QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

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 8.0.0-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 ImmunizationEvaluation - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 4

Definitions for the qicore-immunizationevaluation resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

Guidance on how to interpret the contents of this table can be foundhere

0. ImmunizationEvaluation
Definition | Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.
Short | Immunization evaluation information
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If 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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImmunizationEvaluation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImmunizationEvaluation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. ImmunizationEvaluation.identifier
Definition | A unique identifier assigned to this immunization evaluation record.
Short | (QI) Business identifierBusiness identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ImmunizationEvaluation.status
Definition | Indicates the current status of the evaluation of the vaccination administration event.
Short | (QI) completed | entered-in-errorcompleted | entered-in-error
Control | 1..1
Binding | The codes SHALL be taken from ImmunizationEvaluationStatusCodes http://hl7.org/fhir/ValueSet/immunization-evaluation-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/immunization-evaluation-status|4.0.1` ) The status of the evaluation being done.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid).
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImmunizationEvaluation.patient
Definition | The individual for whom the evaluation is being done.
Short | (QI) Who this evaluation is forWho this evaluation is for
Control | 1..1
Type | Reference(QICore Patient, Patient)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImmunizationEvaluation.date
Definition | The date the evaluation of the vaccine administration event was performed.
Short | (QI) Date evaluation was performedDate evaluation was performed
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ImmunizationEvaluation.authority
Definition | Indicates the authority who published the protocol (e.g. ACIP).
Short | Who is responsible for publishing the recommendations
Control | 0..1
Type | Reference(QICore Organization, Organization)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ImmunizationEvaluation.targetDisease
Definition | The vaccine preventable disease the dose is being evaluated against.
Short | (QI) Evaluation target diseaseEvaluation target disease
Control | 1..1
Binding | The codes SHOULD be taken from For example codes, see ImmunizationEvaluationTargetDiseaseCodes http://hl7.org/fhir/ValueSet/immunization-evaluation-target-disease|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-target-disease` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ImmunizationEvaluation.immunizationEvent
Definition | The vaccine administration event being evaluated.
Short | (QI) Immunization being evaluatedImmunization being evaluated
Control | 1..1
Type | Reference(QICore Immunization, Immunization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ImmunizationEvaluation.doseStatus
Definition | Indicates if the dose is valid or not valid with respect to the published recommendations.
Short | (QI) Status of the dose relative to published recommendationsStatus of the dose relative to published recommendations
Control | 1..1
Binding | The codes SHOULD be taken from For example codes, see ImmunizationEvaluationDoseStatusCodes http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ImmunizationEvaluation.doseStatusReason
Definition | Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.
Short | (QI) Reason for the dose statusReason for the dose status
Control | 0..*
Binding | The codes SHOULD be taken from For example codes, see ImmunizationEvaluationDoseStatusCodes http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status-reason|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. ImmunizationEvaluation
Must Support | false
2. ImmunizationEvaluation.identifier
Short | (QI) Business identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Type | Identifier
4. ImmunizationEvaluation.status
Short | (QI) completed | entered-in-error
6. ImmunizationEvaluation.patient
Short | (QI) Who this evaluation is for
Type | Reference(QICore Patient)
8. ImmunizationEvaluation.date
Short | (QI) Date evaluation was performed
Control | 1..1
10. ImmunizationEvaluation.authority
Type | Reference(QICore Organization)
Must Support | false
12. ImmunizationEvaluation.targetDisease
Short | (QI) Evaluation target disease
Control | 1..1
Binding | The codes SHOULD be taken from ImmunizationEvaluationTargetDiseaseCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-target-disease` )
14. ImmunizationEvaluation.immunizationEvent
Short | (QI) Immunization being evaluated
Control | 1..1
Type | Reference(QICore Immunization)
16. ImmunizationEvaluation.doseStatus
Short | (QI) Status of the dose relative to published recommendations
Control | 1..1
Binding | The codes SHOULD be taken from ImmunizationEvaluationDoseStatusCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )
18. ImmunizationEvaluation.doseStatusReason
Short | (QI) Reason for the dose status
Binding | The codes SHOULD be taken from ImmunizationEvaluationDoseStatusCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )

Guidance on how to interpret the contents of this table can be foundhere

0. ImmunizationEvaluation
Definition | Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.
Short | Immunization evaluation information
Control | 0..*
Is Modifier | false
Must Support | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If 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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. ImmunizationEvaluation.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. ImmunizationEvaluation.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. ImmunizationEvaluation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. ImmunizationEvaluation.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. ImmunizationEvaluation.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. ImmunizationEvaluation.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. ImmunizationEvaluation.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. ImmunizationEvaluation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. ImmunizationEvaluation.identifier
Definition | A unique identifier assigned to this immunization evaluation record.
Short | (QI) Business identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. ImmunizationEvaluation.status
Definition | Indicates the current status of the evaluation of the vaccination administration event.
Short | (QI) completed | entered-in-error
Control | 1..1
Binding | The codes SHALL be taken from ImmunizationEvaluationStatusCodes (required to `http://hl7.org/fhir/ValueSet/immunization-evaluation-status|4.0.1` ) The status of the evaluation being done.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid).
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. ImmunizationEvaluation.patient
Definition | The individual for whom the evaluation is being done.
Short | (QI) Who this evaluation is for
Control | 1..1
Type | Reference(QICore Patient)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. ImmunizationEvaluation.date
Definition | The date the evaluation of the vaccine administration event was performed.
Short | (QI) Date evaluation was performed
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. ImmunizationEvaluation.authority
Definition | Indicates the authority who published the protocol (e.g. ACIP).
Short | Who is responsible for publishing the recommendations
Control | 0..1
Type | Reference(QICore Organization)
Is Modifier | false
Must Support | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. ImmunizationEvaluation.targetDisease
Definition | The vaccine preventable disease the dose is being evaluated against.
Short | (QI) Evaluation target disease
Control | 1..1
Binding | The codes SHOULD be taken from ImmunizationEvaluationTargetDiseaseCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-target-disease` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. ImmunizationEvaluation.immunizationEvent
Definition | The vaccine administration event being evaluated.
Short | (QI) Immunization being evaluated
Control | 1..1
Type | Reference(QICore Immunization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. ImmunizationEvaluation.doseStatus
Definition | Indicates if the dose is valid or not valid with respect to the published recommendations.
Short | (QI) Status of the dose relative to published recommendations
Control | 1..1
Binding | The codes SHOULD be taken from ImmunizationEvaluationDoseStatusCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. ImmunizationEvaluation.doseStatusReason
Definition | Provides an explanation as to why the vaccine administration event is valid or not relative to the published recommendations.
Short | (QI) Reason for the dose status
Control | 0..*
Binding | The codes SHOULD be taken from ImmunizationEvaluationDoseStatusCodes (preferred to `http://hl7.org/fhir/ValueSet/immunization-evaluation-dose-status` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. ImmunizationEvaluation.description
Definition | Additional information about the evaluation.
Short | Evaluation notes
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. ImmunizationEvaluation.series
Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority.
Short | Name of vaccine series
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. ImmunizationEvaluation.doseNumber[x]
Definition | Nominal position in a series.
Short | Dose number within series
Comments | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
Control | 0..1
Type | Choice of: positiveInt, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. ImmunizationEvaluation.seriesDoses[x]
Definition | The recommended number of doses to achieve immunity.
Short | Recommended number of doses for immunity
Comments | The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
Control | 0..1
Type | Choice of: positiveInt, string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)