Immunisations
Immunisations - Data Model
Patient Facing Services incorporates the GP Connect data model, this contains guidelines on how Providers need to populate each of the FHIR resources. It is advised to read the data model first, to understand how this is being populated by GP clinical systems.
The relevant profiles in the data model are as follows:
Immunization - CareConnect-GPC-Immunization-1
Observation - CareConnect-GPC-Observation-1 - (Observation is ancillary information to Immunizations. It does not carry details of an actual vaccination being given. If Consumers are only interested in the actual vaccinations, then you can ignore the Observations.)
However, not all clinical information stored on GP systems may be safe to display for the end user (patients / citizens). This guide is intended to help Consumers understand what is clinically safe and useful to display via PFS from the GP Connect data model. Please see the PFS recommendations below.
PFS Recommendation
Safe to display to patient / citizen - With a safety rating of 'High', 'Medium' or 'Low'.
Useful to display to patient / citizen - With a recommendation of 'Recommended' or 'Not recommended'.
For example, the element 'Id’ has a safety rating of ‘High’, meaning it can be shown via Patient Facing Services (PFS). However, we believe it may not be useful to display 'Not Recommended' for the patient / citizen. It’s worth noting, there are elements that will have no meaning or have any merit in being displayed such as ‘Id’. For example, some elements are just entities that link data together.
For further information on the labelling please visit Data model labels used within this guidance.
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| extension[parentPresent] | ||
| extension[recordedDate] | ||
| extension[vaccinationProcedure] | ||
| identifier | ||
| status | ||
| notGiven | ||
| vaccineCode | ||
| patient | ||
| encounter | ||
| date | ||
| primarySource | ||
| reportOrigin | ||
| location | ||
| manufacturer | ||
| lotNumber | ||
| expirationDate | ||
| site | ||
| route | ||
| doseQuantity | ||
| practitioner | ||
| practitioner.role | ||
| practitioner.actor | ||
| note | ||
| explanation.reason | ||
| explanation.reasonNotGiven | ||
| vaccinationProtocol | ||
| vaccinationProtocol.doseSequence | ||
| vaccinationProtocol.description | ||
| vaccinationProtocol.seriesDoses | ||
| vaccinationProtocol.targetDisease | ||
| vaccinationProtocol.doseStatus |
Further Information
Note - Not every element will have further information. Further information is to simply give additional context and perspective to the element.
extension[recordedDate]
Use with caution for PFS
Further information
The element is an audit trail date or equivalent for the record. This is when it is manually entered into the GP clinical system (or first captured), It is not the date of the immunisation. However, there can be instances where the same date is recorded contemporaneously.
This is not considered the most significant date to a patient / citizen. If used, it should be presented in a less prominent way.
extension[vaccinationProcedure]
Further information
It is recommended your primary identifier (or the type of vaccine) is the ‘extension[vaccinationProcedure]’. Where there is additional useful information in ‘vaccineCode’, you may want to also present that information.
This element is a CodeableConcept. The element may include more than one code for the medication and/or more than one text description. Consumers are strongly advised to use the original term text as the primary text displayed to the end user (patient / citizen). For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
status
Not advised for PFS
Further information
The element has values consisting of 'Complete' or 'Entered in error'. Our approach with 'Entered in error' is not to be shown via PFS. Therefore, displaying just the ‘Complete’ value (fixed value) will have no meaning or can be misinterpreted by the patient / citizen.
notGiven
Not advised for PFS
Further information
The immunization clinical area is designed to support three types of records as captured in GP clinical systems:
- Immunisation administration
- Intended immunisation administration, which did not occur
- Supplementary information related to the process of an immunisation (E.g. sending a letter noting a patient that did not attend their immunisation)
We believe that the majority of the immunisation use cases will be necessary for the first option on the list. You can ensure you only receive that information by setting the optional parameters appropriately. Should you require about option 2, contact the team ( GP Connect team inbox). For option 3 refer to Uncategorised data for the structure of the data to be received in our recommendations around the appropriate use of the elements.
vaccineCode
Use with caution for PFS
Further information
It is recommended your primary identifier (or the type of vaccine) is the ‘extension[vaccinationProcedure]’. Where there is additional useful information in ‘vaccineCode’, you may want to also present that information.
Note – not all GP clinical systems support ‘vaccineCode’.
This element is a CodeableConcept. The element may include more than one code for the medication and/or more one text description. Consumers are strongly advised to use the original term text as the primary text displayed to the end user (patient / citizen). For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
encounter
Further information
Displaying the element alone will have no meaning to the patient. This is not advised and may cause more confusion than benefit to the user. If a clear business case is portrayed, then this can be utilised in conjunction with other information to represent information free from ambiguity or confusion to the patient / citizen.
The element may be useful to show when the vaccine had been given. This can be a linked to the encounter it was given. The elements content is not to be displayed alone but to be used as a link.
date
Further information
If the element 'date' is not populated, it is advised to use 'not known' as the second option. However, this does not apply to every use case, it will depend on the requirement around the use case.
Note – Not all vaccination dates recorded are in the full dd-mm-yyyy format. Vaccination records may be based on patient recollection or historic paper records. In certain cases, only the approximate date will be known or not at all. Therefore, this could be absent, partial or a full date. Please consider the above before developing a sorting / filtering functionality. It is advised to make this clear as possible to the patient / citizen using the application.
primarySource
Use with caution for PFS
Further information
Please be cautious as the default for this Boolean element is set to use true where it is not actually clear in the vaccination record (within in the GP clinical system) as to whether it is a primary or secondary source record. This can be deemed as unreliable. For example, there may be instances where ‘primarySource’ is unknown, whilst a true or false output will still need to be captured.
reportOrigin
Further information
The ‘reportOrigin‘ is for when ‘primarySource’ is set as false. For example, in this case the origin may be set as ‘school nurse’, otherwise the report origin is recognised as the GP practice.
Not many GP clinical systems capture this information. It is likely that if there is a record from a secondary source, it won’t be identified as such and won’t state what the actual origin of the record is.
This element is a CodeableConcept. The element may include more than one code for the medication and/or more one text description. Consumers are strongly advised to use the original term text as the primary text displayed to the end user (patient / citizen). For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
location
Further information
This element is specifically stating the physical location (building) of where the vaccination took place, not the where on the body has the patient been injected (body site). This may not be considered as useful information within the Immunisation section.
expirationDate
Further information
It is advised to highlight that the expiry date is not suggesting the expiry after it has been administered. But simply when the vaccine expires before use.
explanation.reason
Further information
This element is a CodeableConcept. The element may include more than one code for the medication and/or more one text description. Consumers are strongly advised to use the original term text as the primary text displayed to the end user (patient / citizen). For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -