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HdBe-Vaccinatie

CBBConceptStatus
HdBe-Vaccination

Immunisatie kan worden gedefinieerd als “Het opwekken van natuurlijke immuniteit tegen ziekteverwekkers door middel van vaccinatie (actieve immunisatie) of door toediening van immunoglobulinen (passieve immunisatie)”.

In deze bouwsteen worden alleen de toegediende vaccinaties opgenomen. De toediening van immunoglobulines maakt deel uit van het medicatieoverzicht. Vaccinaties hebben levenslang relevantie.

De meeste vaccinaties worden in Nederland uitgevoerd in het kader van het Rijksvaccinatieprogramma (RVP). RVP informatie is vooral van belang bij kinderen.

Vaccinaties zijn ook relevant bij volwassen patiënten zoals transplantatiepatiënten, dialysepatiënten en patiënten met een status na miltextirpatie. Daarnaast zijn er specifieke indicaties voor de vaccinatie van risicogroepen, zoals reizigers, professionals die met bloed in aanraking komen of patiënten met verwondingen, een verminderde afweer of verhoogd risico.

Purpose

Het vastleggen van reeds bij een patiënt uitgevoerde vaccinaties is o.a. van belang voor de diagnostiek van infectieziekten en de indicatiestelling en planning van (re)vaccinatie.

Evidence Base

De documentatie van vaccinaties bevat veel minder gegevenselementen dan die van medicatie. Bij medicatie gaat het om een lopend order proces met veel deelnemers (patiënt, voorschrijver, apotheek, toediener) en complexe, zeer gevarieerde details.

Bij vaccinatie gaat het alleen om wat is toegediend en wanneer.

References

  1. G-standaard [Online] Beschikbaar op: http://www.z-index.nl/ [Geraadpleegd: 23 februari 2015].
  2. Rijksvaccinatieprogramma [Online] Beschikbaar op: http://www.rivm.nl/Onderwerpen/Onderwerpen/R/Rijksvaccinatieprogramma [Geraadpleegd: 23 februari 2015].
active

id0..1string
extensionI0..*Extension
ProductCode0..1CodeableConceptBinding
DoseI0..1Quantity
VaccinationDate0..1dateTime
LocationI0..1Reference(HdBe-HealthcareOrganization)
AdministratorI0..1Reference(HdBe-HealthProfessional)
Comment0..1string

Vaccination0..*
Vaccination.ProductCodeCodeableConcept0..1
Vaccination.DoseQuantity0..1
Vaccination.VaccinationDatedateTime0..1
Vaccination.LocationReference(HdBe-HealthcareOrganization)0..1
Vaccination.AdministratorReference(HdBe-HealthProfessional)0..1
Vaccination.Commentstring0..1


Vaccination
DefinitionRoot concept of the Vaccination information model. This root concept contains all data elements of the Vaccination information model.
Cardinality0...*
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Vaccination.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Vaccination.extension
DefinitionMay 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Vaccination.ProductCode
DefinitionThe product code of the vaccine administered.
Cardinality0...1
TypeCodeableConcept
Binding

Vaccine Product codes

VaccineProduct (extensible)
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.

Invariants
  • 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
Vaccination.Dose
DefinitionThe amount of product administered shown in milliliters. In most cases, the entire product is administered; in some cases, a described part of the product is administered.
Cardinality0...1
TypeQuantity
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.

Invariants
  • 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()
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
Vaccination.VaccinationDate
DefinitionDate (and if possible time) that the vaccine was administered.
Cardinality0...1
TypedateTime
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Vaccination.Location
DefinitionThe healthcare center where the vaccination is or will be carried out.
Cardinality0...1
TypeReference(HdBe-HealthcareOrganization)
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.

Invariants
  • 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)
Vaccination.Administrator
DefinitionThe health professional by whom the vaccination was done or will be done.
Cardinality0...1
TypeReference(HdBe-HealthProfessional)
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.

Invariants
  • 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)
Vaccination.Comment
DefinitionFree text explanation. Examples of commonly used explanations are: - "Vaccination according to the National Immunisation Program". - "Not according to the National Immunisation Program", followed by further explanation. - "Unknown"
Cardinality0...1
Typestring
Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a

Example instances

vaccination
ProductCode 836393002 - Rabies lyssavirus antigen-containing vaccine product (code by SNOMED CT)
Dose
VaccinationDate 2018-02-06
Administrator --
Administrator Reference to HealthProfessional (E. Penninx)
Location Reference to HealthcareOrganization (Enterprise Hospital Ziekenhuis)
Comment Visit to Peru.

zib Vaccination-v4.0 difference

Concept Category Description
Description textual Removed all text about planned vaccinations from the Concept, Purpose and Evidence Base sections.
Description.concept textual Removed Dutch context.
ProductCode terminology Replaced all ValueSets by the ValueSet VaccineProduct with the descendants of SNOMED CT concept 787859002 (Vaccine Product) and loosened the binding from required to extensible.
ProductCode textual Removed contextual information about the multiple valueSets.
VaccinationDate textual Removed text about planned vaccinations, as this CBB is only used for administered vaccinations .
Location element Added element to accommodate healthcareProviders as the location (naming conform pre-adopt of higher zib version).(zib-1447).
Administrator textual Fixed incorrect mentioning of healthcareProvider with health professional as the administrator (zib-1447).
Location textual Replaced 'is or or' with 'is or'.



Terminology Bindings

PathNameStrengthURL
ProductCodeVaccineProductextensiblehttps://fhir.healthdata.be/ValueSet/VaccineProduct