medication-reconciliation/Medication-Management-Plan/). This will foster interoperability and mitigate harm associated with transitions of care.

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-56

meds

Medium

Affirmative + Query

Under Review

AU Base Dispense Record to be extended to accommodate PBS dispensing requirements

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-dispenserecord.html



PBS requirements for dispensing (

http://www.pbs

dot gov dot au/info/healthpro/explanatory-notes/section1/Section_1_3_Explanatory_Notes) includes the date and PBS prescription number of the original prescription for subsequent dispensings. It is uncertain whether these concepts are included in the current resource.

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-55

meds

Medium

Affirmative + Suggestion

Under Review

MULTUM code / as terminology system

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-prescription.html



If there is a proposed MIMS coding, the standard could promote a way to code MULTUM as well

It also applies to:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medication.html


http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-dispenserecord.html


http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medicationstatement.html




Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-54

meds

Medium

Affirmative + Suggestion

Under Review

Inclusion of addition authority numbers in AU Base Prescription

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-prescription.html



Additional fields that may be necessary in a prescription include authority number and specific medication authorisation numbers. Suggest having a dedicated area for these numbers.

Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-53

pa

Medium

Affirmative + Suggestion

Under Review

Sex extension

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html




Sex is required at time of registration (initial) according to NSW Health Client Registration Policy PD2007_094, section 3 and NSW Health Client Registration Guideline GL2007_024, section 3 as well.

Meteor define sex as "… person's biological characteristics."

http://meteor.aihw

dot gov dot au/content/index.phtml/itemId/635126

That is not strictly covered by Gender, which "...refers to the way in which a person identifies their masculine or feminine characteristics."


SNOMED CT Concept (Observable entity) as Patient sex

http://ontoserver.csiro.au/shrimp/?concept=184100006



Reporter: eHealth NSW
E-mail: EHNSW-EnterpriseArchitecture at health dot nsw dot gov dot au

FHIRIG-52

meds

High

Negative

Under Review

medicationCodeableConcept and medicationReference are both 1..1

url:

http://hl7.org.au/fhir/base2018Sep/StructureDefinition-au-medicationstatement.html



medicationCodeableConcept and medicationReference are both 1..1
This makes it impossible to create a profile where only codes are permitted and references are prohibited.

It also means that both must be provided, not just one of the two.

This applies to many of the medication profiles.


Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-51

pa

Low

Negative

Under Review

Patient - Cause of Death

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-patient.html



Is there a need to add cause of death to decease status? There was an extension in FHIR 1.7 but not sure where is it in FHIR 3.

Reporter: Jeffrey Chen
E-mail: jeffrey.chen at live dot com dot au

FHIRIG-50

pa

Medium

Negative

Under Review

Indigenous status

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-indigenous-status.html



The two patient examples do not have the indigenous status information.
There is no value set available from

https://healthterminologies

dot gov dot au/fhir/ValueSet/australian-indigenous-status-1
where can we get the indigenous status values?

Reporter: Jeffrey Chen
E-mail: jeffrey.chen at live dot com dot au

FHIRIG-49

pa

Low

Negative

Under Review

District in Address

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-address.html



Should district field be removed from AU Address profile? There is no such concept in AU setting.

Reporter: Jeffrey Chen
E-mail: jeffrey.chen at live dot com dot au

FHIRIG-48

pa

Low

Negative

Under Review

Address street line

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-address.html



In some case such as NSW Cancer Registry data reporting, the street line has been divided into street no, street name, and street type fields. Is that possible to introduce street type data element in the AU address profile?

Reporter: Jeffrey Chen
E-mail: jeffrey.chen at live dot com dot au

FHIRIG-47

meds

Medium

Negative

Under Review

medication-generic-name

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-medication-generic-name.html



This extension should probably be a CodeableConcept so that if a code for the generic name is available it can be provided. In AMT this may be MP, MPUU or MPP, but it may well be another code system.

Reporter: Dion McMurtrie
E-mail: dion.mcmurtrie at gmail dot com

FHIRIG-46

meds

Medium

Negative

Under Review

CodeableConcept for medication-brand-name

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-medication-brand-name.html



The medication-brand-name extension could be a CodeableConcept allowing someone to specify a text description if that's all they have, but also allowing others to specify a code for the brand if available.

Reporter: Dion McMurtrie
E-mail: dion.mcmurtrie at gmail dot com

FHIRIG-45

pa

Medium

Negative

Under Review

Binding URL to the direct valueset reference, not the CanonicalURI

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-healthcareservice-communication.html




Reporter: Brian Postlethwaite
E-mail: brian_pos at hotmail dot com

FHIRIG-43

meds pa

Medium

Negative

Under Review

Query reference to "AU Base Patient" and "AU Base Organisation"

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-immunisation.html



Query whether the type for Immunization.patient should be "Reference(Patient)" rather than "Reference(AU Base Patient)"?
And similarly query whether the type for Immunization.manufacturer should be "Reference(Organization)" rather than "Reference(AU Base Organisation)"?

Reporter: David McKillop
E-mail: david.mckillop at digitalhealth dot gov dot au

FHIRIG-42

meds

Medium

Negative

Under Review

Too restrictive on bodysite

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-bodysite.html



Think we should slice here and give binding options rather than require in the base.

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-41

meds

Medium

Negative

Under Review

Bodysite Location Qualifier value set incomplete

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-bodysite.html



Wondering the rationale for making this binding "required"? There are some issues with the value set when used with this binding strength. It is not an exhaustive set of concepts for the purpose and you may rightly want to record things such as 255549009 |Anterior|, 46053002 |Distal| or 40415009 |Proximal| which are not present. It also includes |Unilateral left| and |Unilateral right| but not the concepts for |Left| and |Right|. This contradicts the way SNOMED CT defines body structures which at this time exclusively refine laterality with |Left| and |Right|

Thanks

Reporter: Liam Barnes
E-mail: Liam.Barnes at digitalhealth dot gov dot au

FHIRIG-40

pa

Medium

Negative

Under Review

Force extension author practitionerrole.practitioner to match practitioner

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-composition.html



Force extension author practitionerrole.practitioner to match practitioner
look at an invariant to require the extension practitioner role reference to match author practitioner reference

Reporter: Brett Esler
E-mail: brett.esler at oridashi dot com dot au

FHIRIG-39

pa

Medium

Negative

Under Review

Should the "abstract" concept 224891009 (Healthcare services) be included?

url:

http://hl7.org.au/fhir/base2018Oct/ValueSet-snomed-healthcareservice-services.html



The ValueSet inclusion rules include the concept 224891009 |Healthcare services| which does not itself describe "healthcare and other service roles a service may provide".

Is this as-intended? I would not generally expect it to be a valid choice for HealthcareService.speciality


Reporter: Michael Lawley
E-mail: michael.lawley at csiro dot au

FHIRIG-35

pa

Medium

Affirmative + Suggestion

Under Review

Add the OID for ABNs to the page for

http://hl7.org.au/id/abn


url:

http://hl7.org.au/fhir/base2018Sep/StructureDefinition-au-organisation.html



The OID for ABNs is 1.2.36.1.333.1 according to

http://oid-info.com/get/1.2.36.1.333.1



Add it to the page

http://hl7.org.au/id/abn

to make life easier for OID based systems

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-34

pa

Medium

Negative

Under Review

OID for service provision concepts

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/CodeSystem-service-provision-conditions.html



Needs an OID

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-33

meds

Medium

Negative

Under Review

OID for icpc-2plus

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/CodeSystem-icpc2plus.html



Needs an OID for icpc2+

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-32

meds

Medium

Negative

Under Review

PBS items have a code system page, why not PBS sponsors

url:

http://hl7.org.au/fhir/base2018Sep/StructureDefinition-pbs-sponsor.html



There is a page for the code system for PBS items:

http://hl7.org.au/fhir/base2018Sep/CodeSystem-pbs-item.html



Add one for PBS manufacturer or sponsor.
The OID for PBS manufacturers 1.2.36.1.2001.1005.23
"
OID that identifies the two letter manufacturer codes used in the Australian Pharmaceutical Benefit Schedule as managed and published by the Australian Department of Health and Ageing. The Australian Pharmaceutical Benefits schedule is released regularly. The version of the code system should be conveyed along with the code, and the version should be in the form YYYYMMDD which corresponds to the official date of release of the schedule that the code is taken from. Note: The OID is a leaf node - it is used in a coded data element to indicate that the accompanying code in the coded data element identifies an PBS Item. The OID is not an arc that can be extended by adding OIDs below it.
"

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-31

pa

Medium

Negative

Under Review

OID for v2/0203 au extensions

url:

http://hl7.org.au/fhir/base2018Sep/CodeSystem-au-hl7v2-0203.html



Needs an OID for OID-based systems

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-30

meds

Medium

Negative

Under Review

OID for medication type

url:

http://hl7.org.au/fhir/base2018Sep/CodeSystem-medication-type.html



Need an OID for OID-based systems

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-29

meds

Medium

Negative

Under Review

OID needed for pbs item codes

url:

http://hl7.org.au/fhir/base2018Sep/CodeSystem-pbs-item.html



Show the OID for pbs item codes.
One in use is
1.2.36.1.2001.1005.22

Note that pbs manufacturer codes have an OID
1.2.36.1.2001.1005.23

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-28

meds

Medium

Negative

Under Review

OID needed for gtin code system

url:

http://hl7.org.au/fhir/base2018Sep/CodeSystem-gtin.html



This needs an OID for OID-based systems, like

http://hl7.org.au/fhir/base2018Sep/CodeSystem-mims.html

has

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-27

meds

Medium

Negative

Under Review

unknown target disease

url:

http://hl7.org.au/fhir/base2018Sep/StructureDefinition-au-immunisation.html



We should we provide guidance on implementing a dose number with an unknown target disease. Probably an example will do.

See

https://chat.fhir.org/#narrow/stream/4-implementers/topic/Immunization



Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-26

meds

Medium

Negative

Under Review

problems with vs-1

url:

file:///C:/work/git/au-fhir-base-fork/output/StructureDefinition-au-bodyheight-definitions.html



See

https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=17717

FHIRIG-25

if

Medium

Negative

Under Review

Package.tgz - pacakge.json has incorrect URL value

url:

http://hl7.org.au/fhir/base2018Oct/downloads.html



The Package.json file in the package.tgz file has the value:
"url": "file:\\Oridashi\\Repositories
au-fhir-baseoutput",

This should not be a local filename

Reporter: Brian Postlethwaite
E-mail: brian_pos at hotmail dot com

FHIRIG-24

meds

High

Negative

Under Review

Binding: PBS Medicines Item Codes (required) - please review

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-medication.html



Please review "Binding: PBS Medicines Item Codes (required)".
Suggest the use of the Agency's PBS value set that will be regularly updated with a QA process to ensure high quality data. Although the publication date is unknown, the URI is known and may be utilised in this binding. The Agency is currently discussing an agreement with the legal team at DoH to have permission to publish this value set, and we are working hard to have this happen as soon as possible.

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au

FHIRIG-23

if

Medium

Negative

Under Review

vs-2 and obs-7 have problems

url:

http://hl7.org.au/fhir/base2018Oct/StructureDefinition-au-bodyheight.xml.html



Two of the constraints (vs-2 and obs-7) on the vital signs profiles have problems with their fhirpath. See

https://chat.fhir.org/#narrow/stream/4-implementers/topic/Incorrect.20Constraints.20for.20valid.20resources





Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-21

meds

Medium

Negative

Under Review

Intro.md file guidance missing an element that should not be used

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-medication.html



The list of elements whose use is not encouraged as they have been removed from R4 should include Medication.image


Reporter: Danielle Tavares-Rixon
E-mail: danielle.tavares-rixon at digitalhealth dot gov dot au

FHIRIG-20

pa

Medium

Negative

Under Review

Link to non-existent Composition Author Role

url:

http://hl7.org.au/fhir/base2018Sep/extensions.html

FHIRIG-19

pa

Medium

Negative

Under Review

The description of Device.udi includes an unwanted hyperlink

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-device-definitions.html#Device.identifier:paid



The text for udi (

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-device-definitions.html#Device.udi

) starts with a hyperlink.
I think that it should not.

Reporter: Richard Townley-O'Neill
E-mail: richard.townleyoneill at digitalhealth dot gov dot au

FHIRIG-16

if pa

Low

Negative

Under Review

Suggest binding 'Common Languages of Australia' to the 'language' element.

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-practitioner.html



Suggest binding 'Common Languages of Australia' to the 'language' element.

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au

FHIRIG-15

if pa

Low

Negative

Under Review

Suggest NCTS host 'V2 Identifier Type - AU Extended'

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-practitioner.html



Suggest NCTS host 'V2 Identifier Type - AU Extended'.

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au

FHIRIG-14

if pa

Low

Negative

Under Review

Suggest NCTS produce and publish an AU 'V2 Identifier Type' Code System and Value Set.

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-patient.html



If there are no historical requirements governing the use of the HL7 Value Set, suggest NCTS produce and publish an AU 'V2 Identifier Type' Code System and Value Set.

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au

FHIRIG-13

if pa

Low

Negative

Under Review

Suggest NCTS Value Set 'Common Languages in Australia' be used for 'language' binding

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-patient.html



Suggest NCTS Value Set 'Common Languages in Australia' (

https://healthterminologies

dot gov dot au/fhir/ValueSet/common-languages-australia-1) be used for 'language' binding.

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au

FHIRIG-12

if pa

Low

Negative

Under Review

Suggest NCTS host required HL7 Value Sets for terminology bindings

url:

http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-patient.html



Suggest NCTS host the following HL7 Value Sets that are used in the Patient resource:
1. IdentifierUse
2. AdministrativeGender
3. Marital Status
4. AnimalSpecies
5. AnimalBreeds
6. GenderStatus
7. LinkType

Reporter: Jaymee Murdoch
E-mail: jaymee.murdoch at digitalhealth dot gov dot au