QI-Core Implementation Guide
7.0.0-ballot - STU7 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 7.0.0-ballot 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: 7.0.0-ballot
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.

Must Have:
  • status: (QI) completed | entered-in-error | not-done
  • statusReason: (QI) Reason not done
  • vaccineCode: Vaccine Product Type (bind to CVX)
  • patient: (QI) Who was immunized
  • occurrence[x]: Vaccine administration date
QI Elements:
  • notDoneValueSet: (QI) What wasn't administered
  • recorded: (QI) When the immunization was first captured in the subject's record
Primary code path: vaccineCode
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

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 C 0..* USCoreImmunizationProfile Immunization 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..1 code (QI) completed | entered-in-error | not-done
Fixed Value: not-done
... statusReason 1..1 CodeableConcept (QI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... recorded 1..1 dateTime (QI) 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 C 0..* USCoreImmunizationProfile Immunization event information
us-core-5: SHOULD have a translation to the NDC value set
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 ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC 1..1 CodeableConcept Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(US Core Encounter Profile) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime
... recorded 1..1 dateTime (QI) When the immunization was first captured in the subject's record
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... location S 0..1 Reference(US Core Location Profile) Where the vaccine was administered
... isSubpotent ?!Σ 0..1 boolean Dose 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/cvx').exists() implies vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C 0..* USCoreImmunizationProfile Immunization event information
us-core-5: SHOULD have a translation to the NDC value set
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 Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business identifier
... status ?!SΣ 1..1 code (QI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... statusReason S 1..1 CodeableConcept (QI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode SΣC 1..1 CodeableConcept Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(US Core Encounter Profile) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 1..1 dateTime (QI) When the immunization was first captured in the subject's record
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... reportOrigin 0..1 CodeableConcept Indicates 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 S 0..1 Reference(US Core Location Profile) Where the vaccine was administered
... manufacturer 0..1 Reference(Organization) Vaccine manufacturer
... lotNumber 0..1 string Vaccine lot number
... expirationDate 0..1 date Vaccine expiration date
... site 0..1 CodeableConcept Body site vaccine was administered
Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.

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

... doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
... performer Σ 0..* BackboneElement Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function Σ 0..1 CodeableConcept What type of performance was done
Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.

.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization) Individual or organization who was performing
... note Σ 0..* Annotation Additional immunization notes
... reasonCode 0..* CodeableConcept Why immunization occurred
Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.


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


... education C 0..* BackboneElement Educational material presented to patient
imm-1: One of documentType or reference SHALL be present
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... documentType 0..1 string Educational material document identifier
.... reference 0..1 uri Educational material reference pointer
.... publicationDate 0..1 dateTime Educational material publication date
.... presentationDate 0..1 dateTime Educational material presentation date
... programEligibility 0..* CodeableConcept Patient eligibility for a vaccination program
Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.


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

... reaction 0..* BackboneElement Details of a reaction that follows immunization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 0..1 dateTime When reaction started
.... detail 0..1 Reference(Observation) Additional information on reaction
.... reported 0..1 boolean Indicates self-reported reaction
... protocolApplied 0..* BackboneElement Protocol followed by the provider
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... series 0..1 string Name of vaccine series
.... authority 0..1 Reference(Organization) Who is responsible for publishing the recommendations
.... targetDisease 0..* CodeableConcept Vaccine preventatable disease being targetted
Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.


.... doseNumber[x] 1..1 Dose number within series
..... doseNumberPositiveInt positiveInt
..... doseNumberString string
.... seriesDoses[x] 0..1 Recommended number of doses for immunity
..... seriesDosesPositiveInt positiveInt
..... seriesDosesString string

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/cvx').exists() implies vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').exists()

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements
Fixed: 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 C 0..* USCoreImmunizationProfile Immunization 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..1 code (QI) completed | entered-in-error | not-done
Fixed Value: not-done
... statusReason 1..1 CodeableConcept (QI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... recorded 1..1 dateTime (QI) 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 C 0..* USCoreImmunizationProfile Immunization event information
us-core-5: SHOULD have a translation to the NDC value set
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 ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!SΣ 1..1 code (QI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC 1..1 CodeableConcept Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... Slices for extension Content/Rules for all slices
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(US Core Encounter Profile) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime
... recorded 1..1 dateTime (QI) When the immunization was first captured in the subject's record
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... location S 0..1 Reference(US Core Location Profile) Where the vaccine was administered
... isSubpotent ?!Σ 0..1 boolean Dose 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/cvx').exists() implies vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C 0..* USCoreImmunizationProfile Immunization event information
us-core-5: SHOULD have a translation to the NDC value set
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 Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business identifier
... status ?!SΣ 1..1 code (QI) completed | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... statusReason S 1..1 CodeableConcept (QI) Reason not done
Binding: QICore Negation Reason Codes (extensible): The reason the service was not requested

... vaccineCode SΣC 1..1 CodeableConcept Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... notDoneValueSet C 0..1 canonical(ValueSet) (QI) What wasn't administered
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(US Core Encounter Profile) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 1..1 dateTime (QI) When the immunization was first captured in the subject's record
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... reportOrigin 0..1 CodeableConcept Indicates 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 S 0..1 Reference(US Core Location Profile) Where the vaccine was administered
... manufacturer 0..1 Reference(Organization) Vaccine manufacturer
... lotNumber 0..1 string Vaccine lot number
... expirationDate 0..1 date Vaccine expiration date
... site 0..1 CodeableConcept Body site vaccine was administered
Binding: CodesForImmunizationSiteOfAdministration (example): The site at which the vaccine was administered.

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

... doseQuantity 0..1 SimpleQuantity Amount of vaccine administered
... performer Σ 0..* BackboneElement Who performed event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function Σ 0..1 CodeableConcept What type of performance was done
Binding: ImmunizationFunctionCodes (extensible): The role a practitioner or organization plays in the immunization event.

.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization) Individual or organization who was performing
... note Σ 0..* Annotation Additional immunization notes
... reasonCode 0..* CodeableConcept Why immunization occurred
Binding: ImmunizationReasonCodes (example): The reason why a vaccine was administered.


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


... education C 0..* BackboneElement Educational material presented to patient
imm-1: One of documentType or reference SHALL be present
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... documentType 0..1 string Educational material document identifier
.... reference 0..1 uri Educational material reference pointer
.... publicationDate 0..1 dateTime Educational material publication date
.... presentationDate 0..1 dateTime Educational material presentation date
... programEligibility 0..* CodeableConcept Patient eligibility for a vaccination program
Binding: ImmunizationProgramEligibility (example): The patient's eligibility for a vaccation program.


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

... reaction 0..* BackboneElement Details of a reaction that follows immunization
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 0..1 dateTime When reaction started
.... detail 0..1 Reference(Observation) Additional information on reaction
.... reported 0..1 boolean Indicates self-reported reaction
... protocolApplied 0..* BackboneElement Protocol followed by the provider
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... series 0..1 string Name of vaccine series
.... authority 0..1 Reference(Organization) Who is responsible for publishing the recommendations
.... targetDisease 0..* CodeableConcept Vaccine preventatable disease being targetted
Binding: ImmunizationTargetDiseaseCodes (example): The vaccine preventable disease the dose is being administered for.


.... doseNumber[x] 1..1 Dose number within series
..... doseNumberPositiveInt positiveInt
..... doseNumberString string
.... seriesDoses[x] 0..1 Recommended number of doses for immunity
..... seriesDosesPositiveInt positiveInt
..... seriesDosesString string

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/cvx').exists() implies vaccineCode.coding.where(system='http://hl7.org/fhir/sid/ndc').exists()

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron