QI-Core Implementation Guide
6.0.0 - STU6 United States of America flag

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICore Immunization Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationnotdone Version: 6.0.0
Active as of 2018-08-22 Computable Name: QICoreImmunizationNotDone

Negation profile of Immunization for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

The Immunization and ImmunizationNotDone profiles represent the positive and negative statements for an immunization event.

Examples

Negation Example using a valueset reference Immunization not performed due to patient declination for religious reasons; indicates that none of the vaccines in the given "not done value set" were administered.
Negation Example using a single coded concept Immunization not performed due to patient declination for religious reasons; indicates that a specific vaccine, by code, was not administered.

Both of these example instances meet measure intent for exclusion as defined in the following example CQL:

define "Reason for No Polio Immunization":
  ["ImmunizationNotDone": "Inactivated Polio Vaccine (IPV)"] PolioVaccination
    where PolioVaccination.statusReason in "Medical Reason"
      or PolioVaccination.statusReason in "Patient Refusal"

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreImmunizationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... status 1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Fixed Value: not-done
... statusReason 1..1CodeableConcept(QI-Core)(USCDI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG

Constraints

IdGradePath(s)DetailsRequirements
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC1..1CodeableConcept(USCDI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... patient SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who was immunized
... occurrence[x] SΣ1..1(USCDI) Vaccine administration date
.... occurrenceDateTimedateTime
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record
... primarySource SΣ0..1boolean(USCDI) Indicates context the data was recorded in
... isSubpotent ?!Σ0..1booleanDose potency

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Immunization.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/immunization-status
from the FHIR Standard
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Immunization.vaccineCodeextensibleCVXVaccinesAdministeredVaccineSet
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.6

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorImmunizationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorImmunizationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceImmunizationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have a translation to the NDC value set
: vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!SΣ1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... statusReason S1..1CodeableConcept(QI-Core)(USCDI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode SΣC1..1CodeableConcept(USCDI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who was immunized
... encounter 0..1Reference(Encounter)Encounter immunization was part of
... occurrence[x] SΣ1..1(USCDI) Vaccine administration date
.... occurrenceDateTimedateTime S
.... occurrenceStringstring
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record
... primarySource SΣ0..1boolean(USCDI) Indicates context the data was recorded in
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.

... location 0..1Reference(Location)Where immunization occurred
... manufacturer 0..1Reference(Organization)Vaccine manufacturer
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... site 0..1CodeableConceptBody site vaccine was administered
Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.

... route 0..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... performer Σ0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function Σ0..1CodeableConceptWhat type of performance was done
Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.

.... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization)Individual or organization who was performing
... note Σ0..*AnnotationAdditional immunization notes
... reasonCode 0..*CodeableConceptWhy immunization occurred
Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.


... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Why immunization occurred
... isSubpotent ?!Σ0..1booleanDose potency
... subpotentReason 0..*CodeableConceptReason for being subpotent
Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.


... education C0..*BackboneElementEducational material presented to patient
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... documentType 0..1stringEducational material document identifier
.... reference 0..1uriEducational material reference pointer
.... publicationDate 0..1dateTimeEducational material publication date
.... presentationDate 0..1dateTimeEducational material presentation date
... programEligibility 0..*CodeableConceptPatient eligibility for a vaccination program
Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.


... fundingSource 0..1CodeableConceptFunding source for the vaccine
Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.

... reaction 0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... protocolApplied 0..*BackboneElementProtocol followed by the provider
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... series 0..1stringName of vaccine series
.... authority 0..1Reference(Organization)Who is responsible for publishing the recommendations
.... targetDisease 0..*CodeableConceptVaccine preventatable disease being targetted
Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.


.... doseNumber[x] 1..1Dose number within series
..... doseNumberPositiveIntpositiveInt
..... doseNumberStringstring
.... seriesDoses[x] 0..1Recommended number of doses for immunity
..... seriesDosesPositiveIntpositiveInt
..... seriesDosesStringstring

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Immunization.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Immunization.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/immunization-status
from the FHIR Standard
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Immunization.vaccineCodeextensibleCVXVaccinesAdministeredVaccineSet
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.6
Immunization.reportOriginexampleImmunizationOriginCodes
http://hl7.org/fhir/ValueSet/immunization-origin
from the FHIR Standard
Immunization.siteexampleCodesForImmunizationSiteOfAdministration
http://hl7.org/fhir/ValueSet/immunization-site
from the FHIR Standard
Immunization.routeexampleImmunizationRouteCodes
http://hl7.org/fhir/ValueSet/immunization-route
from the FHIR Standard
Immunization.performer.functionextensibleImmunizationFunctionCodes
http://hl7.org/fhir/ValueSet/immunization-function
from the FHIR Standard
Immunization.reasonCodeexampleImmunizationReasonCodes
http://hl7.org/fhir/ValueSet/immunization-reason
from the FHIR Standard
Immunization.subpotentReasonexampleImmunizationSubpotentReason
http://hl7.org/fhir/ValueSet/immunization-subpotent-reason
from the FHIR Standard
Immunization.programEligibilityexampleImmunizationProgramEligibility
http://hl7.org/fhir/ValueSet/immunization-program-eligibility
from the FHIR Standard
Immunization.fundingSourceexampleImmunizationFundingSource
http://hl7.org/fhir/ValueSet/immunization-funding-source
from the FHIR Standard
Immunization.protocolApplied.targetDiseaseexampleImmunizationTargetDiseaseCodes
http://hl7.org/fhir/ValueSet/immunization-target-disease
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorImmunizationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorImmunizationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceImmunizationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
imm-1errorImmunization.educationOne of documentType or reference SHALL be present
: documentType.exists() or reference.exists()
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have a translation to the NDC value set
: vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreImmunizationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... status 1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Fixed Value: not-done
... statusReason 1..1CodeableConcept(QI-Core)(USCDI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG

Constraints

IdGradePath(s)DetailsRequirements
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC1..1CodeableConcept(USCDI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... patient SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who was immunized
... occurrence[x] SΣ1..1(USCDI) Vaccine administration date
.... occurrenceDateTimedateTime
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record
... primarySource SΣ0..1boolean(USCDI) Indicates context the data was recorded in
... isSubpotent ?!Σ0..1booleanDose potency

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Immunization.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/immunization-status
from the FHIR Standard
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Immunization.vaccineCodeextensibleCVXVaccinesAdministeredVaccineSet
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.6

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorImmunizationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorImmunizationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceImmunizationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have a translation to the NDC value set
: vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
ind-1: To indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!SΣ1..1code(QI-Core)(USCDI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... statusReason S1..1CodeableConcept(QI-Core)(USCDI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode SΣC1..1CodeableConcept(USCDI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet C0..1canonical(ValueSet)(QI-Core) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who was immunized
... encounter 0..1Reference(Encounter)Encounter immunization was part of
... occurrence[x] SΣ1..1(USCDI) Vaccine administration date
.... occurrenceDateTimedateTime S
.... occurrenceStringstring
... recorded 1..1dateTime(QI-Core) When the immunization was first captured in the subject's record
... primarySource SΣ0..1boolean(USCDI) Indicates context the data was recorded in
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.

... location 0..1Reference(Location)Where immunization occurred
... manufacturer 0..1Reference(Organization)Vaccine manufacturer
... lotNumber 0..1stringVaccine lot number
... expirationDate 0..1dateVaccine expiration date
... site 0..1CodeableConceptBody site vaccine was administered
Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.

... route 0..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... doseQuantity 0..1SimpleQuantityAmount of vaccine administered
... performer Σ0..*BackboneElementWho performed event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function Σ0..1CodeableConceptWhat type of performance was done
Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.

.... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization)Individual or organization who was performing
... note Σ0..*AnnotationAdditional immunization notes
... reasonCode 0..*CodeableConceptWhy immunization occurred
Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.


... reasonReference 0..*Reference(Condition | Observation | DiagnosticReport)Why immunization occurred
... isSubpotent ?!Σ0..1booleanDose potency
... subpotentReason 0..*CodeableConceptReason for being subpotent
Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.


... education C0..*BackboneElementEducational material presented to patient
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... documentType 0..1stringEducational material document identifier
.... reference 0..1uriEducational material reference pointer
.... publicationDate 0..1dateTimeEducational material publication date
.... presentationDate 0..1dateTimeEducational material presentation date
... programEligibility 0..*CodeableConceptPatient eligibility for a vaccination program
Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.


... fundingSource 0..1CodeableConceptFunding source for the vaccine
Binding: ImmunizationFundingSource (example): The source of funding used to purchase the vaccine administered.

... reaction 0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation)Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction
... protocolApplied 0..*BackboneElementProtocol followed by the provider
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... series 0..1stringName of vaccine series
.... authority 0..1Reference(Organization)Who is responsible for publishing the recommendations
.... targetDisease 0..*CodeableConceptVaccine preventatable disease being targetted
Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.


.... doseNumber[x] 1..1Dose number within series
..... doseNumberPositiveIntpositiveInt
..... doseNumberStringstring
.... seriesDoses[x] 0..1Recommended number of doses for immunity
..... seriesDosesPositiveIntpositiveInt
..... seriesDosesStringstring

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Immunization.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Immunization.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/immunization-status
from the FHIR Standard
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
from this IG
Immunization.vaccineCodeextensibleCVXVaccinesAdministeredVaccineSet
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.6
Immunization.reportOriginexampleImmunizationOriginCodes
http://hl7.org/fhir/ValueSet/immunization-origin
from the FHIR Standard
Immunization.siteexampleCodesForImmunizationSiteOfAdministration
http://hl7.org/fhir/ValueSet/immunization-site
from the FHIR Standard
Immunization.routeexampleImmunizationRouteCodes
http://hl7.org/fhir/ValueSet/immunization-route
from the FHIR Standard
Immunization.performer.functionextensibleImmunizationFunctionCodes
http://hl7.org/fhir/ValueSet/immunization-function
from the FHIR Standard
Immunization.reasonCodeexampleImmunizationReasonCodes
http://hl7.org/fhir/ValueSet/immunization-reason
from the FHIR Standard
Immunization.subpotentReasonexampleImmunizationSubpotentReason
http://hl7.org/fhir/ValueSet/immunization-subpotent-reason
from the FHIR Standard
Immunization.programEligibilityexampleImmunizationProgramEligibility
http://hl7.org/fhir/ValueSet/immunization-program-eligibility
from the FHIR Standard
Immunization.fundingSourceexampleImmunizationFundingSource
http://hl7.org/fhir/ValueSet/immunization-funding-source
from the FHIR Standard
Immunization.protocolApplied.targetDiseaseexampleImmunizationTargetDiseaseCodes
http://hl7.org/fhir/ValueSet/immunization-target-disease
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorImmunizationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorImmunizationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorImmunizationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceImmunizationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
imm-1errorImmunization.educationOne of documentType or reference SHALL be present
: documentType.exists() or reference.exists()
ind-1errorImmunizationTo indicate what immunization was not done, either at least one coding in the vaccineCode element or a notDoneValueSet extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have a translation to the NDC value set
: vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').empty()

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron