Medicare Records FHIR Implementation Guide version 1.0.0

1.0 StructureDefinition-referralrequest-mbsdva

This profile defines a representation of the practitioner that requested the service to support representation of Medicare Benefits Schedule (MBS) claim item records.

Usage Scenarios

The following are the usage scenarios expected:

  • DHS Medicare sends MBS records to the My Health Record system
Each ReferralRequest SHALL have
  1. a profile assertion to this profile
  2. a status of referral request
  3. an intent
  4. a patient
  5. a practitioner that requested the service
Must Support

In the context of this profile Must Support SHALL be interpreted as follows.

  • The system SHALL be able to store and retrieve the following elements:
    • status
    • intent
    • requester
    • requester.agent
    • requester.onBehalfOf
    • specialty
  • The system SHALL be able to take the following elements into account when performing processing:
    • identifier
    • subject
Profile-specific implementation guidance
  • The patient resource should be identified in the subject element with a logical reference, i.e. an Australian IHI
  • If a resource is referenced rather than identified in the applicable element, the referenced resource should be contained
Examples

Sample instances are included within Explanation of Benefit Medicare example instances.

1.0.1 Formal Views of Profile Content

The official URL for this profile is: 

http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva

This profile defines a representation of the practitioner that requested the service to support representation of Medicare Benefits Schedule (MBS) claim item records.

This profile builds on ReferralRequest.

This profile was published on Tue Aug 28 00:00:00 AEST 2018 as a active by Australian Digital Health Agency.

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

This structure is derived from the STU3 FHIR® resource ReferralRequest.

This profile introduces the following variations from the above core resource:

  1. One meta.profile is ‘http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva’
  2. status is ‘completed’
  3. intent is ‘order’
  4. subject as AU Base Patient
  5. Exactly one requester
  6. requester.agent as AU Base Practitioner
  7. requester.onBehalfOf as AU Base Organisation
  8. speciality extensible binding to Australian and New Zealand Standard Classification of Occupations value set
NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest I0..*inv-dh-rr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva'
... meta 1..1Meta
.... profile 1..*uri
... identifier S0..*Identifier
... status S1..1codeFixed Value: completed
... intent S1..1codeFixed Value: order
... subject S1..1​Reference(AU Base Patient)
... requester S1..1BackboneElement
.... agent S1..1​Reference(AU Base Practitioner)
.... onBehalfOf S0..1​Reference(AU Base Organisation)
... specialty S0..1CodeableConceptBinding: https://healthterminologies.gov.au/fhir/ValueSet/anzsco-1 (extensible)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest I0..*A request for referral or transfer of care
inv-dh-rr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva'
... id Σ0..1idLogical id of this artifact
... meta Σ1..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ1..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: Common Tags (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness identifier
... definition Σ0..*Reference(ActivityDefinition | PlanDefinition)Instantiates protocol or definition
... basedOn Σ0..*Reference(ReferralRequest | CarePlan | ProcedureRequest)Request fulfilled by this request
... replaces Σ0..*Reference(ReferralRequest)Request(s) replaced by this request
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!SΣ1..1codedraft | active | suspended | cancelled | completed | entered-in-error | unknown
Binding: RequestStatus (required)
Fixed Value: completed
... intent ?!SΣ1..1codeproposal | plan | order
Binding: RequestIntent (required)
Fixed Value: order
... type Σ0..1CodeableConceptReferral/Transition of care request type
Binding: SNOMED CT Patient Referral (example)
... priority Σ0..1codeUrgency of referral / transfer of care request
Binding: RequestPriority (required)
... serviceRequested Σ0..*CodeableConceptActions requested as part of the referral
Binding: Practice Setting Code Value Set (example)
... subject SΣ1..1​Reference(AU Base Patient)Patient referred to care or transfer
... context Σ0..1Reference(Encounter | EpisodeOfCare)Originating encounter
... occurrence[x] Σ0..1dateTime, PeriodWhen the service(s) requested in the referral should occur
... authoredOn Σ0..1dateTimeDate of creation/activation
... requester SΣI1..1BackboneElementWho/what is requesting service
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... agent SΣ1..1​Reference(AU Base Practitioner)Individual making the request
.... onBehalfOf SΣI0..1​Reference(AU Base Organisation)Organization agent is acting for
... specialty S0..1CodeableConceptThe clinical specialty (discipline) that the referral is requested for
Binding: https://healthterminologies.gov.au/fhir/ValueSet/anzsco-1 (extensible)
... recipient Σ0..*Reference(Practitioner | Organization | HealthcareService)Receiver of referral / transfer of care request
... reasonCode Σ0..*CodeableConceptReason for referral / transfer of care request
Binding: SNOMED CT Clinical Findings (example)
... reasonReference Σ0..*Reference(Condition | Observation)Why is service needed?
... description 0..1stringA textual description of the referral
... supportingInfo 0..*Reference(Resource)Additonal information to support referral or transfer of care request
... note 0..*AnnotationComments made about referral request
... relevantHistory 0..*Reference(Provenance)Key events in history of request

doco Documentation for this format

This structure is derived from the STU3 FHIR® resource ReferralRequest.

This profile introduces the following variations from the above core resource:

  1. One meta.profile is ‘http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva’
  2. status is ‘completed’
  3. intent is ‘order’
  4. subject as AU Base Patient
  5. Exactly one requester
  6. requester.agent as AU Base Practitioner
  7. requester.onBehalfOf as AU Base Organisation
  8. speciality extensible binding to Australian and New Zealand Standard Classification of Occupations value set

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest I0..*inv-dh-rr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva'
... meta 1..1Meta
.... profile 1..*uri
... identifier S0..*Identifier
... status S1..1codeFixed Value: completed
... intent S1..1codeFixed Value: order
... subject S1..1​Reference(AU Base Patient)
... requester S1..1BackboneElement
.... agent S1..1​Reference(AU Base Practitioner)
.... onBehalfOf S0..1​Reference(AU Base Organisation)
... specialty S0..1CodeableConceptBinding: https://healthterminologies.gov.au/fhir/ValueSet/anzsco-1 (extensible)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest I0..*A request for referral or transfer of care
inv-dh-rr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva'
... id Σ0..1idLogical id of this artifact
... meta Σ1..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ1..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: Common Tags (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierBusiness identifier
... definition Σ0..*Reference(ActivityDefinition | PlanDefinition)Instantiates protocol or definition
... basedOn Σ0..*Reference(ReferralRequest | CarePlan | ProcedureRequest)Request fulfilled by this request
... replaces Σ0..*Reference(ReferralRequest)Request(s) replaced by this request
... groupIdentifier Σ0..1IdentifierComposite request this is part of
... status ?!SΣ1..1codedraft | active | suspended | cancelled | completed | entered-in-error | unknown
Binding: RequestStatus (required)
Fixed Value: completed
... intent ?!SΣ1..1codeproposal | plan | order
Binding: RequestIntent (required)
Fixed Value: order
... type Σ0..1CodeableConceptReferral/Transition of care request type
Binding: SNOMED CT Patient Referral (example)
... priority Σ0..1codeUrgency of referral / transfer of care request
Binding: RequestPriority (required)
... serviceRequested Σ0..*CodeableConceptActions requested as part of the referral
Binding: Practice Setting Code Value Set (example)
... subject SΣ1..1​Reference(AU Base Patient)Patient referred to care or transfer
... context Σ0..1Reference(Encounter | EpisodeOfCare)Originating encounter
... occurrence[x] Σ0..1dateTime, PeriodWhen the service(s) requested in the referral should occur
... authoredOn Σ0..1dateTimeDate of creation/activation
... requester SΣI1..1BackboneElementWho/what is requesting service
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... agent SΣ1..1​Reference(AU Base Practitioner)Individual making the request
.... onBehalfOf SΣI0..1​Reference(AU Base Organisation)Organization agent is acting for
... specialty S0..1CodeableConceptThe clinical specialty (discipline) that the referral is requested for
Binding: https://healthterminologies.gov.au/fhir/ValueSet/anzsco-1 (extensible)
... recipient Σ0..*Reference(Practitioner | Organization | HealthcareService)Receiver of referral / transfer of care request
... reasonCode Σ0..*CodeableConceptReason for referral / transfer of care request
Binding: SNOMED CT Clinical Findings (example)
... reasonReference Σ0..*Reference(Condition | Observation)Why is service needed?
... description 0..1stringA textual description of the referral
... supportingInfo 0..*Reference(Resource)Additonal information to support referral or transfer of care request
... note 0..*AnnotationComments made about referral request
... relevantHistory 0..*Reference(Provenance)Key events in history of request

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron

 

1.0.2 Quick Start

Below is an overview of the required search and read operations.

Summary of Search Criteria for StructureDefinition-referralrequest-mbsdva

none defined