Generated Narrative: StructureDefinition Immunization-twcore Name Flags Card. Type Description & Constraints Immunization C 0..* Immunization 疫苗接種 Constraints: tw-core-10 #xD; implicitRules 0..1 uri 創建此內容所依據的一組規則 #xD; modifierExtension 0..* Extension 擴充內容可能會改變資源解釋方式 #xD; status S 1..1 code completed | entered-in-error | not-done #xD; statusReason S 0..1 CodeableConcept 接種未完成的原因 #xD; vaccineCode SC 1..1 CodeableConcept 疫苗產品類型 (綁定到 CVX 疫苗代碼系統) Binding: VaccineAdministeredValueSet (extensible) #xD; patient S 1..1 Reference(TW Core Patient) 接種疫苗的病患 #xD; encounter S 0..1 Reference(TW Core Encounter) 與疫苗接種相關的就醫事件 #xD; occurrence[x] S 1..1 疫苗接種的發生日期/時間 #xD; occurrenceDateTime dateTime S #xD; occurrenceString string #xD; primarySource S 0..1 boolean 資料來源是否為主要來源 #xD; location S 0..1 Reference(TW Core Location) 疫苗接種的地點 #xD; manufacturer 0..1 Reference(TW Core Organization) 疫苗製造商 #xD; performer #xD; actor 1..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Organization) 執行疫苗接種的人員或組織 #xD; reasonReference 0..* Reference(TW Core Condition | TW Core Observation Clinical Result | TW Core DiagnosticReport) 接種疫苗的原因 #xD; isSubpotent S 0..1 boolean 疫苗效價是否低於標準 #xD; reaction #xD; detail 0..1 Reference(TW Core Observation Clinical Result) 接種後反應的細節 #xD; protocolApplied #xD; authority 0..1 Reference(TW Core Organization) 疫苗接種計劃的權責組織 #xD; Documentation for this format
此臺灣核心-疫苗接種 (TW Core Immunization) Profile 說明本 IG 如何進一步定義 FHIR 的 Immunization Resource 以呈現疫苗接種資料。
疫苗接種的記錄，包含接種的疫苗及事件的相關資訊。
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
SHOULD 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()
(exists(f:vaccineCode/f:coding/f:system[@value='http://hl7.org/fhir/sid/ndc']) and exists(f:vaccineCode/f:coding/f:system[@value='http://hl7.org/fhir/sid/cvx'])) or exists(f:vaccineCode/f:coding/f:system[@value='http://hl7.org/fhir/sid/cvx'])not()
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
構建 resource 時遵循的一系列規則的參照，在處理內容時必須理解這些規則。通常這是對 IG 所定義之特殊規則及其他 profiles 的參照。
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.
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
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
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.
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.
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.
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
擴充內容可能會改變資源解釋方式
可以修改標準資源解釋的擴充內容。擴展內容通常會增加其他屬性，但不會更改基本解釋。在理解修改擴展內容之前不應該解釋此疫苗接種資源。
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
A unique identifier assigned to this immunization record.
疫苗接種事件的狀態，表示是否完成接種、記錄有誤或未接種。
Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
A set of codes indicating the current status of an Immunization.
表示為什麼疫苗接種未完成的原因，例如：禁忌症、病患拒絕等。
This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.
The reason why a vaccine was not administered.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
疫苗產品類型 (綁定到 CVX 疫苗代碼系統)
表示疫苗接種發生時的就醫事件參照。
疫苗接種發生的日期與時間，或以字串描述的大概時間。
When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
When the immunization was first captured in the subject's record
The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
指示記錄的資訊是否來自主要來源 (如接種疫苗的人員)，或是從次要來源 (如病患本人回報) 取得。
Reflects the “reliability” of the content.
immunization.uncertaintycode (if primary source=false, uncertainty=U)
Indicates the source of a secondarily reported record
The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Should not be populated if primarySource = True, not required even if primarySource = False.
The source of the data for a record which is not from a primary source.
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
進行疫苗接種的實際地點，如醫療院所、診所等。
RXA-27 (or RXA-11, deprecated as of v2.7)
Body site where vaccine was administered.
The site at which the vaccine was administered.
The path by which the vaccine product is taken into the body.
The route by which the vaccine was administered.
The quantity of vaccine product that was administered.
Indicates who performed the immunization event.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition of the element. 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.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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).
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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Describes the type of performance (e.g. ordering provider, administering provider, etc.).
The role a practitioner or organization plays in the immunization event.
參與疫苗接種的醫療人員、醫療人員角色或組織的參照。
When the individual practitioner who performed the action is known, it is best to send.
Extra information about the immunization that is not conveyed by the other attributes.
Reasons why the vaccine was administered.
The reason why a vaccine was administered.
進行此次疫苗接種的醫療原因參照，例如：特定疾病、臨床觀察或診斷報告。
表明接種的疫苗劑量是否已知低於建議量的標示，例如：部分劑量因患者移動而造成施打不完整、或完整劑量分成多次施打。
Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.
By default, a dose should be considered to be potent.
This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
Reason why a dose is considered to be subpotent.
The reason why a dose is considered to be subpotent.
Educational material presented to patient
Educational material presented to the patient (or guardian) at the time of vaccine administration.
One of documentType or reference SHALL be present
documentType.exists() or reference.exists()
exists(f:documentType) or exists(f:reference)
Educational material document identifier
Identifier of the material presented to the patient.
Reference pointer to the educational material given to the patient if the information was on line.
Date the educational material was published.
Date the educational material was given to the patient.
Patient eligibility for a vaccination program
Indicates a patient's eligibility for a funding program.
The patient's eligibility for a vaccation program.
Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).
The source of funding used to purchase the vaccine administered.
Details of a reaction that follows immunization
Categorical data indicating that an adverse event is associated in time to an immunization.
A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.
OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
疫苗接種後發生的不良反應參照，例如：過敏反應、發燒等臨床結果觀察。
(HL7 v2 doesn't seem to provide for this)
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
The protocol (set of recommendations) being followed by the provider who administered the dose.
One possible path to achieve presumed immunity against a disease - within the context of an authority.
提供或授權此疫苗接種計劃的組織參照。
Vaccine preventatable disease being targetted
The vaccine preventable disease the dose is being administered against.
The vaccine preventable disease the dose is being administered for.
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).
Recommended number of doses for immunity
The recommended number of doses to achieve immunity.