The participation data specification is a foundation document for the suite of data specifications that the Australian Digital Health Agency is developing for the Australian Health Informatics community across a range of health topics.
It is generally agreed that standardising these specifications is a high priority in order to achieve the benefits of semantic interoperability in the Australian healthcare sector.
Participations in the Australian Context
Participations are a fundamental concept within the Agency's information model and are used extensively in Agency structured document templates and data specifications. Participations record context-specific information about relationships between participants and healthcare events. As a result participations are only meaningful within the context in which they are used and are not a stand-alone concept.
The primary purpose of a participation within the Agency structured content specifications is to describe one way in which a participant (a person, organisation or device) participates in an event. The participant can be identified by an identifier or by some combination of information, such as a name, address and date of birth.
Every detailed clinical model and structured content specification that supports the My Health Record system specifies the reuse of the participation data group. The creation of a clinical document based on a structured content specification requires instantiation of a constrained, context-specific variation of participation bound to specific use cases.
Context in Digital Health
There are a number of different participation types in Australia:
- Person: This can be a patient, carer or health provider
- Organisation: Including hospitals
- Device: Such as a medical device sending information to a system, or a computer sending information to My Health Record, or between other systems
The Australian Digital Health Agency has provided the following specifications that apply to the participation business flows described above:
As part of the Agency’s support for HL7™ FHIR® standard (FHIR) a new participant model is being developed. The participant data specification is based on FHIR resources and will support both CDA and FHIR implementations. There will be a number of steps taken to transition the current open EHR-based logical model to FHIR, which are outlined below.
As a result of this work, the specification will be changed from a broader participation specification to the more specific participant specification in both PDF format (for CDA support) and as FHIR implementation guide. The end result will be a set of profiles of FHIR resources that maintains the richness of the Agency’s logical model and supports the requirements for the Australian healthcare context.
The existing Agency participation data specification v3.3 will be deprecated, with modelling to be done in the FHIR space and therefore the use of FHIR data types.
There will be a single profile for each FHIR resource that is in scope of participant v1.0. These profiles are what will be used in specific projects, i.e., a profile of the participant v1.0 profile to represent the My Health Record requirements, or to specifically represent a GP sending a referral.
The HL7™ Australia Patient Administration work group is currently working on a number of participant concepts and developing FHIR profiles of each, with the intention of establishing an Australian core FHIR specification.
It is important that any participant or administration concepts being profiled in the FHIR logical model aligns with the profiles being developed by HL7 Australia and the Australian FHIR community to ensure consistency and interoperability between Australian systems. Ideally the Agency profiles are profiles of the broader HL7 Australia profile, specifically for My Health Record compatible implementations.