Profile: Immunization (Panorama)

This Profile is created and maintained external to the LRA project and is provided here as an aid for implementers of the LRA in finding the base profile definitions. The reader should always verify the profile on the linked source page.

Overview

The scope of this integration is to store all immunizations and related resources retrieved from the Immunization Distribution Service (IDS) into the LRA Platform's Smile CDR. The IDS publishes immunization records from Panorama to a First-In-First-Out (FIFO) queue, which the LRA Platform consumes. Once stored in Smile CDR, it provides technical capabilities to read and query these resources based on various search parameters. Although LRA has the technical capability to retrieve FHIR resources, aligning this with business query requirements and addressing how clients will query immunization-related data will be tackled in the next release.

Important Links

Simplifier Project Page: BCY Immunization Distribution Service

Example Usage Scenarios

Example Bundle: Example Bundle - Immunization

Profiles Content

The Immunization Distribution Service (IDS) sends an immunization bundle whenever a patient's immunization data is updated or changed. This bundle represents the current view of the patient’s immunization status, and while it may include resources that are identical to those in previous bundles, it provides a complete replacement of the prior data for the patient.

The structure of the Immunization bundle includes the following resources:

• MessageHeader 1..1
• Patient 1..1
• Organization 1..*
• Location 1..*
• Immunization 1..*
• AdverseEvent 0..*
• Consent 0..*
• ImmunizationRecommendation 0..*
• RiskAssessment 0..*
• MedicationRequest 0..*
• CarePlan 0..*

All resources within the Immunization bundle conform to IDS-defined profiles, which are based on HL7 FHIR R4 (4.0.1). Some resources, such as Consent and CarePlan, may include contained resources. In such cases, the outer resource, along with all contained resources, should be stored as a single resource.

• MessageHeader

  The MessageHeader resource captures key metadata about the immunization bundle, including details about the source and the destination for the message. This resource helps to understand the context of the immunization data exchange and not stored in the Smile CDR.

  MessageHeader	I		MessageHeader	There are no (further) constraints on this element Element id MessageHeader Short description A resource that describes a message that is exchanged between systems Definition The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Data type MessageHeader Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: 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() dom-3: 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() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act v2: MSH / MSA / ERR rim: Message
  id	Σ	1..1	string	Element id MessageHeader.id Short description Same unique GUID as resourceBundle.id Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments See Mappings Data type string Mappings bundleID: (bundle.id)
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id MessageHeader.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id MessageHeader.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2024.26' (This indicates FHIR changes on 2024 April). Mappings for element REASON updated with Event_Type. Data type id Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..0	instant	There are no (further) constraints on this element Element id MessageHeader.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..0	uri	There are no (further) constraints on this element Element id MessageHeader.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)Fixed Value	Element id MessageHeader.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/MessageHeader' Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/MessageHeader Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id MessageHeader.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id MessageHeader.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id MessageHeader.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id MessageHeader.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id MessageHeader.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id MessageHeader.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). Requirements 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  event[x]	Σ	1..1	Fixed Value	Element id MessageHeader.event[x] Short description Code for the event this message represents or link to event definition Definition Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition. Requirements Drives the behavior associated with this message. Comments Apply 'http://ehealth.bc.ca/panorama/fhir/MessageHeader' Binding One of the message events defined as part of this version of FHIR. MessageEvent (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://ehealth.bc.ca/panorama/fhir/MessageHeader Mappings rim: n/a w5: FiveWs.what[x] v2: MSH-9.2 rim: ./payload[classCode="CACT" and moodCode="EVN" and isNormalAct()]/code[isNormalDatatype()]/code
  eventUri			uri	Data type uri
  destination	Σ	1..*	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.destination Short description Message destination application(s) Definition The destination application which the message is intended for. Requirements Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient". Comments There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.subject[x] rim: ./communicationFunction[typeCode="RCV"] w5: FiveWs.subject
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.destination.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.destination.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  name	Σ	1..1	string	Element id MessageHeader.destination.name Short description Name of system Definition Human-readable name for the target system. Requirements May be used for routing of response and/or to support audit. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-5 rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]/name[type='ST' and isNormalDatatype()]) dest-fha: fha dest-HealthGateway: hgwy dest-iha: iha dest-nha: nha dest-vcha: vcha dest-viha: viha dest-indigenousHealthOrganization: indigenous health organizations
  target	Σ I	0..0	Reference(Device)	There are no (further) constraints on this element Element id MessageHeader.destination.target Short description Particular delivery destination within the destination Definition Identifies the target end system in situations where the initial message transmission is to an intermediary system. Requirements Supports multi-hop routing. Comments 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. Data type Reference(Device) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./entity[determinerCode="INST" and (classCode=("DEV", "PSN", "ORG"]
  endpoint	Σ	1..1	url	Element id MessageHeader.destination.endpoint Short description Actual destination address or id Definition Indicates where the message should be routed to. Requirements Identifies where to route the message. Comments See Mappings Data type url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-25 (or MSH-6) rim: ./telecom dest-fha: [id-system-local-base]/ca-bc-fha dest-HealthGateway: [id-system-local-base]/ca-bc-healthGateway dest-iha: [id-system-local-base]/ca-bc-iha dest-nha: [id-system-local-base]/ca-bc-nha dest-OutOfBC: [id-system-local-base]/ca-bc-outofprovince dest-vch: [id-system-local-base]/ca-bc-vcha dest-viha: [id-system-local-base]/ca-bc-viha dest-IndigenousHealthOrganizations: [id-system-local-base]/ca-bc-indigenous health organizations
  receiver	Σ I	0..0	Reference(Practitioner | PractitionerRole | Organization)	There are no (further) constraints on this element Element id MessageHeader.destination.receiver Short description Intended "real-world" recipient for the data Definition Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient. Requirements Allows routing beyond just the application level. Comments 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. Data type Reference(Practitioner | PractitionerRole | Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  sender	Σ I	0..0	Reference(Practitioner | PractitionerRole | Organization)	There are no (further) constraints on this element Element id MessageHeader.sender Short description Real world sender of the message Definition Identifies the sending system to allow the use of a trust relationship. Requirements Allows routing beyond just the application level. Comments Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone. Data type Reference(Practitioner | PractitionerRole | Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: PRT-5:PRT-4='WAYR' / PRT-8:PRT-4='WAYR' rim: Not directly supported. Could be shared using attentionLine.value with an appropriate keyWordText w5: FiveWs.subject
  enterer	Σ I	0..0	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.enterer Short description The source of the data entry Definition The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: EVN-5 / ORC-10 / PRT-5:PRT-4='EP' / ROL where ROL.3 is EP or ORC.10 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="ENT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  author	Σ I	0..0	Reference(Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id MessageHeader.author Short description The source of the decision Definition The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments Usually only for the request but can be used in a response. Data type Reference(Practitioner | PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author v2: ORC-19 / PRT-5:PRT-4='AUT' / ROL where ROL.3 is IP or ORC.12 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="AUT" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode=("DEV", "PSN") and determinerCode="INST"])
  source	Σ	1..1	BackboneElement	Element id MessageHeader.source Short description Message source application - PIR Definition The source application from which this message originated - Provincial Immunization Registry (PIR) Requirements Allows replies, supports audit. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.actor rim: unique(./communicationFunction[typeCode="SND"])
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.source.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.source.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  name	Σ	1..1	stringFixed Value	Element id MessageHeader.source.name Short description Name of system Definition Human-readable name for the source system. Requirements May be used to support audit. Comments Hardcode as "PIR Immz" Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value PIR Immz Mappings rim: n/a v2: MSH-3 rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/name[type='ST' and isNormalDatatype()])
  software	Σ	0..1	string	There are no (further) constraints on this element Element id MessageHeader.source.software Short description Name of software running the system Definition May include configuration or other information useful in debugging. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-3 ( +SFT-1) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/softwareName[isNormalDatatype()])
  version	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.source.version Short description Version of software running Definition Can convey versions of multiple systems in situations where a message passes through multiple hands. Requirements Supports audit and possibly interface engine behavior. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SFT-2 rim: (Not supported)
  contact	Σ I	0..0	ContactPoint	There are no (further) constraints on this element Element id MessageHeader.source.contact Short description Human contact for problems Definition An e-mail, phone, website or other contact point to use to resolve issues with message communications. Requirements Allows escalation of technical issues. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: (MSH-22?) rim: unique(./entity[determinerCode="INST" and classCode="DEV"]/scopesRole[normalRole() and classCode="CON" and layer[classCode="PSN"]/telecom[isNormalDatatype()])
  endpoint	Σ	1..1	url	Element id MessageHeader.source.endpoint Short description Actual message source address or id Definition Identifies the routing target to send acknowledgements to. Requirements Identifies where to send responses, may influence security permissions. Comments See Mappings Data type url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSH-24 rim: ./telecom[isNormalDatatype()] PIRtest: https://pir.healthbc.org/test/immunization PIRprod: https://pir.healthbc.org/prod/immunization
  responsible	Σ I	1..1	Reference(Practitioner | PractitionerRole | Organization)	Element id MessageHeader.responsible Short description The Panorama Organizational Unit and/or Client Health Region which submitted the message contents. Definition The Panorama Organizational Unit and/or Client Health Region (CHR) that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party. Requirements Need to know for audit/traceback requirements and possibly for authorization. Comments See Mappings Data type Reference(Practitioner | PractitionerRole | Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.witness v2: ORC-12 / PRT-5:PRT-4='OP' / PRT-8:PRT-4='OP' / ROL where ROL.3 is RO or ORC.11 rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/player[isNormalEntity() and classCode="PSN" and determinerCode="INST"] or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[isHighest(priorityCode) and typeCode="RESP" and isNormalParticipation]/role[classCode="ASSIGNED" and isNormalRole()]/scoper[isNormalEntity() and classCode="ORG" and determinerCode="INST"]) source-PIR: CHR or Submitter's Org source-PHSL: clientHealthRegion
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.responsible.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.responsible.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	1..1	string	Element id MessageHeader.responsible.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Organization' + (PIR Org ID). Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id MessageHeader.responsible.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id MessageHeader.responsible.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.responsible.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  reason	Σ	0..1	CodeableConcept	Element id MessageHeader.reason Short description Cause of event Definition Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message. Requirements Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization. Comments See Mappings. List of event type(s) in alphabetical which have been triggered, also can be applied for filtering purposes. Data type CodeableConcept Binding Reason for event occurrence. ExampleMessageReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.why[x] v2: EVN.4 / ORC.16 / OBR-31-reason for study / BPO-13-BP indication for use / RXO-20-indication / RXE-27-give indication / RXD-21-indication / RXG-22-indication / RXA-19-indication rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/reasonCode[isNormalDatatype()]) trigger-CHR: CLIENT trriger-humanSubject: CLIENT trigger-riskFactor: RISKFACTOR trigger-subjectName: CLIENT trigger-consent: CONSENT trigger-consentComment: CONSENTCMMT trigger-AEFI: AEFI trigger-aefiRecommendation: AEFI trigger-invalidVaccine: IMMS trigger-deferral: DEFERRAL trigger-forecast: FORECAST trigger-vaccination: IMMS trigger-immsComments-IC: IMMSCMMTIC trigger-immsComments-SC: IMMSCMMTSC trigger-immsComments-DF: IMMSCMMTDF trigger-immsComments-AE: IMMSCMMTAE trigger-specialConsideration: SPECIALCONSID trigger-vaccineStatus: IMMS trigger-clientMerge: CLIENT
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.reason.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.reason.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id MessageHeader.reason.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	0..1	string	Element id MessageHeader.reason.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments To be applied if IDS message contains only Forecasting data only. See Mappings. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Forecast
  response	Σ	0..0	BackboneElement	There are no (further) constraints on this element Element id MessageHeader.response Short description If this is a reply to prior message Definition Information about the message that this message is a response to. Only present if this message is a response. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: MSA rim: ./conveyedAcknowledgement
  focus	Σ I	1..1	Reference(Resource)	Element id MessageHeader.focus Short description The actual content of the message related to a specific patient. Definition The actual data of the message all related to a specific patient. Requirements Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources. Comments The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: unique(./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/participation[typeCode="SUBJ" and isNormalParticipation]/role or ./controlAct[classCode="CACT" and classCode="EVN" and isNormalAct()]/outboundRelationship[typeCode="SBJ" and isNormalActRelatoinship]/target)
  id		0..0	string	There are no (further) constraints on this element Element id MessageHeader.focus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id MessageHeader.focus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	1..1	string	Element id MessageHeader.focus.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Patient' + PIR Client ID Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id MessageHeader.focus.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id MessageHeader.focus.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id MessageHeader.focus.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  definition	Σ	0..0	canonical(MessageDefinition)	There are no (further) constraints on this element Element id MessageHeader.definition Short description Link to the definition for this message Definition Permanent link to the MessageDefinition for this message. Requirements Allows sender to define the expected contents of the message. Comments see Canonical References Data type canonical(MessageDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: Not directly supported.

• Patient

  The Patient resource contains demographic information about the individual receiving immunization services. This includes essential details such as name, date of birth, and identifiers. The Patient data is retrieved as part of the immunization bundle and reflects the current status of the patient at the time of immunization.

  Patient_CAbaseline (Patient)	I		Patient	Element id Patient Short description IFHIR resource applies for PIR Client Alternate names SubjectOfCare Client Resident Definition IFHIR resource applies for PIR Client Data type Patient Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: 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() dom-3: 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() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act rim: Patient[classCode=PAT] cda: ClinicalDocument.recordTarget.patientRole
  id	Σ	1..1	string	Element id Patient.id Short description PIR Client ID Definition Unique Panorama Client ID Comments See Mappings Data type string Mappings source-PIR: PIR subject_id
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Patient.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Patient.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Patient.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2024.03' (This indicates the FHIR Specs changes on 2024-Mar) Data type id Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..0	instant	There are no (further) constraints on this element Element id Patient.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..0	uri	There are no (further) constraints on this element Element id Patient.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Patient.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Patient' Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Patient.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id Patient.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id Patient.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id Patient.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id Patient.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id Patient.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  genderIdentityExtension	I	0..*	Extension(CodeableConcept)	Element id Patient.extension:genderIdentityExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments 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. Data type Extension(CodeableConcept) Extension URL http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://hl7.org/fhir/StructureDefinition/patient-genderIdentity Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
  id		0..0	string	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..1	Coding	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..1	string	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Patient.extension:genderIdentityExtension.value[x].coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: CLIENT.HUMAN_SUBJECT.GENDER_IDENTITY_CODED_CNCPT_ID
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Patient.extension:genderIdentityExtension.value[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Patient.extension:genderIdentityExtension.value[x].text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Mandatory if CODE = 3131-1 (Other Gender). See Mappings. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: CLIENT.HUMAN_SUBJECT.GENDER_IDENTITY_OTHER
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Patient.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). Requirements 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..*	Identifier	Element id Patient.identifier Short description Identifier(s) for this patient Definition Different types of patient identifier which includes JHN (Jurisdictional Health Number e.g. BC PHN), PI (Patient Internal Identifier e.g. PIR Client ID, HAs' Internal Client ID). Requirements Patients are almost always assigned specific numerical identifiers. Comments Extract from PIR <client.human_subject> Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: PID-3 rim: id cda: .id
  id		0..0	string	There are no (further) constraints on this element Element id Patient.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Patient.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..0	string	There are no (further) constraints on this element Element id Patient.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Patient.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.identifier.type.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uriFixed Value	Element id Patient.identifier.type.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments http://terminology.hl7.org/CodeSystem/v2-0203 Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value http://terminology.hl7.org/CodeSystem/v2-0203 Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Patient.identifier.type.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code JHN: JHN JPID: JPID MR: MR PI: PI
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.identifier.type.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Patient.identifier.type.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Patient.identifier.type.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: Panorama Client ID source-FHA: FHA-PARIS Client ID source-NHA-CeDaR: NHA- CeDaR ID source-NHA-MOIS: NHA - MOIS ID source-VCH: VCH-PARIS Client ID source-ProfileEMR: ProfileEMR_ClientID source-CAN-ArmedForces: Canadian Armed Forces IDentification Number source-CAN-RCMP: Canadian RCMP Regiment Number source-CAN-VeteranAffairs: Veteran Affairs CAnadian Identification Number
  system	Σ	1..1	uri	Element id Patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings below for appropriate URLs and URNs. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType JHN-BC: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-patient-healthcare-id PI-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-client-id JHN-YT: https://fhir.infoway-inforoute.ca/NamingSystem/ca-yt-patient-healthcare-id PI-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha-patient-id PI-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha-patient-id PI-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha-patient-id PI-CAN-ArmedForces: urn: 2.16.840.1.113883.3.51.1.1.6.15 PI-RCMP: urn:2.16.840.1.113883.3.51.1.1.6.16 PI-CAN-VeteranAffairs: urn:2.16.840.1.113883.3.51.1.1.6.18 PI-ProfileEMR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-profile-emr-patient-id
  value	Σ	1..1	string	Element id Patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments PIR Client ID: Extract from PIR (client.human_subject.subject_id); BC PHN or Yukon PHN: Extract from PIR (client.human_subject.health_card_number) Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value JHN-BC: Extract from PIR (client.human_subject.health_card_number) JHN-YT: Extract from PIR (client.human_subject.health_card_number) PI-PIR: Extract from PIR (client.human_subject.subject_id) PI-FHA: FHA-PARIS Client ID PI-NHA: NHA- CeDaR ID PI-VCH: VCH-PARIS Client ID
  period	Σ I	0..0	Period	There are no (further) constraints on this element Element id Patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  active	Σ ?!	1..1	boolean	Element id Patient.active Short description Whether this patient's record is in active use in PIR. Definition It is used to filter patient lists to exclude inactive patients Inactive patient lists include inactive reasons in (Created in Error, Retruned to Birth Parent, Adopted, Soft Deleted, Deceased). Requirements Need to be able to mark a patient record as not to be used because it was created in error. Comments Hardcode as 'True' for all PIR active clients. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status rim: statusCode cda: n/a
  name	Σ	1..*	HumanName	Element id Patient.name Short description A name associated with the patient Definition PIR Client Lastname, Firstname, Middlename Requirements Need to be able to track the patient by multiple names. Examples are your official name and a partner name. Comments Extract from PIR <client.human_subject> Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: PID-5, PID-9 rim: name cda: .patient.name
  id		0..0	string	There are no (further) constraints on this element Element id Patient.name.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.name.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	Element id Patient.name.use Short description usual | official | temp | nickname | anonymous | old | maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments See Mappings Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose legal: official alias: usual
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.name.text Short description Text representation of the full name Definition Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: implied by XPN.11 rim: ./formatted
  family	Σ	1..1	string	Element id Patient.name.family Short description Patient Family Name Alternate names surname Definition Patient Family Name Comments Patient Family Name Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName
  given	Σ	1..*	string	Element id Patient.name.given Short description Patient Given Names Alternate names first name, middle name Definition Patient Given Names Comments Patient Given Names Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames
  prefix	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
  suffix	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XPN/4 rim: ./part[partType = SFX]
  period	Σ I	0..0	Period	There are no (further) constraints on this element Element id Patient.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  telecom	Σ I	0..*	ContactPoint	Element id Patient.telecom Short description A contact detail for the PIR Client Definition A contact detail (e.g. a telephone number or an email address) by which the PIR client may be contacted. Requirements People have (primary) ways to contact them in some way such as phone, email. Comments A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: PID-13, PID-14, PID-40 rim: telecom cda: .telecom
  id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ I	0..1	codeBinding	Element id Patient.telecom.system Short description phone | fax | email | pager | url | sms | other Definition Telecommunications form for contact point - what communications system is required to make use of the contact. Comments Use 'phone | email'. Extract the current phone or email from PIR, not the ones with 'Effective Date To' populated. Data type code Binding Telecommunications form for contact point. ContactPointSystem (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.3 rim: ./scheme servd: ./ContactPointType
  value	Σ	0..1	string	Element id Patient.telecom.value Short description Patient Phone Number or Email Definition Patient Phone Number or Email Requirements Need to support legacy numbers that are not in a tightly controlled format. Comments Patient Phone Number | Email Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.1 (or XTN.12) rim: ./url servd: ./Value
  use	Σ ?!	0..1	codeBinding	Element id Patient.telecom.use Short description home | work | mobile - purpose of this contact point Definition Identifies the purpose for the contact point. Requirements Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Comments Use "home" | "work" |"mobile" (See Mappings). If not listed in the mappings, drop the attirubte USE, do not send. Data type code Binding Use of contact point. ContactPointUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XTN.2 - but often indicated by field rim: unique(./use) servd: ./ContactPointPurpose pirHOME: home pirBUSINESS: work pirMOBILE: mobile
  rank	Σ	0..0	positiveInt	There are no (further) constraints on this element Element id Patient.telecom.rank Short description Specify preferred order of use (1 = highest) Definition Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Comments Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: n/a
  period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.telecom.period Short description Time period when the contact point was/is in use Definition Time period when the contact point was/is in use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: N/A rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  id		0..0	string	There are no (further) constraints on this element Element id Patient.telecom.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.telecom.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low
  end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.telecom.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high
  gender	Σ	1..1	codeBinding	Element id Patient.gender Short description male | female | other | unknown Definition Patient Administrative Gender. PIR gender "Undifferentiate" is mapped to "unknown" in FHIR. Requirements Needed for identification of the individual, in combination with (at least) name and birth date. Comments Patient Administrative Gender Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-8 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender cda: .patient.administrativeGenderCode
  id		0..0	string	There are no (further) constraints on this element Element id Patient.gender.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.gender.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value		0..1	System.String	There are no (further) constraints on this element Element id Patient.gender.value Short description Primitive value for code Definition Primitive value for code Data type System.String Maximum string length 1048576
  birthDate	Σ	1..1	date	Element id Patient.birthDate Short description Patient Date of Birth Definition Patient Date of Birth Requirements Age of the individual drives many clinical processes. Comments Patient Date of Birth (yyyy-mm-dd) Data type date Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-7 rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime cda: .patient.birthTime loinc: 21112-8
  deceased[x]	Σ ?!	0..0		There are no (further) constraints on this element Element id Patient.deceased[x] Short description Indicates if the individual is deceased or not Definition Indicates if the individual is deceased or not. Requirements The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. Comments If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-30 (bool) and PID-29 (datetime) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime cda: n/a
  address	Σ	0..1	Address	Element id Patient.address Short description An address for the individual Definition An address for the individual. Requirements May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Comments Extract the LATEST client address from PIR Data type Address Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address v2: PID-11 rim: addr cda: .addr
  id		0..0	string	There are no (further) constraints on this element Element id Patient.address.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..1	codeBinding	Element id Patient.address.use Short description home | work | temp | old | billing - purpose of this address Definition The purpose of this address: home | work Requirements Allows an appropriate address to be chosen from a list of many. Comments See Mappings Data type code Binding The use of an address. AddressUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General home Mappings rim: n/a v2: XAD.7 rim: unique(./use) servd: ./AddressPurpose pir-PrimaryHome: home
  type	Σ	0..1	codeBinding	Element id Patient.address.type Short description postal | physical | both Definition Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. Comments See Mappings. Data type code Binding The type of an address (physical / postal). AddressType (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General both Mappings rim: n/a v2: XAD.18 rim: unique(./use) vcard: address type parameter pir-PostalAddress: postal
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.address.text Short description Text representation of the address Definition Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. Requirements A renderable, unencoded form. Comments Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 137 Nowhere Street, Erewhon 9132 Mappings rim: n/a v2: XAD.1 + XAD.2 + XAD.3 + XAD.4 + XAD.5 + XAD.6 rim: ./formatted vcard: address label parameter
  line	Σ	0..*	string	Element id Patient.address.line Short description Street name, number, direction & P.O. Box etc. Definition This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Comments Use address.line for international address Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 137 Nowhere Street Mappings rim: n/a v2: XAD.1 + XAD.2 (note: XAD.1 and XAD.2 have different meanings for a company address than for a person address) rim: AD.part[parttype = AL] vcard: street servd: ./StreetAddress (newline delimitted)
  id		0..1	string	There are no (further) constraints on this element Element id Patient.address.line.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.line.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _line	I	0..1	Extension(string)	Element id Patient.address.line.extension:_line Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments See Mappings Data type Extension(string) Extension URL http://hl7.org/fhir/StructureDefinition/iso21090-ADXP Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A houseNumber: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber streetName: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName streetNameType: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetNameType direction: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-direction unitID: http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID
  value		0..1	System.String	There are no (further) constraints on this element Element id Patient.address.line.value Short description Primitive value for string Definition Primitive value for string Data type System.String Maximum string length 1048576
  city	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.city Short description Name of city, town etc. Alternate names Municpality Definition The name of the city, town, suburb, village or other community or delivery center. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General Erewhon Mappings rim: n/a v2: XAD.3 rim: AD.part[parttype = CTY] vcard: locality servd: ./Jurisdiction
  district	Σ	0..0	string	There are no (further) constraints on this element Element id Patient.address.district Short description District name (aka county) Alternate names County Definition The name of the administrative area (county). Comments District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General Madison Mappings rim: n/a v2: XAD.9 rim: AD.part[parttype = CNT | CPA]
  state	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.state Short description Sub-unit of country (abbreviations ok) Alternate names Province, Territory Definition Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD.4 rim: AD.part[parttype = STA] vcard: region servd: ./Region
  postalCode	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.postalCode Short description Postal code for area Alternate names Zip Definition A postal code designating a region defined by the postal service. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 9132 Mappings rim: n/a v2: XAD.5 rim: AD.part[parttype = ZIP] vcard: code servd: ./PostalIdentificationCode
  country	Σ	0..1	string	There are no (further) constraints on this element Element id Patient.address.country Short description Country (e.g. can be ISO 3166 2 or 3 letter code) Definition Country - a nation as commonly understood or generally accepted. Comments ISO 3166 3 letter codes can be used in place of a human readable country name. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD.6 rim: AD.part[parttype = CNT] vcard: country servd: ./Country
  period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Patient.address.period Short description Time period when address was/is in use Definition Time period when address was/is in use. Requirements Allows addresses to be placed in historical context. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Examples General { "start": "2010-03-23", "end": "2010-07-01" } Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: XAD.12 / XAD.13 + XAD.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
  id		0..0	string	There are no (further) constraints on this element Element id Patient.address.period.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Patient.address.period.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  start	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.address.period.start Short description Starting time with inclusive boundary Definition The start of the period. The boundary is inclusive. Comments If the low element is missing, the meaning is that the low boundary is not known. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.1 rim: ./low
  end	Σ I	0..1	dateTime	There are no (further) constraints on this element Element id Patient.address.period.end Short description End time with inclusive boundary, if not ongoing Definition The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Meaning when missing If the end of the period is missing, it means that the period is ongoing Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: DR.2 rim: ./high
  maritalStatus		0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Patient.maritalStatus Short description Marital (civil) status of a patient Definition This field contains a patient's most recent marital (civil) status. Requirements Most, if not all systems capture it. Comments 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. Data type CodeableConcept Binding The domestic partnership status of a person. Marital Status Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-16 rim: player[classCode=PSN]/maritalStatusCode cda: .patient.maritalStatusCode
  multipleBirth[x]		0..0		There are no (further) constraints on this element Element id Patient.multipleBirth[x] Short description Whether patient is part of a multiple birth Definition Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). Requirements For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Comments Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: PID-24 (bool), PID-25 (integer) rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber cda: n/a
  photo	I	0..0	Attachment	There are no (further) constraints on this element Element id Patient.photo Short description Image of the patient Definition Image of the patient. Requirements Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Comments Guidelines: Use id photos, not clinical photos. Limit dimensions to thumbnail. Keep byte count low to ease resource updates. Data type Attachment Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) att-1: If the Attachment has data, it SHALL have a contentType data.empty() or contentType.exists() Mappings rim: n/a v2: ED/RP rim: ED v2: OBX-5 - needs a profile rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/desc cda: n/a
  contact	I	0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.contact Short description A contact party (e.g. guardian, partner, friend) for the patient Definition A contact party (e.g. guardian, partner, friend) for the patient. Requirements Need to track people you can contact about the patient. Comments Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) pat-1: SHALL at least contain a contact's details or a reference to an organization name.exists() or telecom.exists() or address.exists() or organization.exists() Mappings rim: n/a rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON] cda: n/a
  communication		0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.communication Short description A language which may be used to communicate with the patient about his or her health Definition A language which may be used to communicate with the patient about his or her health. Requirements If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. Comments If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: LanguageCommunication cda: patient.languageCommunication
  generalPractitioner	I	0..0	Reference(Organization | Practitioner | PractitionerRole)	There are no (further) constraints on this element Element id Patient.generalPractitioner Short description Patient's nominated primary care provider Alternate names careProvider Definition Patient's nominated care provider. Comments This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources. Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Data type Reference(Organization | Practitioner | PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: PD1-4 rim: subjectOf.CareEvent.performer.AssignedEntity cda: n/a
  managingOrganization	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Patient.managingOrganization Short description Organization that is the custodian of the patient record Definition Organization that is the custodian of the patient record. Requirements Need to know who recognizes this patient record, manages and updates it. Comments There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: scoper cda: .providerOrganization
  link	Σ ?!	0..0	BackboneElement	There are no (further) constraints on this element Element id Patient.link Short description Link to another patient resource that concerns the same actual person Definition Link to another patient resource that concerns the same actual patient. Requirements There are multiple use cases: Duplicate patient records due to the clerical errors associated with the difficulties of identifying humans consistently, and Distribution of patient information across multiple servers. Comments There is no assumption that linked patient records have mutual links. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: outboundLink cda: n/a

• Organization

  The Organization resource represents the health facility or institution associated with the immunization data. This resource is crucial for identifying which organization is responsible for providing immunization services and managing the immunization data.

  OrganizationPIR (Organization)	I		Organization	Element id Organization Short description FHIR resource applies for PIR/Panorama as root organization Definition FHIR resource applies for PIR/Panorama as root organization Data type Organization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: 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() dom-3: 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() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() org-1: The organization SHALL at least have a name or an identifier, and possibly more than one (identifier.count() + name.count()) > 0 Mappings rim: Entity. Role, or Act v2: (also see master files messages) rim: Organization(classCode=ORG, determinerCode=INST) servd: Organization
  id	Σ	1..1	string	Element id Organization.id Short description PIR Organizational ID of Panorama as the root. Definition PIR Organizational ID of Panorama as the root. Comments See Mappings Data type string Mappings Org-PIR: "1"
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Organization.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Organization.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Organization.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Organization.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply '2023.01' (This indicates FHIR changes on 2023-Jan) Data type id Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..0	instant	There are no (further) constraints on this element Element id Organization.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..0	uri	There are no (further) constraints on this element Element id Organization.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Organization.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Apply "http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/OrganizationPIR" Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Organization.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id Organization.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id Organization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id Organization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id Organization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id Organization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Organization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Organization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). Requirements 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ I	1..1	Identifier	Element id Organization.identifier Short description PIR Organizational ID of Panorama as the root. Definition PIR Organizational ID of Panorama as the root. Requirements Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: XON.10 / XON.3 rim: .scopes[Role](classCode=IDENT) servd: ./Identifiers
  id		0..0	string	There are no (further) constraints on this element Element id Organization.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Organization.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Organization.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Organization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	Σ	1..1	uri	Element id Organization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Use 'https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-organization-unit-id' Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
  value	Σ	1..1	string	Element id Organization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments Apply "1" to indicate Panorama. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
  period	Σ I	0..0	Period	There are no (further) constraints on this element Element id Organization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Organization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  active	Σ ?!	0..0	boolean	There are no (further) constraints on this element Element id Organization.active Short description Whether the organization's record is still in active use Definition Whether the organization's record is still in active use. Requirements Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. Comments This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status v2: No equivalent in HL7 v2 rim: .status servd: ./Status (however this concept in ServD more covers why the organization is active or not, could be delisted, deregistered, not operational yet) this could alternatively be derived from ./StartDate and ./EndDate and given a context date.
  type	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id Organization.type Short description Kind of organization Definition The kind(s) of organization that this is. Requirements Need to be able to track the kind of organization that this is - different organization types have different uses. Comments Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality. Data type CodeableConcept Binding Used to categorize the organization. OrganizationType (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class v2: No equivalent in v2 rim: .code servd: n/a
  name	Σ I	1..1	string	Element id Organization.name Short description Name used for the organization - Panorama Definition A name associated with the organization - Panorama Requirements Need to use the name as the label of the organization. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XON.1 rim: .name servd: .PreferredName/Name source-PIR: ploephs.organization_unit.name
  alias		0..0	string	There are no (further) constraints on this element Element id Organization.alias Short description A list of alternate names that the organization is known as, or was known as in the past Definition A list of alternate names that the organization is known as, or was known as in the past. Requirements Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful. Comments There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  telecom	I	0..0	ContactPoint	There are no (further) constraints on this element Element id Organization.telecom Short description A contact detail for the organization Definition A contact detail for the organization. Requirements Human contact for the organization. Comments The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() org-3: The telecom of an organization can never be of use 'home' where(use = 'home').empty() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint v2: ORC-22? rim: .telecom servd: ./ContactPoints
  address	I	0..0	Address	There are no (further) constraints on this element Element id Organization.address Short description An address for the organization Definition An address for the organization. Requirements May need to keep track of the organization's addresses for contacting, billing or reporting requirements. Comments Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used. Data type Address Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) org-2: An address of an organization can never be of use 'home' where(use = 'home').empty() Mappings rim: n/a v2: XAD rim: AD servd: Address v2: ORC-23? rim: .address servd: ./PrimaryAddress and ./OtherAddresses
  partOf	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Organization.partOf Short description The organization of which this organization forms a part Definition The organization of which this organization forms a part. Requirements Need to be able to track the hierarchy of organizations within an organization. Comments 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. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: No equivalent in HL7 v2 rim: .playedBy[classCode=Part].scoper servd: n/a
  contact		0..0	BackboneElement	There are no (further) constraints on this element Element id Organization.contact Short description Contact for the organization for a certain purpose Definition Contact for the organization for a certain purpose. Requirements Need to keep track of assigned contact points within bigger organization. Comments Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .contactParty
  endpoint	I	0..0	Reference(Endpoint)	There are no (further) constraints on this element Element id Organization.endpoint Short description Technical endpoints providing access to services operated for the organization Definition Technical endpoints providing access to services operated for the organization. Requirements Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Comments 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. Data type Reference(Endpoint) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

• Location

  The Location resource identifies the physical site where immunizations were administered. This resource helps to associate the immunization event with a specific place, which is essential for tracking the location of immunization delivery.

  Location	I		Location	Element id Location Short description FHIR resource applies for PIR Vaccine Administered SDL Definition FHIR resource applies for PIR Vaccine Administered Service Delivery Location (SDL) Data type Location Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: 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() dom-3: 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() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act rim: .Role[classCode=SDLC]
  id	Σ	1..1	string	Element id Location.id Short description PIR internal SDL ID + PIR internal Immz Org Definition PIR internal Service Delivery Location (SDL) Identifier + PIR internal Immunization Organization (Immz Org) Identifier. SDL refers to the site where vaccine is being administered. Comments See Mappings Data type string Mappings source-PIR: (PIR Location Id) + 'org' + (PIR Imms Org ID)
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Location.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Location.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Location.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Location.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Use '2023.01' (This indicates FHIR changes on 2023-Jan) Data type id Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..0	instant	There are no (further) constraints on this element Element id Location.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..0	uri	There are no (further) constraints on this element Element id Location.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Location.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Location' Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Location.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id Location.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id Location.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id Location.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id Location.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id Location.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Location.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Location.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). Requirements 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier	Σ	1..1	Identifier	Element id Location.identifier Short description PIR internal SDL ID Definition PIR internal Service Delivery Location (SDL) Identifier. SDL refers to the site where vaccine is being administered. Requirements Organization label locations in registries, need to keep track of those. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier rim: .id
  id		0..0	string	There are no (further) constraints on this element Element id Location.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Location.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Location.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Location.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  system	Σ	1..1	uri	Element id Location.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-service-delivery-location-id
  value	Σ	1..1	string	Element id Location.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments Extract from (imms.h33_vaccination_master.location_id) Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
  period	Σ I	0..0	Period	There are no (further) constraints on this element Element id Location.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Location.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Location.status Short description active | suspended | inactive Definition The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Indicates whether the location is still in use. LocationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.status rim: .statusCode
  operationalStatus	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Location.operationalStatus Short description The operational status of the location (typically only for a bed/room) Definition The operational status covers operation values most relevant to beds (but can also apply to rooms/units/chairs/etc. such as an isolation unit/dialysis chair). This typically covers concepts such as contamination, housekeeping, and other activities like maintenance. Comments 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. Data type Coding Binding The operational status if the location (where typically a bed/room). v2.0116 (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding w5: FiveWs.status
  name	Σ	0..1	string	Element id Location.name Short description Name of the SDL Definition Name of the Service Delivery Location where vaccine is being administered. Comments SDL - Derive name from location name (imms.h33_vaccination_master.location_id) Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  alias		0..0	string	There are no (further) constraints on this element Element id Location.alias Short description A list of alternate names that the location is known as, or was known as, in the past Definition A list of alternate names that the location is known as, or was known as, in the past. Requirements Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the location was known by can be very useful. Comments There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .name
  description	Σ	0..0	string	There are no (further) constraints on this element Element id Location.description Short description Additional details about the location that could be displayed as further information to identify the location beyond its name Definition Description of the Location, which helps in finding or referencing the place. Requirements Humans need additional information to verify a correct location has been identified. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .playingEntity[classCode=PLC determinerCode=INSTANCE].desc
  mode	Σ	0..0	codeBinding	There are no (further) constraints on this element Element id Location.mode Short description instance | kind Definition Indicates whether a resource instance represents a specific location or a class of locations. Requirements When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location. Comments This is labeled as a modifier because whether or not the location is a class of locations changes how it can be used and understood. Data type code Binding Indicates whether a resource instance represents a specific location or a class of locations. LocationMode (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.class rim: .playingEntity[classCode=PLC].determinerCode
  type	Σ	0..0	CodeableConceptBinding	There are no (further) constraints on this element Element id Location.type Short description Type of function performed Definition Indicates the type of function performed at the location. Comments 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. Data type CodeableConcept Binding Indicates the type of function performed at the location. v3.ServiceDeliveryLocationRoleType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .code
  telecom	I	0..0	ContactPoint	There are no (further) constraints on this element Element id Location.telecom Short description Contact details of the location Definition The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sites. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) cpt-2: A system is required if a value is provided. value.empty() or system.exists() Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint rim: .telecom
  address		0..0	Address	There are no (further) constraints on this element Element id Location.address Short description Physical location Definition Physical location. Requirements If locations can be visited, we need to keep track of their address. Comments Additional addresses should be recorded using another instance of the Location resource, or via the Organization. Data type Address Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: XAD rim: AD servd: Address rim: .addr
  physicalType	Σ	0..0	CodeableConcept	There are no (further) constraints on this element Element id Location.physicalType Short description Physical form of the location Definition Physical form of the location, e.g. building, room, vehicle, road. Requirements For purposes of showing relevant locations in queries, we need to categorize locations. Comments 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. Data type CodeableConcept Binding Physical form of the location. LocationType (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .playingEntity [classCode=PLC].code
  position		0..0	BackboneElement	There are no (further) constraints on this element Element id Location.position Short description The absolute geographic location Definition The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML). Requirements For mobile applications and automated route-finding knowing the exact location of the Location is required. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .playingEntity [classCode=PLC determinerCode=INSTANCE].positionText
  managingOrganization	Σ I	1..1	Reference(Organization)	Element id Location.managingOrganization Short description Immunization Organization responsible for the SDL Definition The immunization organization responsible for the provisioning and upkeep of the service delivery location. Requirements Need to know who manages the location. Comments This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .scopingEntity[classCode=ORG determinerKind=INSTANCE]
  id		0..0	string	There are no (further) constraints on this element Element id Location.managingOrganization.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Location.managingOrganization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	1..1	string	Element id Location.managingOrganization.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Organization' + (PIR Imms Org ID from vaccine_master) Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBindingFixed Value	Element id Location.managingOrganization.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments Hardcode as "Organization" Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Fixed value Organization Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Location.managingOrganization.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Location.managingOrganization.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  partOf	I	0..0	Reference(Location)	There are no (further) constraints on this element Element id Location.partOf Short description Another Location this one is physically a part of Definition Another Location of which this Location is physically a part of. Requirements For purposes of location, display and identification, knowing which locations are located within other locations is important. Comments 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. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .inboundLink[typeCode=PART].source[classCode=SDLC]
  hoursOfOperation		0..0	BackboneElement	There are no (further) constraints on this element Element id Location.hoursOfOperation Short description What days/times during a week is this location usually open Definition What days/times during a week is this location usually open. Comments This type of information is commonly found published in directories and on websites informing customers when the facility is available. Specific services within the location may have their own hours which could be shorter (or longer) than the locations hours. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: .effectiveTime
  availabilityExceptions		0..0	string	There are no (further) constraints on this element Element id Location.availabilityExceptions Short description Description of availability exceptions Definition A description of when the locations opening ours are different to normal, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as detailed in the opening hours Times. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  endpoint	I	0..0	Reference(Endpoint)	There are no (further) constraints on this element Element id Location.endpoint Short description Technical endpoints providing access to services operated for the location Definition Technical endpoints providing access to services operated for the location. Requirements Organizations may have different systems at different locations that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Comments 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. Data type Reference(Endpoint) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

• Immunization

  The Immunization resource records the immunization event, including the vaccine administered, the patient receiving the immunization, and other pertinent details such as lot number and expiration date. It represents both current and historical immunization data, providing a complete record of a patient’s immunization history. This data is essential for tracking the vaccines received by a patient over time, supporting clinical decision-making, and ensuring compliance with immunization schedules. The patient and location references are mapped to corresponding records stored as part of the immunization bundle.

  Immunization	I		Immunization	Element id Immunization Short description FHIR resource applies for PIR Immunization History Definition FHIR resource applies for PIR Immunization History Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty() dom-4: 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() dom-3: 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() dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty() Mappings rim: Entity. Role, or Act workflow: Event v2: VXU_V04 rim: SubstanceAdministration
  id	Σ	1..1	string	Element id Immunization.id Short description PIR Internal Immunization ID Definition PIR Internal Immunization ID Comments See Mappings Data type string Mappings source-PIR: PIR Imms ID source-PHSL: immunizationId
  meta	Σ	1..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource Definition 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. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  versionId	Σ	0..1	id	Element id Immunization.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments Apply "2024.04". This indicates the FHIR Specs as of year 2024 April. Replaces CVC code with NVC code. Data type id Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  lastUpdated	Σ	0..0	instant	There are no (further) constraints on this element Element id Immunization.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  source	Σ	0..0	uri	There are no (further) constraints on this element Element id Immunization.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  profile	Σ	1..1	canonical(StructureDefinition)	Element id Immunization.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments Use 'http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/Immunization' Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  security	Σ	0..0	CodingBinding	There are no (further) constraints on this element Element id Immunization.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  tag	Σ	0..0	Coding	There are no (further) constraints on this element Element id Immunization.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  implicitRules	Σ ?!	0..0	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  language		0..0	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a
  text		0..0	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition 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. Comments 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A rim: Act.text?
  contained		0..0	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition 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. Comments 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  antigenDose	I	0..*	Extension(Complex)	Element id Immunization.extension:antigenDose Short description Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered Alternate names extensions, user content Definition Antgien(s) + Antigen Dose Number + Antigen Dose Status associated with the Agent administered Comments To apply for antigens information Data type Extension(Complex) Extension URL http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-antigen Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  antigenCode	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode Short description Imms Antigen Alternate names extensions, user content Definition Imms Antigen Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value antigenCode Mappings rim: N/A
  value[x]		0..1		There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data type CodeableConcept
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-SNOMED: http://snomed.info/sct
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenCode.value[x].text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: immunizationAntigenCombinedDescription
  antigenDoseNum	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseNum Short description Imms Antigen Dose Number Alternate names extensions, user content Definition Imms Antigen Dose Number Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseNum.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseNum.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseNum.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value antigenDoseNum Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseNum.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  antigenDoseStatus	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseStatus Short description Imms Antigen Dose Status Alternate names extensions, user content Definition Imms Antigen Dose Status Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseStatus.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value antigenDoseStatus Mappings rim: N/A
  value[x]		1..1		There are no (further) constraints on this element Element id Immunization.extension:antigenDose.extension:antigenDoseStatus.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueString			string	There are no (further) constraints on this element Data type string
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.extension:antigenDose.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value http://ehealth.bc.ca/fhir/StructureDefinition/bc-bcyimmunizationdistribution/immz-antigen Mappings rim: N/A
  value[x]		0..0		There are no (further) constraints on this element Element id Immunization.extension:antigenDose.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). Requirements 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  identifier		1..*	Identifier	Element id Immunization.identifier Short description PIR internal Immunization Identifier + External Immunization ID from source system(s) Definition PIR Immunization Identifier(s) which include Panorama Internal Immunization ID, External Immunization ID from different source systems). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier w5: FiveWs.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  use	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Immunization.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: N/A rim: Role.code or implied by context
  type	Σ	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.identifier.type.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.type.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..0	Coding	There are no (further) constraints on this element Element id Immunization.identifier.type.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  text	Σ	1..1	string	Element id Immunization.identifier.type.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: PANORAMAIMMZID' source-NHA: NHACEDARIMMS source-VCH: VCHPARISIMMS source-FHA: FHAPARISIMMS source-PNet: PHARMANETIMMS source-CznSub: CZNSUBIMMSID source-immsBC: HEALTHCONNECT source-eForms: EFORMIMMSID
  system	Σ	1..1	uri	Element id Immunization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType source-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-document-number source-NHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-nha source-FHA: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-fha source-VCH: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-vcha source-PNet: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-pharmanet-document-number source-CznSub: https://ehealthbc.ca/NamingSystem/ca-bc-citizen-submission source-eForms: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-eForm source-immsBC: https://ehealthbc.ca/NamingSystem/ca-bc-health-connect
  value	Σ	1..1	string	Element id Immunization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value source-PIR: PIR Immunization ID source-FHA: FHA PARIS Immunization ID source-NHA: NHA CeDaR Immunization ID source-VCH: VCH PARIS Immunization ID source-PNet: PharmaNet Immunization ID source-PHSL: immunizationId
  period	Σ I	0..0	Period	There are no (further) constraints on this element Element id Immunization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) per-1: If present, start SHALL have a lower value than end start.hasValue().not() or end.hasValue().not() or (start <= end) Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
  assigner	Σ I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
  status	Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed | entered-in-error | Definition Indicates the current status of the immunization record. Comments IDS sends "completed" or "entered-in-error" immunization records only. Data type code Binding A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.status w5: FiveWs.status rim: statusCode
  statusReason		0..0	CodeableConcept	There are no (further) constraints on this element Element id Immunization.statusReason Short description Reason not done Definition Indicates the reason the immunization event was not performed. Comments This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. Data type CodeableConcept Binding The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.statusReason rim: .inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
  vaccineCode	Σ	1..1	CodeableConcept	Element id Immunization.vaccineCode Short description Vaccine product administered Definition Vaccine that was administered. Comments 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. Data type CodeableConcept Binding The code for vaccine product administered. VaccineAdministeredValueSet (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code w5: FiveWs.what[x] v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	Element id Immunization.vaccineCode.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Sliced: Unordered, Open, by code(Value) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  (All Slices)				There are no (further) constraints on this element
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentNVC	Σ	1..1	Coding	Element id Immunization.vaccineCode.coding:AgentNVC Short description Agent administered Definition Agent code and name in NVC Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:AgentNVC.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-NVC: https://nvc-cnv.canada.ca code-SNOMED: http://snomed.info/sct
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Immunization.vaccineCode.coding:AgentNVC.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTING.RBCY_FN_GET_CONCEPT_CODE(H33_VACCINATION_MASTER_ASIIS_VACC_CODE) source-PHSL: immunizationAgentCode
  display	Σ	1..1	string	Element id Immunization.vaccineCode.coding:AgentNVC.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTING.GET_ITERM_DESC(H33_VACCINATION_MASTER_ASIIS_VACC_CODE) source-PHSL: immunizationAgentDescription
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentNVC.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  AgentPIR	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:AgentPIR.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-PIR: https://fhir.infoway-inforoute.ca/NamingSystem/ca-bc-panorama-code
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:AgentPIR.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  Tradename	Σ	0..1	Coding	Element id Immunization.vaccineCode.coding:Tradename Short description Tradename administered Definition Tradename of agent administered Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Tradename of agent administered Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	1..1	uri	Element id Immunization.vaccineCode.coding:Tradename.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments See Mappings Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem code-CVC: https://cvc.canimmunize.ca code-SNOMED: http://snomed.info/sct
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	1..1	code	Element id Immunization.vaccineCode.coding:Tradename.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments See Mappings Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code source-PIR: BCYREPORTNG.RBCY_FN_GET_CONCEPT_CODE (H33_VACCINATION_MASTER.ASIIS_VACC_CODE) source-PHSL: tradeName
  display	Σ	0..1	string	Element id Immunization.vaccineCode.coding:Tradename.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName source-PIR: REPORTNG.GET_ITERM_DESC(H33_VACCINATION_MASTER.ASIIS_VACC_CODE)
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.vaccineCode.coding:Tradename.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..1	string	Element id Immunization.vaccineCode.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText source-PIR: immunizationAgentCombineDescription source-PHSL: immunizationAgentCombineDescription
  patient	Σ I	1..1	Reference(Patient)	There are no (further) constraints on this element Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Comments 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. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[ttypeCode=].role w5: FiveWs.subject
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.patient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.patient.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	1..1	string	Element id Immunization.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A source-PIR: fullURL of Panorama + "Patient'+PIR Client ID
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id Immunization.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Immunization.patient.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  encounter	I	0..0	Reference(Encounter)	There are no (further) constraints on this element Element id Immunization.encounter Short description Encounter immunization was part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Comments 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. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context w5: FiveWs.context v2: PV1-19 rim: component->EncounterEvent
  occurrence[x]	Σ	1..1		Element id Immunization.occurrence[x] Short description Vaccine administration date Definition Date vaccine administered Comments See Mappings Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.occurrence[x] w5: FiveWs.done[x] v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value source-PIR: imms.h33_vaccination_master.vacc_date source-PHSL: vaccDate
  occurrenceDateTime			dateTime	Data type dateTime
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  _occurrenceDateTime	I	0..*	Extension(boolean)	Element id Immunization.occurrence[x].extension:_occurrenceDateTime Short description Estimated Flag for Vaccination Date Alternate names extensions, user content Definition Estimated Flag for Vaccination Date Comments See Mappings Data type Extension(boolean) Extension URL https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A source-PHSL: VM.VACC_DATE_ESTIMATED_IND = 'Y source-PHSL: note="E"
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  url		1..1	uriFixed Value	There are no (further) constraints on this element Element id Immunization.occurrence[x].extension:_occurrenceDateTime.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data type uri Fixed value https://ehealthontario.ca/API/FHIR/StructureDefinition/ca-on-extension-estimated-date Mappings rim: N/A
  value[x]		0..1		Element id Immunization.occurrence[x].extension:_occurrenceDateTime.value[x] Short description Value of extension Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Comments Apply PIR: H33_VACCINATION_MASTER.VACC_DATE Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  valueBoolean			boolean	There are no (further) constraints on this element Data type boolean
  value		0..1	System.DateTime	There are no (further) constraints on this element Element id Immunization.occurrence[x].value Short description Primitive value for dateTime Definition Primitive value for dateTime Data type System.DateTime
  recorded		0..0	dateTime	There are no (further) constraints on this element Element id Immunization.recorded Short description When the immunization was first captured in the subject's record Definition The date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.recorded rim: .participation[typeCode=AUT].time
  primarySource	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.primarySource Short description Indicates context the data was recorded in Definition An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a w5: FiveWs.source v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U)
  reportOrigin		0..0	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record Definition The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Comments Should not be populated if primarySource = True, not required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.source v2: RXA-9 rim: .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)
  location	I	0..1	Reference(Location)	Element id Immunization.location Short description Immunization Service Delivery Location (SDL) Definition Immunization Service Delivery Location (SDL) Comments See Mappings Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.location w5: FiveWs.where[x] v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV source-PHSL: serviceDeliveryLocationName source-PIR: H33_VACCINATION_MASTER.location_id
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.location.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.location.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	1..1	string	Element id Immunization.location.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Location' + PIR Loc ID + 'org' + PIR Imms Org ID Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..0	uriBinding	There are no (further) constraints on this element Element id Immunization.location.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id Immunization.location.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
  display	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.location.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  manufacturer	I	0..0	Reference(Organization)	There are no (further) constraints on this element Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Comments 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. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
  lotNumber		0..1	string	Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText source-PIR: INV_PRODUCT_LOT_INFO.LOT_NUMBER source-PHSL: lotNumber
  expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
  site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Comments 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. Data type CodeableConcept Binding The site at which the vaccine was administered. CodesForImmunizationSiteOfAdministration (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.site.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.site.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	Element id Immunization.site.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Use 'http://snomed.info/sct'' Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.site.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Immunization.site.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Apply SNOMED code Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.site.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Comments 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. Data type CodeableConcept Binding The route by which the vaccine was administered. ImmunizationRouteCodes (example) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.route.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: C*E.1-8, C*E.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.route.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.coding.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  system	Σ	0..1	uri	Element id Immunization.route.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments Use 'http://snomed.info/sct' Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.3 rim: ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
  version	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.route.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.7 rim: ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
  code	Σ	0..1	code	Element id Immunization.route.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Apply SNOMED code Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.1 rim: ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  display	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.2 - but note this is not well followed rim: CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id Immunization.route.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
  text	Σ	0..0	string	There are no (further) constraints on this element Element id Immunization.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: C*E.9. But note many systems use C*E.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
  doseQuantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Comments 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. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists() sqty-1: The comparator is not used on a SimpleQuantity comparator.empty() Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXA-6 / RXA-7 rim: .doseQuantity
  id		0..0	string	There are no (further) constraints on this element Element id Immunization.doseQuantity.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.doseQuantity.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  value	Σ	0..1	decimal	Element id Immunization.doseQuantity.value Short description Numerical value (with implicit precision) Definition The value of the measured amount. The value includes an implicit precision in the presentation of the value. Requirements Precision is handled implicitly in almost all cases of measurement. Comments See Mappings Data type decimal Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SN.2 / CQ - N/A rim: PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value source-PIR: H33_VACCINATION_MASTER.CC_VOLUME source-PHSL: dosage
  comparator	Σ ?!	0..0	codeBinding	There are no (further) constraints on this element Element id Immunization.doseQuantity.comparator Short description < | <= | >= | > - how to understand the value Definition Not allowed to be used in this context Requirements Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Meaning when missing If there is no comparator, then there is no modification of the value Data type code Binding How the Quantity should be understood and represented. QuantityComparator (required) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: SN.1 / CQ.1 rim: IVL properties
  unit	Σ	0..1	string	Element id Immunization.doseQuantity.unit Short description Unit representation Definition A human-readable form of the unit. Requirements There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. Comments See Mappings Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.unit source-PIR: H33_VACCINATION_MASTER.DOSAGE_UOM_CNCPT_ID source-PHSL: dosageUOMDescription
  system	Σ I	0..0	uri	There are no (further) constraints on this element Element id Immunization.doseQuantity.system Short description System that defines coded unit form Definition The identification of the system that provides the coded form of the unit. Requirements Need to know the system that defines the coded form of the unit. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: CO.codeSystem, PQ.translation.codeSystem
  code	Σ	0..0	code	There are no (further) constraints on this element Element id Immunization.doseQuantity.code Short description Coded form of the unit Definition A computer processable form of the unit in some unit representation system. Requirements Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. Comments The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. Data type code Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: (see OBX.6 etc.) / CQ.2 rim: PQ.code, MO.currency, PQ.translation.code
  performer	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.performer Short description Who performed event Definition Indicates who performed the immunization event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition 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). Requirements 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  function	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.performer.function Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Comments 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. Data type CodeableConcept Binding The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.function rim: .participation.functionCode
  actor	Σ I	1..1	Reference(Practitioner | PractitionerRole | Organization)	Element id Immunization.performer.actor Short description Provider who administered the vaccine Definition Provider who administered the vaccine Comments When the individual practitioner who performed the action is known, it is best to send. Data type Reference(Practitioner | PractitionerRole | Organization) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor w5: FiveWs.actor rim: .player
  id		0..1	string	There are no (further) constraints on this element Element id Immunization.performer.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
  extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.performer.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) ext-1: Must have either extensions or value[x], not both extension.exists() != value.exists() Mappings rim: n/a rim: N/A
  reference	Σ I	0..1	string	Element id Immunization.performer.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments fullURL of Panorama + 'Practitioner' + PIR Provider ID Data type string Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Immunization.performer.actor.type Short description Type the reference refers to (e.g. "Patient") Definition The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). Comments This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count()) Mappings rim: n/a rim: N/A
  identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Immunization.performer.actor.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands