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Updates to ExplanationOfBenefits post MDS design meeting
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#143
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@dtr-agency
dtr-agency committed Apr 20, 2022
1 parent 4e0dee1 commit 8f06e18
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Showing 10 changed files with 50 additions and 61 deletions.
25 changes: 7 additions & 18 deletions examples/ExplanationOfBenefit/explanationofbenefit-mbs-mds.xml
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@@ -1,18 +1,18 @@
<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
<id value="d46a4133-ba17-11ec-833a-b1763b0a7715"/>
<id value="mbs-mds"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id d46a4133-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1"/>
</meta>
<contained>
<PractitionerRole>
<id value="d46a4134-ba17-11ec-833a-b1763b0a7715"/>
<id value="01"/>
<practitioner>
<reference value="#01"/>
<reference value="#02"/>
</practitioner>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.13.62"/>
<system value="http://www.abs.gov.au/ausstats/[email protected]/mf/1220.0"/>
<code value="250000"/>
</coding>
<text value="Health Professional"/>
Expand All @@ -21,7 +21,7 @@
</contained>
<contained>
<Practitioner>
<id value="01"/>
<id value="02"/>
<name>
<use value="usual"/>
<family value="KILLER"/>
Expand Down Expand Up @@ -64,21 +64,10 @@
</patient>
<created value="2022-04-07"/>
<insurer>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
</coding>
<text value="ABN"/>
</type>
<system value="http://hl7.org.au/id/abn"/>
<value value="83605426759"/>
</identifier>
<display value="Australian Government Department of Health"/>
<reference value="Organization/healthau"/>
</insurer>
<provider>
<reference value="#d46a4134-ba17-11ec-833a-b1763b0a7715"/>
<reference value="#01"/>
</provider>
<outcome value="complete"/>
<insurance>
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29 changes: 9 additions & 20 deletions examples/ExplanationOfBenefit/explanationofbenefit-pbs-mds.xml
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@@ -1,16 +1,16 @@
<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
<id value="9b28d09f-ba17-11ec-833a-b1763b0a7715"/>
<id value="pbs-mds"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id 9b28d09f-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1"/>
</meta>
<contained>
<MedicationRequest>
<id value="9b28d0a2-ba17-11ec-833a-b1763b0a7715"/>
<id value="01"/>
<status value="unknown"/>
<intent value="order"/>
<medicationReference>
<reference value="#9b28d0a1-ba17-11ec-833a-b1763b0a7715"/>
<reference value="#02"/>
</medicationReference>
<subject>
<identifier>
Expand All @@ -36,7 +36,7 @@
</contained>
<contained>
<Medication>
<id value="9b28d0a1-ba17-11ec-833a-b1763b0a7715"/>
<id value="02"/>
<extension url="http://hl7.org.au/fhir/StructureDefinition/medication-generic-name">
<valueString value="BENZYLPENICILLIN"/>
</extension>
Expand All @@ -45,15 +45,15 @@
</extension>
<code>
<coding>
<system value="urn:oid:1.2.36.1.2001.1005.22"/>
<system value="http://pbs.gov.au/code/item"/>
<version value="v1.0"/>
<code value="02647H"/>
<display value="BENZYLPENICILLIN"/>
</coding>
</code>
<manufacturer>
<identifier>
<system value="urn:oid:1.2.36.1.2001.1005.23"/>
<system value="http://pbs.gov.au/code/manufacturer"/>
<value value="CS"/>
</identifier>
</manufacturer>
Expand Down Expand Up @@ -96,26 +96,15 @@
</patient>
<created value="2020-01-16"/>
<insurer>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
</coding>
<text value="ABN"/>
</type>
<system value="http://hl7.org.au/id/abn"/>
<value value="83605426759"/>
</identifier>
<display value="Australian Government Department of Health"/>
<reference value="Organization/healthau"/>
</insurer>
<provider>
<extension url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode value="unknown"/>
</extension>
</provider>
<prescription>
<reference value="#9b28d0a2-ba17-11ec-833a-b1763b0a7715"/>
<reference value="#01"/>
</prescription>
<outcome value="complete"/>
<insurance>
Expand All @@ -138,7 +127,7 @@
</category>
<productOrService>
<coding>
<system value="urn:oid:1.2.36.1.2001.1005.22"/>
<system value="http://pbs.gov.au/code/item"/>
<version value="v1.0"/>
<code value="02647H"/>
<display value="BENZYLPENICILLIN"/>
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6 changes: 3 additions & 3 deletions examples/Medication/medication-mds.xml
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@@ -1,5 +1,5 @@
<Medication xmlns="http://hl7.org/fhir">
<id value="9b28d0a1-ba17-11ec-833a-b1763b0a7715"/>
<id value="02"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id 9b28d09f-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-medication-core-1"/>
Expand All @@ -12,15 +12,15 @@
</extension>
<code>
<coding>
<system value="urn:oid:1.2.36.1.2001.1005.22"/>
<system value="http://pbs.gov.au/code/item"/>
<version value="v1.0"/>
<code value="02647H"/>
<display value="BENZYLPENICILLIN"/>
</coding>
</code>
<manufacturer>
<identifier>
<system value="urn:oid:1.2.36.1.2001.1005.23"/>
<system value="http://pbs.gov.au/code/manufacturer"/>
<value value="CS"/>
</identifier>
</manufacturer>
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11 changes: 4 additions & 7 deletions examples/MedicationRequest/medicationrequest-mds.xml
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@@ -1,6 +1,6 @@
<?xml version="1.0" encoding="UTF-8"?>
<MedicationRequest xmlns="http://hl7.org/fhir">
<id value="9b28d0a2-ba17-11ec-833a-b1763b0a7715"/>
<id value="01"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id 9b28d09f-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-medicationrequest-pbs-claim-1"/>
Expand All @@ -13,10 +13,9 @@
<status value="unknown"/>
<intent value="order"/>
<medicationReference>
<reference value="Medication/cephalexin-01"/>
<reference value="Medication/02"/>
</medicationReference>
<subject>
<reference value="Patient/mhr-field-sally"/>
<identifier>
<type>
<coding>
Expand All @@ -30,12 +29,10 @@
<value value="8003608833357361"/>
</identifier>
</subject>
<authoredOn value="2020-01-15"/>
<authoredOn value="2022-04-08"/>
<dispenseRequest>
<numberOfRepeatsAllowed value="1"/>
<quantity>
<value value="500"/>
<unit value="tablet"/>
<value value="10"/>
</quantity>
</dispenseRequest>
</MedicationRequest>
2 changes: 1 addition & 1 deletion examples/Practitioner/practitioner-mds.xml
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@@ -1,6 +1,6 @@
<?xml version="1.0" encoding="UTF-8"?>
<Practitioner xmlns="http://hl7.org/fhir">
<id value="01"/>
<id value="02"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id d46a4133-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitioner-core-1"/>
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4 changes: 2 additions & 2 deletions examples/PractitionerRole/practitionerrole-mds.xml
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@@ -1,6 +1,6 @@
<?xml version="1.0" encoding="UTF-8"?>
<PractitionerRole xmlns="http://hl7.org/fhir">
<id value="d46a4134-ba17-11ec-833a-b1763b0a7715"/>
<id value="01"/>
<!--R4 conversion of MDS test data ExplanationOfBenefit.id d46a4133-ba17-11ec-833a-b1763b0a7715-->
<meta>
<profile value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-core-1" />
Expand All @@ -10,7 +10,7 @@
</practitioner>
<code>
<coding>
<system value="urn:oid:2.16.840.1.113883.13.62"/>
<system value="http://www.abs.gov.au/ausstats/[email protected]/mf/1220.0"/>
<code value="250000"/>
</coding>
<text value="Health Professional"/>
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10 changes: 5 additions & 5 deletions pages/_includes/dh-explanationofbenefit-medicare-mbs-1-examples.md
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Expand Up @@ -33,10 +33,10 @@
<td><a href="ExplanationOfBenefit-mbs-03.ttl.html">Turtle</a></td>
</tr>
<tr>
<td><a href="ExplanationOfBenefit-d46a4133-ba17-11ec-833a-b1763b0a7715.html">R4 conversion of MDS test data ExplanationOfBenefit.id d46a4133-ba17-11ec-833a-b1763b0a7715</a></td>
<td>d46a4133-ba17-11ec-833a-b1763b0a7715</td>
<td><a href="ExplanationOfBenefit-d46a4133-ba17-11ec-833a-b1763b0a7715.xml.html">XML</a></td>
<td><a href="ExplanationOfBenefit-d46a4133-ba17-11ec-833a-b1763b0a7715.json.html">JSON</a></td>
<td><a href="ExplanationOfBenefit-d46a4133-ba17-11ec-833a-b1763b0a7715.ttl.html">Turtle</a></td>
<td><a href="ExplanationOfBenefit-mbs-mds.html">R4 conversion of MDS test data ExplanationOfBenefit.id d46a4133-ba17-11ec-833a-b1763b0a7715</a></td>
<td>mbs-mds</td>
<td><a href="ExplanationOfBenefit-mbs-mds.xml.html">XML</a></td>
<td><a href="ExplanationOfBenefit-mbs-mds.json.html">JSON</a></td>
<td><a href="ExplanationOfBenefit-mbs-mds.ttl.html">Turtle</a></td>
</tr>
</table>
10 changes: 5 additions & 5 deletions pages/_includes/dh-explanationofbenefit-medicare-pbs-1-examples.md
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Expand Up @@ -33,10 +33,10 @@
<td><a href="ExplanationOfBenefit-pbs-cont-02.ttl.html">Turtle</a></td>
</tr>
<tr>
<td><a href="ExplanationOfBenefit-9b28d09f-ba17-11ec-833a-b1763b0a7715.html">R4 conversion of MDS test data ExplanationOfBenefit.id 9b28d09f-ba17-11ec-833a-b1763b0a7715</a></td>
<td>9b28d09f-ba17-11ec-833a-b1763b0a7715</td>
<td><a href="ExplanationOfBenefit-9b28d09f-ba17-11ec-833a-b1763b0a7715.xml.html">XML</a></td>
<td><a href="ExplanationOfBenefit-9b28d09f-ba17-11ec-833a-b1763b0a7715.json.html">JSON</a></td>
<td><a href="ExplanationOfBenefit-9b28d09f-ba17-11ec-833a-b1763b0a7715.ttl.html">Turtle</a></td>
<td><a href="ExplanationOfBenefit-pbs-mds.html">R4 conversion of MDS test data ExplanationOfBenefit.id 9b28d09f-ba17-11ec-833a-b1763b0a7715</a></td>
<td>pbs-mds</td>
<td><a href="ExplanationOfBenefit-pbs-mds.xml.html">XML</a></td>
<td><a href="ExplanationOfBenefit-pbs-mds.json.html">JSON</a></td>
<td><a href="ExplanationOfBenefit-pbs-mds.ttl.html">Turtle</a></td>
</tr>
</table>
7 changes: 7 additions & 0 deletions resources/dh-explanationofbenefit-medicare-mbs-1.xml
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Expand Up @@ -34,6 +34,13 @@
<expression value="patient.reference.exists() or patient.identifier.where(system.count() + value.count() &gt;1).exists()"/>
<source value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1"/>
</constraint>
<constraint>
<key value="inv-dh-eob-mbs-02"/>
<severity value="error"/>
<human value="The insurer shall at least have a reference or an identifier with at least a system and a value"/>
<expression value="insurer.reference.exists() or insurer.identifier.where(system.count() + value.count() &gt;1).exists()"/>
<source value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1"/>
</constraint>
</element>
<element id="ExplanationOfBenefit.identifier">
<path value="ExplanationOfBenefit.identifier"/>
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7 changes: 7 additions & 0 deletions resources/dh-explanationofbenefit-medicare-pbs-1.xml
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Expand Up @@ -34,6 +34,13 @@
<expression value="patient.reference.exists() or patient.identifier.where(system.count() + value.count() &gt;1).exists()"/>
<source value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1"/>
</constraint>
<constraint>
<key value="inv-dh-eob-pbs-02"/>
<severity value="error"/>
<human value="The insurer shall at least have a reference or an identifier with at least a system and a value"/>
<expression value="insurer.reference.exists() or insurer.identifier.where(system.count() + value.count() &gt;1).exists()"/>
<source value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1"/>
</constraint>
</element>
<element id="ExplanationOfBenefit.identifier">
<path value="ExplanationOfBenefit.identifier"/>
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