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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="profile-DwImmunization" />
  <url value="https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwImmunization" />
  <name value="DwImmunization" />
  <status value="draft" />
  <date value="2024-05-03T22:11:40.4165223+00:00" />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="Immunization" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Immunization" />
  <derivation value="constraint" />
  <differential>
    <element id="Immunization.id">
      <path value="Immunization.id" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.meta">
      <path value="Immunization.meta" />
    </element>
    <element id="Immunization.meta.lastUpdated">
      <path value="Immunization.meta.lastUpdated" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.status">
      <path value="Immunization.status" />
      <comment value="PS: &quot;Refused treatment&quot; = not-done&#xD;&#xA;&#xD;&#xA;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." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.statusReason">
      <path value="Immunization.statusReason" />
      <comment value="PSS does not handle all reasons, but does handle patient refusal MA has a cancel reason that would need to be mapped into a code.&#xD;&#xA; &quot; Patient Declined&quot; and &quot;Refused treatment&quot; will map to &quot;PATOBJ&quot; &#xD;&#xA;&#xD;&#xA;This is generally only used for the status of &quot;not-done&quot;. The reason for performing the immunization event is captured in reasonCode, not here." />
      <mustSupport value="true" />
      <binding>
        <strength value="example" />
        <valueSet value="https://hl7.fhir.r4.core/4.0.1/files/package/valueset-immunization-status-reason" />
      </binding>
    </element>
    <element id="Immunization.statusReason.coding.code">
      <path value="Immunization.statusReason.coding.code" />
      <comment value="PS - Code will be PATOBJ when immunization is refused&#xD;&#xA;&#xD;&#xA;Note that FHIR strings SHALL NOT exceed 1MB in size" />
    </element>
    <element id="Immunization.statusReason.coding.display">
      <path value="Immunization.statusReason.coding.display" />
      <comment value="PS - display patient objection when flagged as refused&#xD;&#xA;MA - &#xD;&#xA;Note that FHIR strings SHALL NOT exceed 1MB in size" />
    </element>
    <element id="Immunization.statusReason.text">
      <path value="Immunization.statusReason.text" />
      <comment value="PS - Refused Treatment &#xD;&#xA;&#xD;&#xA;Very often the text is the same as a displayName of one of the codings." />
    </element>
    <element id="Immunization.vaccineCode">
      <path value="Immunization.vaccineCode" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding">
      <path value="Immunization.vaccineCode.coding" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Immunization.vaccineCode.coding:vaccineIPScoding">
      <path value="Immunization.vaccineCode.coding" />
      <sliceName value="vaccineIPScoding" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips" />
      </binding>
    </element>
    <element id="Immunization.vaccineCode.coding:vaccineIPScoding.system">
      <path value="Immunization.vaccineCode.coding.system" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:vaccineIPScoding.code">
      <path value="Immunization.vaccineCode.coding.code" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:vaccineIPScoding.display">
      <path value="Immunization.vaccineCode.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCTradename">
      <path value="Immunization.vaccineCode.coding" />
      <sliceName value="CVCTradename" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename" />
      </binding>
    </element>
    <element id="Immunization.vaccineCode.coding:CVCTradename.system">
      <path value="Immunization.vaccineCode.coding.system" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCTradename.code">
      <path value="Immunization.vaccineCode.coding.code" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCTradename.display">
      <path value="Immunization.vaccineCode.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCGeneric">
      <path value="Immunization.vaccineCode.coding" />
      <sliceName value="CVCGeneric" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic" />
      </binding>
    </element>
    <element id="Immunization.vaccineCode.coding:CVCGeneric.system">
      <path value="Immunization.vaccineCode.coding.system" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCGeneric.version">
      <path value="Immunization.vaccineCode.coding.version" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCGeneric.code">
      <path value="Immunization.vaccineCode.coding.code" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:CVCGeneric.display">
      <path value="Immunization.vaccineCode.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization">
      <path value="Immunization.vaccineCode.coding" />
      <sliceName value="absentOrUnknownImmunization" />
      <comment value="Usage Note:  Where there are no immunizations recorded for the patient the &quot;no known immunization&quot; code will be provided.&#xD;&#xA;&#xD;&#xA;Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSet value="http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips" />
      </binding>
    </element>
    <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization.system">
      <path value="Immunization.vaccineCode.coding.system" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization.version">
      <path value="Immunization.vaccineCode.coding.version" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization.code">
      <path value="Immunization.vaccineCode.coding.code" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.coding:absentOrUnknownImmunization.display">
      <path value="Immunization.vaccineCode.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.vaccineCode.text">
      <path value="Immunization.vaccineCode.text" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.patient">
      <path value="Immunization.patient" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.occurrence[x]">
      <path value="Immunization.occurrence[x]" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.occurrence[x].extension:data-absent-reason">
      <path value="Immunization.occurrence[x].extension" />
      <sliceName value="data-absent-reason" />
      <type>
        <code value="Extension" />
        <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" />
      </type>
      <isModifier value="false" />
    </element>
    <element id="Immunization.recorded">
      <path value="Immunization.recorded" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.primarySource">
      <path value="Immunization.primarySource" />
      <comment value="PS:  Started/Performed by external provider = false otherwise it will be true&#xD;&#xA;MA: N/A no way to reliably tell who performed the immunization&#xD;&#xA;Reflects the “reliability” of the content." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.reportOrigin">
      <path value="Immunization.reportOrigin" />
      <comment value="PS:  Provider Name where populated &#xD;&#xA;Should not be populated if primarySource = True, not required even if primarySource = False." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.manufacturer">
      <path value="Immunization.manufacturer" />
      <comment value="PSS - captured as a text field (OMD requirement) - may be populated in display&#xD;&#xA;MA - captured as a text field (OMD requirement) - may be populated in display&#xD;&#xA;&#xD;&#xA;References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
    </element>
    <element id="Immunization.lotNumber">
      <path value="Immunization.lotNumber" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.expirationDate">
      <path value="Immunization.expirationDate" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.site">
      <path value="Immunization.site" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.site.coding">
      <path value="Immunization.site.coding" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Immunization.site.coding:siteCVC">
      <path value="Immunization.site.coding" />
      <sliceName value="siteCVC" />
      <binding>
        <strength value="required" />
        <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-AnatomicalSite" />
      </binding>
    </element>
    <element id="Immunization.site.text">
      <path value="Immunization.site.text" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.route">
      <path value="Immunization.route" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.route.coding">
      <path value="Immunization.route.coding" />
      <slicing>
        <discriminator>
          <type value="type" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Immunization.route.coding:routeCVC">
      <path value="Immunization.route.coding" />
      <sliceName value="routeCVC" />
      <binding>
        <strength value="required" />
        <valueSet value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-RouteOfAdmin" />
      </binding>
    </element>
    <element id="Immunization.route.coding:routeCVC.system">
      <path value="Immunization.route.coding.system" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.route.coding:routeCVC.code">
      <path value="Immunization.route.coding.code" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.route.coding:routeCVC.display">
      <path value="Immunization.route.coding.display" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.route.text">
      <path value="Immunization.route.text" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.doseQuantity">
      <path value="Immunization.doseQuantity" />
      <comment value="PSS - will be provided when entered&#xD;&#xA;MA - will be provided when documented&#xD;&#xA;&#xD;&#xA;The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.performer">
      <path value="Immunization.performer" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.performer.function">
      <path value="Immunization.performer.function" />
      <comment value="MA - &quot;Vaccine Administered&quot; here = AP (administering provider) not provided when &quot;Vaccine Administered&quot; =elsewhere&#xD;&#xA;PSS -  AP  or not provide when &quot;Performed by External Provider&quot; &#xD;&#xA;&#xD;&#xA;Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
    </element>
    <element id="Immunization.performer.function.coding">
      <path value="Immunization.performer.function.coding" />
      <comment value="PSS - AP for any immunizations given by the clinic  Not provided for immunizations given elsewhere and being recorded in the EMR &#xD;&#xA;MA - TBD&#xD;&#xA;Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true." />
    </element>
    <element id="Immunization.note">
      <path value="Immunization.note" />
      <comment value="PSS - Will provide notes from comment field in immunization window if present and also provide comments that are appended to the treatment as a separate note &#xD;&#xA;MA - Will provide notes from Observation template and Task Template&#xD;&#xA;&#xD;&#xA;For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate &quot;modifying&quot; information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible)." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.reasonCode">
      <path value="Immunization.reasonCode" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="coding.system" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <comment value="PSS - Provide documentation from Indication field when documented may be ICD-9, ICD-10 Encode or SNOMED&#xD;&#xA;MA - Provide documentation from reason field whendocumented  may be ICD-9 or SNOMED&#xD;&#xA;&#xD;&#xA;Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.reasonCode:ICD9Code">
      <path value="Immunization.reasonCode" />
      <sliceName value="ICD9Code" />
    </element>
    <element id="Immunization.reasonCode:ICD10Code">
      <path value="Immunization.reasonCode" />
      <sliceName value="ICD10Code" />
    </element>
    <element id="Immunization.reasonCode:SNOMEDCode">
      <path value="Immunization.reasonCode" />
      <sliceName value="SNOMEDCode" />
    </element>
    <element id="Immunization.reasonCode:ENCODECode">
      <path value="Immunization.reasonCode" />
      <sliceName value="ENCODECode" />
      <code>
        <system value="https://www.insite-fm.com/encode-fm" />
      </code>
    </element>
    <element id="Immunization.reaction">
      <path value="Immunization.reaction" />
      <comment value="PSS - When a reaction is recorded against a vaccine a reference to the Allergy Resource will be provided. &#xD;&#xA;&#xD;&#xA;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." />
    </element>
    <element id="Immunization.protocolApplied">
      <path value="Immunization.protocolApplied" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.protocolApplied.series">
      <path value="Immunization.protocolApplied.series" />
      <mustSupport value="true" />
    </element>
    <element id="Immunization.protocolApplied.doseNumber[x]">
      <path value="Immunization.protocolApplied.doseNumber[x]" />
      <type>
        <code value="string" />
      </type>
      <mustSupport value="true" />
    </element>
  </differential>
</StructureDefinition>

name : DwImmunization

{

}

<name value="DwImmunization" />