Breast Screening NZ FHIR Implementation Guide
1.1.0 - Release

Breast Screening NZ FHIR Implementation Guide - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Profiles and Extensions

Profiles and Extensions

This page provides a list of the FHIR profiles and extensions defined in this Implementation Guide.

Profiles

The following profiles have been defined for this implementation guide.

CarePlan Profile

​CarePlan - Breast Screening

This profile defines constraints on the CarePlan resource for representing a participant's enrollment and progression through the breast screening programme. It tracks the participant's pathway state, programme status, and key dates throughout their screening journey.

Key Features:

  • Required subject (Patient reference)
  • Fixed intent of "plan"
  • Enrollment period tracking
  • Managing organization reference
  • Support for programme and pathway tracking extensions

Must Support Elements:

  • status - Current status of the care plan
  • intent - Always set to "plan"
  • subject - The patient enrolled in screening
  • period - Enrollment and exit dates
  • author - Managing organization

Extensions

The following extensions have been defined for this implementation guide. These extensions are used to capture breast screening-specific data that is not part of the base FHIR specification.

Programme Status Extension

Programme Status

Indicates the participant's enrollment status in the breast screening programme.

This extension captures whether a participant is actively enrolled, suspended, or has exited the programme.

Pathway State Extension

Pathway State

Represents the current state of the participant within the screening pathway.

  • Context of Use: CarePlan
  • Type: CodeableConcept
  • Cardinality: 0..1 (Required in CarePlan-BreastScreening profile: 1..1)
  • Binding: Pathway State ValueSet (required)

This extension tracks where the participant is in the screening workflow (e.g., invited, booked, screening, reading).

Possible Values:

  • Available for invitation
  • Invited
  • Booked
  • Deferred
  • Screening
  • Reading
  • Returned to routine screening
  • Exited

Pathway Substate Extension

Pathway Substate

Provides additional detail about the participant's current pathway state.

  • Context of Use: CarePlan
  • Type: CodeableConcept
  • Cardinality: 0..1 (Required in CarePlan-BreastScreening profile: 1..1)
  • Binding: Pathway Substate ValueSet (required)

This extension captures more granular status information that provides context to the main pathway state.

Pathway State Date Last Modified Extension

Pathway State Date Last Modified

Records when the pathway state was last updated.

  • Context of Use: CarePlan
  • Type: dateTime
  • Cardinality: 0..1 (Required in CarePlan-BreastScreening profile: 1..1)

This extension enables tracking of when the participant's pathway state changed, supporting audit and reporting requirements.

Terminology

Code Systems

The following code systems are defined in this implementation guide:

Value Sets

The following value sets are defined in this implementation guide:

Usage Notes

Using Extensions with the CarePlan Profile

When creating a CarePlan resource that conforms to the Breast Screening profile, the extensions should be populated as follows:

{
  "resourceType": "CarePlan",
  "meta": {
    "profile": [
      "https://bsa-uat.pinga.health/ig/StructureDefinition/CarePlan-BreastScreening"
    ]
  },
  "extension": [
    {
      "url": "https://bsa-uat.pinga.health/ig/StructureDefinition/pathway-state",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://bsa-uat.pinga.health/ig/CodeSystem/pathway-state",
            "code": "invited",
            "display": "Invited"
          }
        ]
      }
    },
    {
      "url": "https://bsa-uat.pinga.health/ig/StructureDefinition/pathway-state-date-last-modified",
      "valueDateTime": "2025-11-14T10:30:00Z"
    }
  ],
  "status": "active",
  "intent": "plan",
  "subject": {
    "reference": "Patient/example"
  }
}

Extension Cardinality in Profile vs Base Definition

Note that while the base extension definitions allow cardinality of 0..1, the CarePlan-BreastScreening profile constrains certain extensions to be required (1..1):

  • pathwayState - Required (1..1)
  • pathwaySubstate - Required (1..1)
  • pathwayStateLastModified - Required (1..1)
  • programmeStatus - Optional (0..1)