Taiwan Digital COVID-19 Certificate Implementation Guide (TWDCC IG), published by Ministry of Health and Welfare. This is not an authorized publication; it is the continuous build for version 1.1.0). This version is based on the current content of https://github.com/hitstdio/dcc-tw-test/ and changes regularly. See the Directory of published versions

IG Home

Official URL: https://dccfhirig.mohw.gov.tw/fhir/ImplementationGuide/dccfhirig.mohw.gov.tw				Version: 1.1.0
Active as of 2022-04-28				Computable Name: TWDCC

• New Logical (Data) Model Mapping
  • Vaccination Status (TWDCC:VS) Data Model: Mapping TWDCC:VS data model to the SHCVaccinationBundleAD Profile of Smart Health Cards (SHC).
• Update Logical (Data) Model Mapping
  • Vaccination Status (TWDCC:VS) Data Model：Strengthen the corresponding Vaccination Status Data Model to the actual field of TWDCC.
  • Test Result (TWDCC:TR) Data Model：Strengthen the corresponding Test Result Data Model to the actual field of TWDCC.
• New Examples
  • BundleSHCVS : Present the content values of TWDCC BundleDCCVS Profile in SHC SHCVaccinationBundleAD Profile format.
• Adding concept mapping
  • TW Covid-19 Vaccine Name ConceptMap : Added concept mapping between “TW COVID-19 Vaccine Names” code system and “SHC COVID-19 vaccine”, mainly referenced from https://github.com/HL7/fhir-shc-vaccination-ig/tree/master/examples/byCodeSystem#vaccine-codes.
• Adding codes for Taiwan’s code system
  • TW COVID-19 Testing Center : Added “Evergreen General Hospital” and “Cambridge Medical Laboratory” as the designated testing center for nucleic acid testing.
• Update PatientDCC
  • PatientDCC：Strengthen the description of PatientDCC.name and change PatientDCC.name.family to 0..1 to meet the requirements of domestic and foreign use.

Introduction

The Taiwan Digital COVID-19 Certificate Implementation Guide (TWDCC IG) details how to use Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) for consistent digital representation of COVID-19 vaccination and test results certificates.

In response to requests from different national units, the design principle of the TWDCC IG is to maximize the coverage of the data elements designed in the relevant digital certificates IGs, as shown below.

• European Union (EU): EU Digital COVID Certification Implementaiton Guide (EUDCC IG) 2021-07-29
• the United States (US): Smart Health Cards (SHC) 0.6.2 - STU 1 (Ballot Version)
• World Health Organization (WHO): Digital Documentation of COVID-19 Certifiates: Vaccination Status (DDCC:VS)(0.2.1- CI Build)

TWDCC IG is derived from EUDCC IG. The EUDCC IG is mainly based on the EU eHealth Network guidelines and is designed on the basis of the International Patient Summary Implementation Guide (IPS IG 1.0.0 - STU 1, FHIR R4.0.1). Its draft is updated to July 2021. To speed up the implementation of DCC in Taiwan, the data elements and Code systems required to standardize are continuously revised based on EUDCC IG.

Implementors can find the changes made to the previous release in a separate page “Publication (Version) History” is in TWDCC IG for reference.

Background

In the first half of 2021, there are still many controversies in promoting digital vaccine certification in various countries. Only a few countries, such as the US industry and the EU, have implemented digital certificates. With the increasing vaccinations and the development and launch of related new drugs, the pressure on the economy to recover, and the need to travel abroad have led to digital certificates being accepted.

During the second half of 2021, the US, the EU and WHO provided tools and specifications for implementing digital certificates. The US and WHO adopt FHIR as the core architecture. And the EU is mainly based on customized JSON, to develop a digital vaccination certificate format to meet the needs of cross-border interoperable data exchange.

In early 2021, the Ministry of Health and Welfare of Taiwan (MOHW) also began planing the adoption of digital COVID-19 certificates. Along with adopting the EU QR Code, the EU DCC IG was the model IG to set up the TWDCC IG. Also, DDCC DocumentReference return for QR of WHO DDCC:VS was used for DocumentReferenceDCC of TWDCC. TWDCC IG was developed under the “COVID-19 Health Information Digital Certificates Issuance Platform Project” (July 2021) by Central Epidemic Command Center (CECC), Taiwan Centerr of Disease Control (CDC), MOHW. Implementors should construct an FHIR server based on the TWDCC IG to store and query the required digital certificates.

How to read this Implementation Guide

The website architecture of TWDCC IG is shown in the figure above. The description for each feature is as follows:

• IG Home: Introduction and Background of TWDCC IG.
• Logical Models: TWDCC IG has two main logical models: “COVID-19 Vaccination Status Data Model (TWDCC:VS)” and “COVID-19 Test Results Data Model (TWDCC:TR)”. Each data model specifies the set of data fields used in the corresponding context. The data fields are named in an easy-to-understand way for the implementation to understand quickly. The implementor then uses the “Mappings” function tab in the logic model to determine what Profiles’ element is used for each data field.
• Artifact
  • FHIR Profiles
    • Definitions and examples of all Profiles which are defined by TWDCC IG.
    • Mandatory restrictions on the use of Terminology for specific elements.
    • Constraints for each data element.
    • Search parameters available for searching specific Profiles in FHIR Server of TWDCC IG implementation, e.g., Patient can only be searchable using parameters “identifier” and “birthDate”.
  • Terminologies: TWDCC IG uses specialized terminology, including Code Systems, Value Sets, and Concept Maps.
  • Search Parameter: What search parameters are available for each profile while implementing the TWDCC IG FHIR server.
  • Capability Statement: TWDCC FHIR Server should have operational features: which Resources/Profiles can be added, deleted, and searched for; which search parameters can be used to find Profiles.
• Examples：The examples that conform to the profiles defined by TWDCC IG.
• Downloads: Implementers who do not prefer to use the Profile APIs defined by TWDCC IG to verify that their instances conforms to the Profiles can directly download the required format validation file, including XML, JSON, and Turtle formats.
• Security：It mainly explains the data access authorization approaches when accessing a TWDCC IG FHIR Server.
• Publication (Version) History：Suppose there is a change in the version of this IG. In that case, you can understand the difference between the versions through the Directory of published versions page.

Authors and Contributors

Roles	Name	Organization	Contact
Author	Li-Hui Lee	Department of Health Care Management, National Taipei University of Nursing and Health Sciences	cclhlee@gmail.com cclhlee@ntunhs.edu.tw
Author	Yu-Jia Tseng	Department of Health Care Management, National Taipei University of Nursing and Health Sciences	yujia151645@gmail.com 102116007@ntunhs.edu.tw