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Immunization-example.xml

Public Health and Emergency Response Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw XML (canonical form + also see XML Format Specification)

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Example of Immunization (id = "example")

<?xml version="1.0" encoding="UTF-8"?>

<Immunization xmlns="http://hl7.org/fhir">
  <id value="example"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative</b> </p> <p> <b> id</b> : example</p> <p> <b> identifier</b> : urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p> <p> <b> status</b> : completed</p> <p> <b> vaccineCode</b> : <span> Fluvax (Influenza)</span> </p> <p> <b> patient</b> : <a> Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James
           Chalmers (OFFICIAL), Jim , Peter James Windsor (MAIDEN); -unknown-(HOME), ph: (03) 5555
           6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate:
           1974-12-25; </a> </p> <p> <b> encounter</b> : <a> Generated Summary: id: example; status: in-progress; <span> inpatient encounter</span> </a> </p> <p> <b> occurrence</b> : 2013-01-10</p> <p> <b> primarySource</b> : true</p> <p> <b> location</b> : <a> Generated Summary: id: 1; B1-S.F2; status: active; name: South Wing, second floor; alias:
           BU MC, SW, F2, alias: Burgers University Medical Center, South Wing, second floor; description:
           Second floor of the Old South Wing, formerly in use by Psychiatry; mode: instance; ph:
           2328(WORK), fax: 2329(WORK), second wing admissions, http://sampleorg.com/southwing(WORK);
           <span> Wing</span> </a> </p> <p> <b> manufacturer</b> : <a> Generated Summary: id: hl7; name: Health Level Seven International; alias: HL7 International;
           ph: (+1) 734-677-7777, fax: (+1) 734-677-6622, hq@HL7.org</a> </p> <p> <b> lotNumber</b> : AAJN11K</p> <p> <b> expirationDate</b> : 2015-02-15</p> <p> <b> site</b> : <span> left arm</span> </p> <p> <b> route</b> : <span> Injection, intramuscular</span> </p> <p> <b> doseQuantity</b> : 5 mg</p> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : <span> Ordering Provider</span> </p> <p> <b> actor</b> : <a> Generated Summary: id: example; 23; active; Adam Careful </a> </p> </blockquote> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : <span> Administering Provider</span> </p> <p> <b> actor</b> : <a> Generated Summary: id: example; 23; active; Adam Careful </a> </p> </blockquote> <p> <b> note</b> : Annotation: Notes on adminstration of vaccine</p> <p> <b> reason</b> : </p> <p> <b> isSubpotent</b> : true</p> <h3> Educations</h3> <table> <tr> <td> -</td> <td> <b> DocumentType</b> </td> <td> <b> PublicationDate</b> </td> <td> <b> PresentationDate</b> </td> </tr> <tr> <td> *</td> <td> 253088698300010311120702</td> <td> 2012-07-02</td> <td> 2013-01-10</td> </tr> </table> <p> <b> programEligibility</b> : <span> Not Eligible</span> </p> <p> <b> fundingSource</b> : <span> Private</span> </p> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/> 
  </identifier> 
  <status value="completed"/> 
  <vaccineCode> 
    <coding> 
      <system value="urn:oid:1.2.36.1.2001.1005.17"/> 
      <code value="FLUVAX"/> 
    </coding> 
    <text value="Fluvax (Influenza)"/> 
  </vaccineCode> 
  <patient> 
    <reference value="Patient/example"/> 
  </patient> 
  <encounter> 
    <reference value="Encounter/example"/> 
  </encounter> 
  <occurrenceDateTime value="2013-01-10"/> 
  <primarySource value="true"/> 
  <location> 
    <reference value="Location/1"/> 
  </location> 
  <manufacturer> 
    <reference value="Organization/hl7"/> 
  </manufacturer> 
  <lotNumber value="AAJN11K"/> 
  <expirationDate value="2015-02-15"/> 
  <site> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/> 
      <code value="LA"/> 
      <display value="left arm"/> 
    </coding> 
  </site> 
  <route> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/> 
      <code value="IM"/> 
      <display value="Injection, intramuscular"/> 
    </coding> 
  </route> 
  <doseQuantity> 
    <value value="5"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="mg"/> 
  </doseQuantity> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="OP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="AP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <note> 
    <text value="Notes on adminstration of vaccine"/> 
  </note> 
  <reason> 
    <concept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="429060002"/> 
      </coding> 
    </concept> 
  </reason> 
  <isSubpotent value="true"/> 
  <education> 
    <documentType value="253088698300010311120702"/> 
    <publicationDate value="2012-07-02"/> 
    <presentationDate value="2013-01-10"/> 
  </education> 
  <programEligibility> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/> 
      <code value="ineligible"/> 
    </coding> 
  </programEligibility> 
  <fundingSource> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/> 
      <code value="private"/> 
    </coding> 
  </fundingSource> 
</Immunization> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.