Consolidated CDA Release 2.1 StructureDefinition Publication
2.1 - CI Build United States of America flag

Consolidated CDA Release 2.1 StructureDefinition Publication, published by Health Level Seven. This is not an authorized publication; it is the continuous build for version 2.1). This version is based on the current content of https://github.com/HL7/CDA-ccda-2.1-sd/ and changes regularly. See the Directory of published versions

Logical Model: Immunization Activity

Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/ImmunizationActivity Version: 2.1
Draft as of 2023-09-29 Computable Name: ImmunizationActivity
Other Identifiers: id: urn:hl7ii:2.16.840.1.113883.10.20.22.4.52:2015-08-01

An Immunization Activity describes immunization substance administrations that have actually occurred or are intended to occur. Immunization Activities in “INT” mood are reflections of immunizations a clinician intends a patient to receive. Immunization Activities in “EVN” mood reflect immunizations actually received.

An Immunization Activity is very similar to a Medication Activity with some key differentiators. The drug code system is constrained to CVX codes. Administration timing is less complex. Patient refusal reasons should be captured. All vaccines administered should be fully documented in the patient’s permanent medical record. Healthcare providers who administer vaccines covered by the National Childhood Vaccine Injury Act are required to ensure that the permanent medical record of the recipient indicates:

  1. Date of administration
  2. Vaccine manufacturer
  3. Vaccine lot number
  4. Name and title of the person who administered the vaccine and the address of the clinic or facility where the permanent record will reside
  5. Vaccine information statement (VIS)

a. Date printed on the VIS b. Date VIS given to patient or parent/guardian.

This information should be included in an Immunization Activity when available. (Reference: [https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/c/vis-instruct.pdf])

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CDAR2.SubstanceAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
... classCode 1..1cs
... moodCode 1..1csBinding: MoodCodeEvnInt (required)
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... extension 1..1stRequired Pattern: 2015-08-01
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
... negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... statusCode 1..1CS
.... code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode, profile:participantRole
.... participant:drugVehicle 0..*Participant2
..... typeCode 1..1csFixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... typeCode 1..1csFixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... typeCode 1..1csFixed Value: SUBJ
..... inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... typeCode 1..1csFixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... typeCode 1..1csFixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... typeCode 1..1csFixed Value: COMP
..... inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... typeCode 1..1csFixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPL Drug Route of Administration Terminology
SubstanceAdministration.routeCode.translationrequiredMedication Route
SubstanceAdministration.approachSiteCoderequiredBody Site Value Set
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration 1..1CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csBinding: ActClass (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (extensible)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... @unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode, profile:participantRole
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeextensibleActSubstanceAdministrationCode
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPL Drug Route of Administration Terminology
SubstanceAdministration.routeCode.translationrequiredMedication Route
SubstanceAdministration.approachSiteCoderequiredBody Site Value Set
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
4537-9333errorSubstanceAdministration.entryRelationship:medDispense.supplyA supply act **SHALL** contain one product/Medication Information *OR* one product/Immunization Medication Information template (CONF:4537-9333).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration 1..1CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csBinding: ActClass (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... realmCode 0..*CS
... typeId 0..1II
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... id 1..*II
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (extensible)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 1..1csBinding: ActStatus (required)
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
.... @value 0..1real
.... @operator 0..1csBinding: SetOperator (required)
.... low 0..1IVXB_PQ
.... center 0..1PQ
.... width 0..1PQ
.... high 0..1IVXB_PQ
... rateQuantity 0..1IVL_PQ
... maxDoseQuantity 0..1RTO_PQ_PQ
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... realmCode 0..*CS
.... typeId 0..1II
.... templateId 0..*II
.... @typeCode 0..1csBinding: ParticipationTargetDirect (required)
Fixed Value: CSM
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... subject 0..1Subject
... specimen 0..*Specimen
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... informant 0..*Informant
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode, profile:participantRole
.... participant:drugVehicle 0..*Participant2
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... @contextControlCode 0..1csBinding: ContextControl (required)
Fixed Value: OP
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... sdtcFunctionCode 0..1CEXML Namespace: urn:hl7-org:sdtc
XML: functionCode (urn:hl7-org:sdtc)
..... time 0..1IVL_TS
..... awarenessCode 0..1CE
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 1..1IndicationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:instruction 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 1..1InstructionBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 1..1ReactionObservationBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... @inversionInd 0..1bl
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 0..1Act
..... encounter 0..1Encounter
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... @contextConductionInd 0..1bl
..... @negationInd 0..1bl
..... sequenceNumber 0..1INT
..... seperatableInd 0..1BL
..... act 1..1SubstanceAdministeredActBase for all types and resources
..... encounter 0..1Encounter
..... observation 0..1Observation
..... observationMedia 0..1ObservationMedia
..... organizer 0..1Organizer
..... procedure 0..1Procedure
..... regionOfInterest 0..1RegionOfInterest
..... substanceAdministration 0..1SubstanceAdministration
..... supply 0..1Supply
... reference 0..*Reference
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... realmCode 0..*CS
..... typeId 0..1II
..... templateId 0..*II
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.templateId:primary.nullFlavorrequiredNullFlavor
SubstanceAdministration.codeextensibleActSubstanceAdministrationCode
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.nullFlavorrequiredNullFlavor
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.priorityCodeextensibleActPriority
SubstanceAdministration.routeCoderequiredSPL Drug Route of Administration Terminology
SubstanceAdministration.routeCode.nullFlavorrequiredNullFlavor
SubstanceAdministration.routeCode.translationrequiredMedication Route
SubstanceAdministration.approachSiteCoderequiredBody Site Value Set
SubstanceAdministration.doseQuantity.nullFlavorrequiredNullFlavor
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.doseQuantity.operatorrequiredSetOperator
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.consumable.nullFlavorrequiredNullFlavor
SubstanceAdministration.consumable.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.nullFlavorrequiredNullFlavor
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.participant:drugVehicle.contextControlCoderequiredFixed Value: OP
SubstanceAdministration.entryRelationship:indication.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.nullFlavorrequiredNullFlavor
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.nullFlavorrequiredNullFlavor
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
4537-9333errorSubstanceAdministration.entryRelationship:medDispense.supplyA supply act **SHALL** contain one product/Medication Information *OR* one product/Immunization Medication Information template (CONF:4537-9333).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

This structure is derived from CDAR2.SubstanceAdministration

Summary

Mandatory: 9 elements (11 nested mandatory elements)
Fixed Value: 11 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element SubstanceAdministration.templateId is sliced based on the values of value:root, value:extension
  • The element SubstanceAdministration.participant is sliced based on the values of value:typeCode, profile:participantRole
  • The element SubstanceAdministration.entryRelationship is sliced based on the values of profile:act, profile:observation, profile:supply
  • The element SubstanceAdministration.precondition is sliced based on the value of profile:criterion

Differential View

This structure is derived from CDAR2.SubstanceAdministration

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
... classCode 1..1cs
... moodCode 1..1csBinding: MoodCodeEvnInt (required)
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... extension 1..1stRequired Pattern: 2015-08-01
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
... negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... statusCode 1..1CS
.... code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1SXCM_TS, IVL_TS, EIVL_TS, PIVL_TS, SXPR_TS
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode, profile:participantRole
.... participant:drugVehicle 0..*Participant2
..... typeCode 1..1csFixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... typeCode 1..1csFixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... typeCode 1..1csFixed Value: SUBJ
..... inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... typeCode 1..1csFixed Value: REFR
..... supply 1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... typeCode 1..1csFixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... typeCode 1..1csFixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... typeCode 1..1csFixed Value: COMP
..... inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... typeCode 1..1csFixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPL Drug Route of Administration Terminology
SubstanceAdministration.routeCode.translationrequiredMedication Route
SubstanceAdministration.approachSiteCoderequiredBody Site Value Set
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration 1..1CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csBinding: ActClass (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (extensible)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... statusCode 1..1CSBinding: ActStatus (required)
.... @code 1..1csBinding: ActStatus (required)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... @unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
... administrationUnitCode 0..1CEBinding: AdministrationUnitDoseForm (required)
... consumable 1..1InfrastructureRoot
.... manufacturedProduct 1..1ImmunizationMedicationInformationBase for all types and resources
... performer 0..1Performer2
... author 0..*AuthorParticipationBase for all types and resources
... Slices for participant 0..*Participant2Slice: Unordered, Open by value:typeCode, profile:participantRole
.... participant:drugVehicle 0..*Participant2
..... @typeCode 1..1csBinding: ParticipationType (required)
Fixed Value: CSM
..... participantRole 1..1DrugVehicleBase for all types and resources
... Slices for entryRelationship 0..*EntryRelationshipSlice: Unordered, Open by profile:act, profile:observation, profile:supply
.... entryRelationship:indication 0..*EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation 1..1IndicationBase for all types and resources
.... entryRelationship:instruction 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: SUBJ
..... @inversionInd 1..1blFixed Value: true
..... act 1..1InstructionBase for all types and resources
.... entryRelationship:medSupplyOrder 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply 1..1MedicationSupplyOrderBase for all types and resources
.... entryRelationship:medDispense 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: REFR
..... supply C1..1MedicationDispenseBase for all types and resources
.... entryRelationship:reactionObs 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: CAUS
..... observation 1..1ReactionObservationBase for all types and resources
.... entryRelationship:immunizationRefusal 0..1EntryRelationship
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: RSON
..... observation 1..1ImmunizationRefusalReasonBase for all types and resources
.... entryRelationship:substanceAdmin 0..*EntryRelationshipThe following entryRelationship is used to indicate a given immunization's order in a series. The nested Substance Administered Act identifies an administration in the series. The entryRelationship/sequenceNumber shows the order of this particular administration in that series.
..... @typeCode 1..1csBinding: x_ActRelationshipEntryRelationship (required)
Fixed Value: COMP
..... @inversionInd 1..1blFixed Value: true
..... sequenceNumber 0..1INT
..... act 1..1SubstanceAdministeredActBase for all types and resources
... Slices for precondition 0..*PreconditionSlice: Unordered, Open by profile:criterion
.... precondition:substanceAdmin 0..*Precondition
..... @typeCode 1..1csBinding: ActRelationshipType (required)
Fixed Value: PRCN
..... criterion 1..1PreconditionforSubstanceAdministrationBase for all types and resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
SubstanceAdministration.classCoderequiredFixed Value: SBADM
SubstanceAdministration.moodCoderequiredMoodCodeEvnInt
SubstanceAdministration.codeextensibleActSubstanceAdministrationCode
SubstanceAdministration.statusCoderequiredActStatus
SubstanceAdministration.statusCode.coderequiredActStatus
SubstanceAdministration.routeCoderequiredSPL Drug Route of Administration Terminology
SubstanceAdministration.routeCode.translationrequiredMedication Route
SubstanceAdministration.approachSiteCoderequiredBody Site Value Set
SubstanceAdministration.doseQuantity.unitrequiredUnitsOfMeasureCaseSensitive (a valid code from UCUM)
SubstanceAdministration.administrationUnitCoderequiredAdministrationUnitDoseForm
SubstanceAdministration.participant:drugVehicle.typeCoderequiredFixed Value: CSM
SubstanceAdministration.entryRelationship:indication.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:instruction.typeCoderequiredFixed Value: SUBJ
SubstanceAdministration.entryRelationship:medSupplyOrder.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:medDispense.typeCoderequiredFixed Value: REFR
SubstanceAdministration.entryRelationship:reactionObs.typeCoderequiredFixed Value: CAUS
SubstanceAdministration.entryRelationship:immunizationRefusal.typeCoderequiredFixed Value: RSON
SubstanceAdministration.entryRelationship:substanceAdmin.typeCoderequiredFixed Value: COMP
SubstanceAdministration.precondition:substanceAdmin.typeCoderequiredFixed Value: PRCN

Constraints

IdGradePath(s)DetailsRequirements
4537-9333errorSubstanceAdministration.entryRelationship:medDispense.supplyA supply act **SHALL** contain one product/Medication Information *OR* one product/Immunization Medication Information template (CONF:4537-9333).
:
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. SubstanceAdministration 1..1CDAR2.SubstanceAdministrationXML Namespace: urn:hl7-org:v3
Elements defined in Ancestors: @classCode, @moodCode, realmCode, typeId, templateId, id, code, @negationInd, text, statusCode, effectiveTime, priorityCode, repeatNumber, routeCode, approachSiteCode, doseQuantity, rateQuantity, maxDoseQuantity, administrationUnitCode, consumable, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition
Base for all types and resources
... @classCode 1..1csBinding: ActClass (required)
Fixed Value: SBADM
... @moodCode 1..1csBinding: MoodCodeEvnInt (required)
... realmCode 0..*CS
... typeId 0..1II
... Slices for templateId 1..*IISlice: Unordered, Open by value:root, value:extension
.... templateId:primary 1..1II
..... @nullFlavor 0..1csBinding: NullFlavor (required)
..... @assigningAuthorityName 0..1st
..... @displayable 0..1bl
..... @root 1..1oid, uuid, ruidRequired Pattern: 2.16.840.1.113883.10.20.22.4.52
..... @extension 1..1stRequired Pattern: 2015-08-01
... id 1..*II
... code 0..1CDSubstanceAdministration.code is an optional field. Per HL7 Pharmacy Committee, "this is intended to further specify the nature of the substance administration act. To date the committee has made no use of this attribute". Because the type of substance administration is generally implicit in the routeCode, in the consumable participant, etc., the field is generally not used and there is no defined value set.
Binding: ActSubstanceAdministrationCode (extensible)
... @negationInd 1..1blUse negationInd="true" to indicate that the immunization was not given.
... text 0..1ED
... statusCode 1..1CSBinding: ActStatus (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 1..1csBinding: ActStatus (required)
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
... effectiveTime 1..1
.... effectiveTimeSXCM_TS
.... effectiveTimeIVL_TS
.... effectiveTimeEIVL_TS
.... effectiveTimePIVL_TS
.... effectiveTimeSXPR_TS
... priorityCode 0..1CEBinding: ActPriority (extensible)
... repeatNumber 0..1IVL_INTIn "INT" (intent) mood, the repeatNumber defines the number of allowed administrations. For example, a repeatNumber of "3" means that the substance can be administered up to 3 times. In "EVN" (event) mood, the repeatNumber is the number of occurrences. For example, a repeatNumber of "3" in a substance administration event means that the current administration is the 3rd in a series.
... routeCode 0..1CEBinding: SPL Drug Route of Administration Terminology (required)
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @code 0..1cs
.... @codeSystem 0..1oid, uuid, ruid
.... @codeSystemName 0..1st
.... @codeSystemVersion 0..1st
.... @displayName 0..1st
.... @sdtcValueSet 0..1oidXML Namespace: urn:hl7-org:sdtc
XML: valueSet (urn:hl7-org:sdtc)
.... @sdtcValueSetVersion 0..1stXML Namespace: urn:hl7-org:sdtc
XML: valueSetVersion (urn:hl7-org:sdtc)
.... originalText 0..1ED
.... translation 0..*CDBinding: Medication Route (required)
... approachSiteCode 0..1CDBinding: Body Site Value Set (required)
... doseQuantity 0..1IVL_PQ
.... @nullFlavor 0..1csBinding: NullFlavor (required)
.... @unit 0..1csBinding: UnitsOfMeasureCaseSensitive (required)
.... @value 0..1real
.... @operator