QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot 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 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 Immunization Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationnotdone Version: 8.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: QICoreImmunizationNotDone

Negation profile of Communication for decision support/quality metrics. Indicates that the communication was not performed for a reason.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:
  • statusReason: (QI) Reason not done
  • occurrence[x]: (QI) Vaccine administration date
  • patient: (QI) Who was immunized
  • status: (QI) not-done
  • vaccineCode: (QI) Vaccine Product Type (bind to CVX)
QI Elements:
  • recorded: (QI) Documented date Immunization did not occur.
  • vaccineCode.extension(codeOptions): (QI) Url of a value set of candidate vaccines
Primary code path: vaccineCode
(PCPath) This element is the primary code path for this resource CQL Retrieve

Usage

The Immunization profile defines the conformance expectations for an Immunization event, regardless of whether it is a positive or negative statement. The ImmunizationDone and ImmunizationNotDone profiles represent the positive and negative statements for an immunization event.

The following example illustrates retrieving instances that meet measure intent for exclusion:

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.

See the patterns page for implementation and usage patterns.

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 `codeOptions` 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.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization C 0..* QICoreImmunization Immunization event information
Constraints: us-core-5, qim-1
... 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) not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC 1..1 CodeableConcept (QI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate vaccines
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(QICore Encounter) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 (QI) Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 0..1 dateTime (QI) Documented date Immunization did not occur.
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... location S 0..1 Reference(QICore Location) Where the vaccine was administered
... lotNumber S 0..1 string Vaccine lot number
... performer SΣ 0..* BackboneElement Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor SΣ 1..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile) Individual or organization who was performing
... 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()
qim-1errorImmunizationTo indicate what vaccine, either at least one coding in the vaccineCode element or a codeOptions extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have an additional coding 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 QICoreImmunization

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization 0..* QICoreImmunization Immunization event information
... status 1..1 code (QI) 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
... encounter 0..1 Reference(QICore Encounter) Encounter the immunization was part of
... location 0..1 Reference(QICore Location) Where the vaccine was administered

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Immunization.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization C 0..* QICoreImmunization Immunization event information
Constraints: us-core-5, qim-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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) 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 (QI) 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
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate vaccines
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... 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(QICore Encounter) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 (QI) Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 0..1 dateTime (QI) Documented date Immunization did not occur.
... 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(QICore Location) Where the vaccine was administered
... manufacturer 0..1 Reference(Organization) Vaccine manufacturer
... lotNumber S 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 SΣ 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 SΣ 1..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile) 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
Constraints: imm-1
.... 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
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
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()
qim-1errorImmunizationTo indicate what vaccine, either at least one coding in the vaccineCode element or a codeOptions extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have an additional coding 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 QICoreImmunization

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization C 0..* QICoreImmunization Immunization event information
Constraints: us-core-5, qim-1
... 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) not-done
Binding: ImmunizationStatusCodes (required)
Fixed Value: not-done
... vaccineCode SΣC 1..1 CodeableConcept (QI) Vaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set . (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate vaccines
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who was immunized
... encounter S 0..1 Reference(QICore Encounter) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 (QI) Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 0..1 dateTime (QI) Documented date Immunization did not occur.
... primarySource SΣ 0..1 boolean Indicates context the data was recorded in
... location S 0..1 Reference(QICore Location) Where the vaccine was administered
... lotNumber S 0..1 string Vaccine lot number
... performer SΣ 0..* BackboneElement Who performed event
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor SΣ 1..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile) Individual or organization who was performing
... 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()
qim-1errorImmunizationTo indicate what vaccine, either at least one coding in the vaccineCode element or a codeOptions extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have an additional coding 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()

Differential View

This structure is derived from QICoreImmunization

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization 0..* QICoreImmunization Immunization event information
... status 1..1 code (QI) 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
... encounter 0..1 Reference(QICore Encounter) Encounter the immunization was part of
... location 0..1 Reference(QICore Location) Where the vaccine was administered

doco Documentation for this format

Terminology Bindings (Differential)

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

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Immunization C 0..* QICoreImmunization Immunization event information
Constraints: us-core-5, qim-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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) 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 (QI) 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
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate vaccines
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... 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(QICore Encounter) Encounter the immunization was part of
... occurrence[x] SΣ 1..1 (QI) Vaccine administration date
.... occurrenceDateTime dateTime S
.... occurrenceString string
... recorded 0..1 dateTime (QI) Documented date Immunization did not occur.
... 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(QICore Location) Where the vaccine was administered
... manufacturer 0..1 Reference(Organization) Vaccine manufacturer
... lotNumber S 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 SΣ 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 SΣ 1..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile) 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
Constraints: imm-1
.... 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
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
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()
qim-1errorImmunizationTo indicate what vaccine, either at least one coding in the vaccineCode element or a codeOptions extension shall be provided
: vaccineCode.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor vaccineCode.coding.exists()
us-core-5best practiceImmunizationSHOULD have an additional coding 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 QICoreImmunization

 

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