AU Base & AU Core Variance process

[dt-r]

I would like to see a requirement for AU realm FHIR implementation guides to:

• use AU Base always*
• use AU Core profiles - if an IG is unable to use an AU Core profile then there should be a variance request process

*can there be acceptable variation? My view is no

The variance process should be part of the Project Scope Statement process and be part Balloting approval process.

Elaborating what is proposed:

• AU Core SHALL build upon AU Base, e.g. AU Core SHALL NOT redefine extensions. AU Core will profile AU Base to define the minimum expectations for a system to record, update, search, and retrieve core digital health and administrative information associated with a patient.
• Downstream IGs e.g. AU Requesting SHALL build upon:
  • AU Base: The downstream IG SHALL NOT redefine what is in AU Base, content will be a profile of AU Base to define the conformance requirements for that downstream IG.
  • AU Core: The downstream IG SHALL conform to AU Core profiles, content will be a profile of AU Core to define conformance requirements for the Downstream IG
  • If a downstream IG profiles a resource, and that profile cannot conform to the AU Core profile of that resource then the a variance request is to be logged, and dispositioned by the FHIR WG (and AFCC?)

Draft proposed AU Base & AU Core variance process

All variance requests should be discussed in the FHIR WG and voted upon. The requester will be invited to the FHIR WG meeting to represent the variance request and be informed of the decision. Variance request SHALL be specific on the deviation requested. For example, an approval to deviate on Must Support or other cardinality does not allow deviation on terminology. If a terminology variance is needed, it SHALL be specified in the variance request.

To log a variance request:

1. Create a new tracker ?
2. List specific profiles with links
3. Detail the specific reasons you can not use the underlying AU Core profile
4. Note any terminology variances
5. Email FHIIRWG co-chairs with a link to your Variance issue. As well, post to Zulip in the <where?> with the links to your tracker.
6. FHIRWG will provide a week to review the variance request and then will discuss the issue at the next scheduled FHIRWG meeting after that week of review. (If there is a need for urgency in the variance request, please inform the co-chairs when you email them.)
7. Before ballot FHIR WG will confirm that all downstream IG profiles conform to AU Core profile or that there is an approved variance in place.
8. At publication FHIR WG will confirm that all downstream IG profiles conform to AU Core profile or that there is an approved variance in place.

No variance is required when new or changed content is only found in the CI build version of AU Base or AU Core.
Multiple variance requests for the same type of profile will be considered for inclusion into AU Core.

In implementing this variance process:

• AU Base is published - we can and should come to a position on the requirement for AU Realm FHIR IGs to conform to AU Base including making conformance a requirement on PSSs and Balloting and Publication.
• AU Core is in development - the variance process can be discussed and drafted to go live in tandem with publication if approved

[brettesler-ext]

AU Base use can there be acceptable variation? My view is no
+1 from me;

• if this would be a problem for a use case would think we need to examine AU Base as to why this occurred (underyling AU Base issue)
• expect additions to AU Base may be proposed i.e. an identifier not yet defined; an extension not yet defined; a FHIR resource element with no localised binding

[RichardTON]

"use AU Base always"
"use AU Core profiles"

1- does use mean conform to, derive from, something else?
2- does this imply that there are AU Base and AU Core profiles for every resource type profiled in an Australian IG?

[dt-r]

1 - derive is a very limited term. It is one way to use an existing FHIR conformance artefact to define further conformance requirements. We could say 'conform'. I view AU Base as AU extension of the FHIR Standard. It adds in AU realm concepts in a definitional sense and this goes through the community to agree on how to share that information. I think that if something is defined in AU Base e.g. Australian Indigenous Status then an AU realm FHIR IG should not redefine that concept.
and is too prescriptive. in my view it gets treated like the FHIR standard. Don't redefine extensions that are defined in AU Base,
2 - I don't think it does imply that. I think if it exists you use it.

As an additional part of point 2, in my opinion several resources like Observation or Device don't make sense as an AU Base profile. The commonality is sufficiently described by the FHIR standard and you need to profile for some use to be meaningful.

[dt-r]

@brettesler-ext reflagging this one now as something the FHIR WG needs to work on now that AU eRequesting is kicking off. How AU Base and AU Core are to be used in the AU Realm including expectations of use, implementation in downstream IGs.

I'll move this proposal into AU FHIR WG Confluence.

[dt-r]

Moved to https://confluence.hl7.org/pages/viewpage.action?pageId=227217286. Discussed in 2024-03-20 FHIRWG F2F Meeting Minutes (Sydney).

Proposal with modification approved.