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My Health Record Document Types and Sub Types Register

Version 5 - 21 May 2024

The list below are the recommended tags for document types each document may have (there may be more than one).

Tag Name Tag Description
Continuity of Care Continuity of Care Tag
Health Program Health Program Tag
Medicines Medicines Tag
Diagnostics Diagnostics Tag
Patient Entered Information Patient Entered Information Tag

The list below is the current list of document types and subtypes that the My Health Record currently supports.

Class Code Class Code System Class Code System Name Class Code Display Name Class Document Generation Classification Class CisCsp Accessible Class CisCsp Requestable Class CisCsp Recommended Request Class Descripion Type Code Type Code System Type Code System Name Type Code Category Type Code Display Name Type Descripion Type Activation Date Type Deprecation Date Type Retirement Date Type CisCsp Accessible Type CisCsp Requestable Type CisCsp Recommended Request CIS/CSP Upload CRP Upload MOS Upload NCP Upload NPP Upload Tag 1 Name Tag 2 Relationship Tag 2 Name Tag 2 Relationship
60591-5 2.16.840.1.113883.6.1 LOINC Shared Health Summary Document True True True The shared health summary provides key pieces of information about an individual's health status, facilitating care across their entire healthcare domain. Nominated healthcare providers author a shared health summary during or soon after a consultation with a patient. It might contain information about allergies and adverse reactions, past medical history and or immunisation information. 60591-5 2.16.840.1.113883.6.1 LOINC Clinical Document Shared Health Summary The shared health summary provides key pieces of information about an individual's health status, facilitating care across their entire healthcare domain. Nominated healthcare providers author a shared health summary during or soon after a consultation with a patient. It might contain information about allergies and adverse reactions, past medical history and or immunisation information. 01/01/2010 True True True Default Default Continuity of Care Primary
57133-1 2.16.840.1.113883.6.1 LOINC e-Referral Document True True True Referrals are communications with the intention of initiating a transfer of responsibility for some aspects of a consumer's ongoing management from one provider to another across a range of healthcare and human services fields. 57133-1 2.16.840.1.113883.6.1 LOINC Clinical Document e-Referral Referrals are communications with the intention of initiating a transfer of responsibility for some aspects of a consumer's ongoing management from one provider to another across a range of healthcare and human services fields. 01/01/2010 True True True Default Default Continuity of Care Primary
51852-2 2.16.840.1.113883.6.1 LOINC Specialist Letter Document True True True Specialist letters are used in replying to a referral or reporting on a health event. They contain information related to the event or the requested diagnosis or treatment by a specialist. 51852-2 2.16.840.1.113883.6.1 LOINC Clinical Document Specialist Letter Specialist letters are used in replying to a referral or reporting on a health event. They contain information related to the event or the requested diagnosis or treatment by a specialist. 01/01/2010 True True True Default Default Continuity of Care Primary
51852-2 2.16.840.1.113883.6.1 LOINC Specialist Letter Document True True True Specialist letters are used in replying to a referral or reporting on a health event. They contain information related to the event or the requested diagnosis or treatment by a specialist. 84106-4 2.16.840.1.113883.6.1 LOINC Clinical Document Gastroenterology Letter Document that contains information about an individual's gastrointestinal health conditions and include relevant findings, assessments, recommendations, and treatment plans. It is typically authored by a gastroenterologist. 01/10/2023 True True True Default Default Continuity of Care Primary
51852-2 2.16.840.1.113883.6.1 LOINC Specialist Letter Document True True True Specialist letters are used in replying to a referral or reporting on a health event. They contain information related to the event or the requested diagnosis or treatment by a specialist. 68593-3 2.16.840.1.113883.6.1 LOINC Clinical Document Plastic Surgery Letter Document that contains information about an individual's health condition or concerns requiring reconstructive surgery to restore and/or improve functions and appearance. They include evaluations, treatments, and recommendations. It is typically composed by a plastic surgeon. 01/10/2023 True True True Default Default Continuity of Care Primary
18842-5 2.16.840.1.113883.6.1 LOINC Discharge Summary Document True True True Discharge Summary documents support the transfer of a patient from a hospital back to the care of their nominated primary healthcare provider. They capture details about the patient's hospital stay, including the diagnosis, diagnostic procedures performed, the prognosis, medications prescribed and follow-up actions recommended. 18842-5 2.16.840.1.113883.6.1 LOINC Clinical Document Discharge Summary Discharge Summary documents support the transfer of a patient from a hospital back to the care of their nominated primary healthcare provider. They capture details about the patient's hospital stay, including the diagnosis, diagnostic procedures performed, the prognosis, medications prescribed and follow-up actions recommended. 01/01/2010 True True True Default Default Continuity of Care Primary
18842-5 2.16.840.1.113883.6.1 LOINC Discharge Summary Document True True True Discharge Summary documents support the transfer of a patient from a hospital back to the care of their nominated primary healthcare provider. They capture details about the patient's hospital stay, including the diagnosis, diagnostic procedures performed, the prognosis, medications prescribed and follow-up actions recommended. 88645-7 2.16.840.1.113883.6.1 LOINC Clinical Document Outpatient hospital Discharge Summary A collection of information about events during care by a provider or organisation in the outpatient or ambulatory care setting, which is released when an individual is discharged from the care of the provider organisation without being formally admitted to the hospital as an inpatient. 01/10/2023 True True True Default Default Continuity of Care Primary
18842-5 2.16.840.1.113883.6.1 LOINC Discharge Summary Document True True True Discharge Summary documents support the transfer of a patient from a hospital back to the care of their nominated primary healthcare provider. They capture details about the patient's hospital stay, including the diagnosis, diagnostic procedures performed, the prognosis, medications prescribed and follow-up actions recommended. 59258-4 2.16.840.1.113883.6.1 LOINC Clinical Document Emergency department Discharge Summary Emergency department discharge summary documents are generated when an individual is treated in an emergency department and is subsequently discharged. They capture details about an individual's presenting complaint, assessment, the diagnosis, diagnostic procedures performed, the prognosis, medications prescribed and follow-up actions recommended. 01/10/2023 True True True Default Default Continuity of Care Primary
34133-9 2.16.840.1.113883.6.1 LOINC Event Summary Document True True True Event Summary documents are used to capture key health information about significant healthcare events that are relevant to the ongoing care of an individual. 34133-9 2.16.840.1.113883.6.1 LOINC Clinical Document Event Summary Event Summary documents are used to capture key health information about significant healthcare events that are relevant to the ongoing care of an individual. 01/01/2010 True True True Default Default Continuity of Care Primary
34133-9 2.16.840.1.113883.6.1 LOINC Event Summary Document True True True Event Summary documents are used to capture key health information about significant healthcare events that are relevant to the ongoing care of an individual. 96344-7 2.16.840.1.113883.6.1 LOINC Clinical Document Oncology Summary Note Information about an oncology treatment event. It includes pertinent data about diagnostic, provision of cancer treatment and care. It is typically written by an oncology specialist. 01/10/2023 True True True Default Default Continuity of Care Primary
100.16650 1.2.36.1.2001.1001.101 NCTIS Pharmaceutical Benefits Report Document True True True Information about pharmaceutical items prescribed and dispensed to an individual that were partially or fully funded under the Pharmaceutical Benefit Schedule (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS). 100.16650 1.2.36.1.2001.1001.101 NCTIS Medicare Document Pharmaceutical Benefits Report Information about pharmaceutical items prescribed and dispensed to an individual that were partially or fully funded under the Pharmaceutical Benefit Schedule (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS). 01/01/2010 True True True Medicare Continuity of Care Primary
100.16671 1.2.36.1.2001.1001.101 NCTIS Australian Organ Donor Register Document True True True The Australian Organ Donor Register (AODR) is the national register for people to record their decision about becoming an organ and tissue donor. The AODR is the only national register for people to record their decision about becoming an organ and tissue donor for transplantation after death. 100.16671 1.2.36.1.2001.1001.101 NCTIS Medicare Document Australian Organ Donor Register The Australian Organ Donor Register (AODR) is the national register for people to record their decision about becoming an organ and tissue donor. The AODR is the only national register for people to record their decision about becoming an organ and tissue donor for transplantation after death. 01/01/2010 True True True Medicare Health Program Primary
100.17042 1.2.36.1.2001.1001.101 NCTIS Australian Immunisation Register Document True True True The Australian Immunisation Register (AIR) (Formally the Australian Childhood Immunisation Register) is a national register that records vaccinations given to people of all ages in Australia. 100.17042 1.2.36.1.2001.1001.101 NCTIS Medicare Document Australian Immunisation Register The Australian Immunisation Register (AIR) (Formally the Australian Childhood Immunisation Register) is a national register that records vaccinations given to people of all ages in Australia. 01/01/2010 True True True Medicare Health Program Primary
100.16644 1.2.36.1.2001.1001.101 NCTIS Medicare/DVA Benefits Report Document True True False Information about a Medicare or DVA partially or fully funded service under the Medicare Benefits Schedule or Department of Veterans' Affairs (DVA). 100.16644 1.2.36.1.2001.1001.101 NCTIS Medicare Document Medicare/DVA Benefits Report Information about a Medicare or DVA partially or fully funded service under the Medicare Benefits Schedule or Department of Veterans' Affairs (DVA). 01/01/2010 True True True Medicare Health Program Primary
100.16767 1.2.36.1.2001.1001.101 NCTIS Data Components Medicare Overview DocumentView True False False Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual's My Health Record. 100.16767.1 1.2.36.1.2001.1001.101 NCTIS Data Components Medicare Document Medicare Overview - all Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual's My Health Record. 01/01/2010 True False False Health Program Primary
100.16767 1.2.36.1.2001.1001.101 NCTIS Data Components Medicare Overview DocumentView True False False Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual's My Health Record. 100.16767.2 1.2.36.1.2001.1001.101 NCTIS Data Components Medicare Document Medicare Overview - past 12 months Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual's My Health Record. 01/01/2010 True False False Health Program Primary
100.16764 1.2.36.1.2001.1001.101 NCTIS Data Components eHealth Prescription Record Document True True False Prescription records are a digital record of prescribed medications. These documents do not represent actual prescriptions, but instead support the sharing of information about medication prescriptions. 100.16764 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document eHealth Prescription Record Prescription records are a digital record of prescribed medications. These documents do not represent actual prescriptions, but instead support the sharing of information about medication prescriptions. 01/01/2010 True True False Default NPDR Medicines Primary
100.16765 1.2.36.1.2001.1001.101 NCTIS Data Components eHealth Dispense Record Document True True False Dispense Records are a digital record of dispensed medications by a pharmacist. 100.16765 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document eHealth Dispense Record Dispense Records are a digital record of dispensed medications by a pharmacist. 01/01/2010 True True False Default NPDR Medicines Primary
56445-0 2.16.840.1.113883.6.1 LOINC Pharmacist Shared Medicines List Document True True False The Shared Medicine List contains detailed information about medicines the consumer is known to be taking when the list was created. This includes both prescription and non-prescription medicines, including 'over-the-counter' (OTC) medicines and complementary medicines such as vitamins and herbal products. 56445-0 2.16.840.1.113883.6.1 LOINC Clinical Document Pharmacist Shared Medicines List The Shared Medicine List contains detailed information about medicines the consumer is known to be taking when the list was created. This includes both prescription and non-prescription medicines, including 'over-the-counter' (OTC) medicines and complementary medicines such as vitamins and herbal products. 01/01/2010 True True False Default Medicines Primary
100.32002 1.2.36.1.2001.1001.101 NCTIS Data Components Medicines View DocumentView True False False Medicines View Document 100.32002 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Medicines View Medicines View Document 01/01/2010 True False False Medicines Primary
100.32034 1.2.36.1.2001.1001.101 NCTIS Data Components Immunisation Consolidated View DocumentView True False False Immunisation Consolidated View Document 100.32034 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Immunisation Consolidated View Immunisation Consolidated View Document 01/01/2010 True False False Medicines Primary
100.16957 1.2.36.1.2001.1001.101 NCTIS Data Components Diagnostic Imaging Report Document True True True Diagnostic imaging reports are used to share information about diagnostic imaging examinations via an individual's digital health record. The Diagnostic Imaging Report PDF may contain one or more examinations that are uploaded by the diagnostic imaging provider to the individual's digital health record. 100.16957 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Diagnostic Imaging Report Diagnostic imaging reports are used to share information about diagnostic imaging examinations via an individual's digital health record. The Diagnostic Imaging Report PDF may contain one or more examinations that are uploaded by the diagnostic imaging provider to the individual's digital health record. 01/01/2010 True True True Default Default Diagnostics Primary
100.32001 1.2.36.1.2001.1001.101 NCTIS Data Components Pathology Report Document True True False Pathology reports can be used to share information about pathology tests via an individual's digital health record. The Pathology Report PDF may contain one or more tests that are uploaded by the pathology provider to the individual's digital health record. 100.32001 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Pathology Report Pathology reports can be used to share information about pathology tests via an individual's digital health record. The Pathology Report PDF may contain one or more tests that are uploaded by the pathology provider to the individual's digital health record. 01/01/2010 True True False Default Default Diagnostics Primary
100.32026 1.2.36.1.2001.1001.101 NCTIS Data Components Pathology Overview DocumentView True False False A consolidated overview of some of the Pathology Reports in a patient's record. 100.32026 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Pathology Overview A consolidated overview of some of the Pathology Reports in a patient's record. 01/01/2010 True False False Diagnostics Primary
100.32025 1.2.36.1.2001.1001.101 NCTIS Data Components Diagnostic Imaging Overview DocumentView True False False A consolidated overview of some of the Diagnostic Imaging Reports in a patient's record. 100.32025 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Diagnostic Imaging Overview A consolidated overview of some of the Diagnostic Imaging Reports in a patient's record. 01/01/2010 True False False Diagnostics Primary
100.16975 1.2.36.1.2001.1001.101 NCTIS Data Components Advance Care Information Document True True True Advance care planning information can include a statement by a competent person expressing decisions about his or her future care, should they become incapable of participating in medical treatment decisions. These statements are currently recorded in paper-based advance care directives. 100.16998 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Advance Care Planning Document Advance care planning information can include a statement by a competent person expressing decisions about his or her future care, should they become incapable of participating in medical treatment decisions. These statements are currently recorded in paper-based advance care directives. 01/01/2010 True True True Default Consumer Patient Entered Information Primary
100.16975 1.2.36.1.2001.1001.101 NCTIS Data Components Advance Care Information Document True True True Advance care planning information can include a statement by a competent person expressing decisions about his or her future care, should they become incapable of participating in medical treatment decisions. These statements are currently recorded in paper-based advance care directives. 100.32016 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Goals of Care Document The Goals of Care clinical document type is used to capture advance care information and can a statement related to a person's care in the context of a serious illness, as agreed between him/her, his/her family, carers and healthcare team. 01/01/2010 True True True Default Patient Entered Information Primary
100.16919 1.2.36.1.2001.1001.101 NCTIS Data Components Child Parent Questionnaire Document True True True Child Parent Questionnaire Document 100.16919 1.2.36.1.2001.1001.101 NCTIS Data Components Child eHealth Record (CeHR) Document Child Parent Questionnaire Child Parent Questionnaire Document 01/01/2010 True True True Consumer Consumer Patient Entered Information Primary
100.16870 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Entered Measurements Document True True True Consumer Entered Measurements Document 100.16870 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Consumer Entered Measurements Consumer Entered Measurements Document 01/01/2010 True True True Consumer Consumer Patient Entered Information Primary
100.16696 1.2.36.1.2001.1001.101 NCTIS Data Components Advance Care Directive Custodian Record Document True True True The advance care document custodian form provides information about the custodian of the individual's advance care directive. Such documents do not contain the advance care directive itself. 100.16696 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Advance Care Directive Custodian Record The advance care document custodian form provides information about the custodian of the individual's advance care directive. Such documents do not contain the advance care directive itself. 01/01/2010 True True True Consumer Consumer Patient Entered Information Primary
100.16920 1.2.36.1.2001.1001.101 NCTIS Data Components Health Check Assessment Document True True False Health Check Assessment Document 100.16920 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Health Check Assessment Health Check Assessment Document 01/01/2010 True True False Default Default Patient Entered Information Primary
100.16812 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Entered Achievements Document True True False Consumer Entered Achievements Document 100.16812 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Consumer Entered Achievements Consumer Entered Achievements Document 01/01/2010 True True False Consumer Consumer Patient Entered Information Primary
100.16685 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Entered Health Summary Document True True False Consumer Entered Health Summary Document 100.16685 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Consumer Entered Health Summary Consumer Entered Health Summary Document 01/01/2010 True True False Consumer Consumer Patient Entered Information Primary
100.16681 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Entered Notes Document False False False Consumer Entered Notes Document 100.16681 1.2.36.1.2001.1001.101 NCTIS Data Components Consumer Document Consumer Entered Notes Consumer Entered Notes Document 01/01/2010 False False False Consumer Consumer Patient Entered Information Primary
18761-7 2.16.840.1.113883.6.1 LOINC Transfer Summary DocumentView True True True A summary of information related to an individual's transfer from one healthcare facility to another. 100.32047 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Residential Care Transfer Overview A residential care transfer overview is a logical view/document generated by My Health Record and contains information relevant to create safe, effective communication, ensuring continuity as the individual moves through care transition from a residential care setting. A residential care transfer overview includes the particulars of the transfer from a residential care setting and a summary of an individual's record. 01/01/2023 True True True Continuity of Care Primary
18761-7 2.16.840.1.113883.6.1 LOINC Transfer Summary Document True True True A summary of information related to an individual's transfer from one healthcare facility to another. 100.32044 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Residential Care Transfer Reason A residential care transfer reason is generated by the originating residential care facility and contains the particulars of the transfer from a residential care setting including provider information, reason for transfer, and date of transfer. 01/01/2023 True True True Default Default Continuity of Care Primary
80565-5 2.16.840.1.113883.6.1 LOINC Medication Chart Document True True True A summary of all of the medications for an individual over a certain period of time. 100.32046 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Residential Care Medication Chart A residential medication chart is used as a record of orders and administration of prescription medicines, non-prescription medicines and nutritional supplements for individuals living in residential care facilities. 01/01/2023 True True True Default Default Continuity of Care Primary
100.32048 1.2.36.1.2001.1001.101 NCTIS Data Components MyMedicare Registered Practice Information Document True True True Displays the practice information that the person is registered with, as well as their preferred health professional from that practice. 100.32048 1.2.36.1.2001.1001.101 NCTIS Data Components Medicare Document MyMedicare Registered Practice Information Displays the practice information that the person is registered with, as well as their preferred health professional from that practice. 01/01/2023 True True True Medicare Health Program Primary
100.32050 1.2.36.1.2001.1001.101 NCTIS Data Components Patient Health Summary Document True True True A summary of an individual's health information needed for healthcare coordination, supporting continuity of care during unexpected healthcare encounters or when the individual seeks care from providers other than their regular healthcare provider. 100.32049 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Residential Care Health Summary A residential care health summary contains information about a residential care individual's environment, health and care to support continuity of care. 01/01/2023 True True True Default Default Continuity of Care Primary
100.32050 1.2.36.1.2001.1001.101 NCTIS Data Components Patient Health Summary Document True True True A summary of an individual's health information needed for healthcare coordination, supporting continuity of care during unexpected healthcare encounters or when the individual seeks care from providers other than their regular healthcare provider. 100.32051 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical View Medical Conditions View The patients and their representatives, and providers have easier access to healthcare recipients' medical conditions and other relevant clinical information such as procedures, symptoms, medical implants, devices, allergies/ adverse reactions and medicines by enabling them to view them all in a consolidated location, thereby improve clinical decision making and user experience. 30/06/2024 True True True Continuity of Care Primary
18776-5 2.16.840.1.113883.6.1 LOINC Care or Support Plan Document True True True Care and support plan data that include identified concerns - problems about healthcare recipient, and the goals and strategies and - or recommended interventions, services and support to be provided. The plan may also contain information about ongoing care of the patient and information regarding goals and care - clinical reminder. 100.32052 1.2.36.1.2001.1001.101 NCTIS Data Components Clinical Document Aged Care Support Plan Aged care support plan data that capture assessment of an Aged Care recipient's health concerns - needs that also include goals to achieve, and the recipient's at home support needs, recommended support activities, procedures and services required. 1/08/2024 True True True Health Health Program Primary

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