Implementation Guidance Index> Difference between Version 1.0.0 and 2.0.0
Difference between version 1.0.0 and 2.0.0
This page lists the differences for resource profile definitions between Version 1.0.0 and this Version 2.0.0 of the OLIS FHIR Consumer Query implementation guide. The purpose is to help implementers who are supporting Version 1.0.0 understand the necessary changes required to migrate to Version 2.0.0. At this point, both versions will be supported by Ontario Health.
Support of fhirVersion in Accept header
In order for OLIS endpoint to support both FHIR STU3 and R4 content, fhirVersion must be used in the R4 request header. Refer to "FHIR Versioning" section in Implementation Consideration page on how to support this.
STU3 profiles replaced in R4
The following profiles in version 1.0.0 have been replaced or renamed in version 2.0.0.
| Profile | Changes |
|---|---|
| ProcedureRequest | Renamed to ServiceRequest in R4 |
| Observation(MicrobiologyChild) | Replaced by Observation profile in version 2.0.0 |
| Practitioner(Ordering, Performing and Reporting) | Replaced by various elements in other resources and practitioner profile in 2.0.0 |
| Practitioner(Attending) | Replaced by Practitioner profile in version 2.0.0 |
| Practitioner(Admitting) | Replaced by Practitioner profile in version 2.0.0 |
| Organization(Ordering Facility) | Removed in version 2.0.0 |
| Organization(Specimen Collector) | Replaced by Specimen.collector and Organization profile in 2.0.0 |
| Organization(Destination Laboratory) | Replaced by ServiceRequest.performer in 2.0.0 |
| Organization(Identifier Assigner) | Replaced by identifier.assigner and organization profile in 2.0.0 |
| Organization(Requesting) | Replaced by ServiceRequest.requester and organization profile in 2.0.0 |
Profiling Changes
Version 2.0.0 of the implmentation guide introduces the following changes in the profiling design. The details are listed below.
DiagnosticReport profile:
| Change | Rationale | Note |
|---|---|---|
| DiagnosticReport.identifier.assigner reference changed to Organization instead of OrganizationAssigner | OrganizationAssigner is not necessary as identifier.assigner provides the meaning. | |
| DiagnosticReport.performer.actor removes slicing definition | The reference supports either Practitioner or Organization, and no slice is necessary | |
| DiagnosticReport.result removes ObservationMicroBiology reference | ObservationMicroBiology has been consolidated into the new Observation profile, and therefore not needed for the reference | |
| DiagnosticReport.codedDiagnosis is no longer used for diagnosis information. DG1.3 will be mapped to ServiceRequest.reasonCode | Based on DG1 usage in OLIS, labs may send DG1 for diagnosis related to the order. Therefore it should be mapped to ServiceRequest. |
Observation profile:
| Change | Rationale | Note |
|---|---|---|
| Removed Observation-SubID and note extension | SubID and note can be represented in standard element Observation.hasMemeber and Observation.note | FHIR R4 changes Observation.comment to Observation.note |
| Removed slicing definition on Observation.performer | The elements supports either Practitioner or Organization. No slice is necessary | |
| Observation.value[x] contains an extension to support valueAttachment | FHIR R4 removes attachment from value[x] choice types. In order to support binary data observation value, Observation.value[x] will contain an inter-version extension to support binary observation value. | This is a change in FHIR R4. |
| Added MustSupport for Observation.hasMember | These two elements will be used to support parent child observations. | FHIR R4 added Observation.hasMember |
ProcedureRequest profile (now changed to ServiceRequest):
| Change | Rationale | Note |
|---|---|---|
| ProcedureRequest changed to ServiceRequest. | FHIR R4 changes ProcedureRequest to ServiceRequest. | This is a change in FHIR R4. |
| Removed request-replace extension | Replace flag can be represented by ServiceRequest.replaces | |
| Removed note extension | Note can be represented by ServiceRequest.note | |
| Added ServiceRequest.reasonCode | This field will be populated with ICD-10-CA code if lab sends diagnosis related to the test request | |
| Added ServiceRequest.reasonReference | A test request may be ordered as the result of an observation. For example, if urine culture identifies bacteria, an antibiotic sensitivity panel may be ordered. The panel test request will reference the bacteria observation. |
Specimen profile
| Change | Rationale | Note |
|---|---|---|
| Replaced OrganizationSpecimenCollector extension with PractitionerRole reference in Specimen.collector | FHIR R4 added support for PractitionerRole which can support organization as specimen collector | This is a change in FHIR R4. |
Encounter profile
| Change | Rationale | Note |
|---|---|---|
| Encounter.participant references Practitioner Profile instead of PractitionerAttending and PractitionerAdmitting profile | The role of practitioner is expressed in Encounter.participant.role |
Practitioner Profile
| Change | Rationale | Note |
|---|---|---|
| Encounter.participant references Practitioner Profile instead of PractitionerAttending and PractitionerAdmitting profile | The role of practitioner is expressed in Encounter.participant.role | |
| Removed Practitioner.telecom and address elements as MustSupport | Provider call back number and address will be mapped to PractitionerRole.telecom and PractitionerRole.location.address |
PractitionerRole Profile
This profile is added to support Specimen Collector Organization. Refer to Specimen profile change details.
PractitionerRole.telecom is MustSupport and mapped to OBR.17 (Practitioner Call Back Number)
PractitionerRole.location.address is MustSupport and mapped to ORC.24 (Ordering Practitioner address)
Patient Profile
No changes
FHIR element mapping changes
The mapping for these elements has changed.
| FHIR Element | STU3 mapping | R4 mapping | Rationale |
|---|---|---|---|
| ServiceRequest.performer | ZBR.6 (Performing Lab) | ZBR.8 (Destination Lab) | ServiceRequest.performer should capture the intended performer for the test request, therefore should be mapped to ZBR.8. ZBR.6 will be mapped to Observation.performer |