DwImmunization
Purpose
The purpose of this resource to provide documentation of current and historical vaccine administration and will include patient refusal of vaccines.
| DwImmunization (Immunization) | C | Immunization | There are no (further) constraints on this element Element idImmunizationShort description Immunization event information DefinitionDescribes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
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| id | S Σ | 0..1 | id | Element idImmunization.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idImmunization.metaShort description Metadata about the resource DefinitionThe 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.meta.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.meta.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idImmunization.meta.versionIdShort description Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| lastUpdated | S Σ | 0..1 | instant | Element idImmunization.meta.lastUpdatedShort description When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| source | S Σ | 0..1 | uri | Element idImmunization.meta.sourceShort description Identifies where the resource comes from DefinitionA 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. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idImmunization.meta.profileShort description Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. canonical(StructureDefinition) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| security | S Σ | 0..* | CodingBinding | Element idImmunization.meta.securityShort description Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. EMR Support:
CHR: Populated when the patient record is restricted. Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.meta.tagShort description Tags applied to this resource DefinitionTags 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. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.implicitRulesShort description A set of rules under which this content was created DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idImmunization.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idImmunization.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idImmunization.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| identifier | S | 0..* | Identifier | Element idImmunization.identifierShort description Business identifier DefinitionA unique identifier assigned to this immunization record. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| status | S Σ ?! | 1..1 | codeBinding | Element idImmunization.statusShort description completed | entered-in-error | not-done DefinitionIndicates the current status of the immunization event. EMR Support:
CHR: Set to "completed" when an injection date is recorded; "not-done" when the patient refused (refusal date recorded, no injection date); "entered-in-error" when the record has been archived or deleted. PS: "Refused treatment" = not-done Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| statusReason | S | 0..1 | CodeableConcept | Element idImmunization.statusReasonShort description Reason not done DefinitionIndicates the reason the immunization event was not performed. EMR Support:
CHR: Only populated when the status is "not-done" (i.e., the patient refused the injection). The code will be PATOBJ (patient objection), display "patient objection", and text "Patient Refused". PSS does not handle all reasons, but does handle patient refusal MA & CHR has a cancel reason that would need to be mapped into a code. " Patient Declined" and "Refused treatment" will map to "PATOBJ" This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.statusReason.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.statusReason.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.statusReason.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.statusReason.coding.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.statusReason.coding.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.statusReason.coding.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.statusReason.coding.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| code | Σ | 0..1 | code | Element idImmunization.statusReason.coding.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. PS & CHR - Code will be PATOBJ when immunization is refused Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| display | Σ | 0..1 | string | Element idImmunization.statusReason.coding.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. PS & CHR - display patient objection when flagged as refused MA - Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.statusReason.coding.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | Σ | 0..1 | string | Element idImmunization.statusReason.textShort description Plain text representation of the concept DefinitionA 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. 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. PS - Refused Treatment CHR - Patient Refused The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| vaccineCode | S Σ | 1..1 | CodeableConcept | Element idImmunization.vaccineCodeShort description Vaccine product administered DefinitionVaccine that was administered or was to be administered. EMR Support:
The code for vaccine product administered. VaccineAdministeredValueSet (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.vaccineCode.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | Element idImmunization.vaccineCode.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by system(Value) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| absentOrUnknownImmunization | S Σ | 0..* | CodingBinding | Element idImmunization.vaccineCode.coding:absentOrUnknownImmunizationShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. EMR Support:
Usage Note: Where there are no immunizations recorded for the patient the "no known immunization" code will be provided. Note: MA pipeline currently emits the ValueSet URL as coding.system instead of the CodeSystem URL; pipeline fix required. http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| system | S Σ | 1..1 | uriFixed Value | Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ipsMappings
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| version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.vaccineCode.coding:absentOrUnknownImmunization.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | S Σ | 0..1 | string | Element idImmunization.vaccineCode.textShort description Plain text representation of the concept DefinitionA 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. 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. EMR Support:
CHR: Target mapping is a free-text field composed from the Name, Drug Code, Trade Name, and Strength fields in the Injections UI. The vaccine name can be chosen from a clinic-wide list or typed in manually; strength is a qualitative free-text descriptor of the vaccine product (e.g. "Strong") with no structured home elsewhere in the resource. Note: the current pipeline only maps the Name field — Drug Code, Trade Name, and Strength are not yet concatenated in. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| patient | S Σ C | 1..1 | Reference(DwPatient) | Element idImmunization.patientShort description Who was immunized DefinitionThe patient who either received or did not receive the immunization. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| encounter | S C | 0..1 | Reference(DwEncounter) | Element idImmunization.encounterShort description Encounter immunization was part of DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of. EMR Support:
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| occurrence[x] | S Σ | 1..1 | Element idImmunization.occurrence[x]Short description Vaccine administration date DefinitionDate vaccine administered or was to be administered. EMR Support:
CHR: Uses the injection date when available; otherwise uses the refusal date. The date may be masked to year or month only when full precision is not recorded. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| occurrenceDateTime | dateTime | There are no (further) constraints on this element Data type | ||||
| occurrenceString | string | There are no (further) constraints on this element Data type | ||||
| recorded | S | 0..1 | dateTime | Element idImmunization.recordedShort description When the immunization was first captured in the subject's record DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event. EMR Support:
CHR: The date the immunization record was created in the system. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| primarySource | S Σ | 0..1 | boolean | Element idImmunization.primarySourceShort description Indicates context the data was recorded in DefinitionAn 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. EMR Support:
CHR: Set to false when the immunization was administered by an external provider; true otherwise. PS: Started/Performed by external provider = false otherwise it will be true MA: N/A no way to reliably tell who performed the immunization Reflects the "reliability" of the content. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| reportOrigin | S | 0..1 | CodeableConcept | Element idImmunization.reportOriginShort description Indicates the source of a secondarily reported record DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. EMR Support:
CHR: Only populated when primarySource is false. Contains the name of the external provider who administered the vaccine. PS: Provider Name where populated Should not be populated if primarySource = True, not required even if primarySource = False. The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| location | C | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idImmunization.locationShort description Where immunization occurred DefinitionThe service delivery location where the vaccine administration occurred. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| manufacturer | S C | 0..1 | Reference(Organization) | Element idImmunization.manufacturerShort description Vaccine manufacturer DefinitionName of vaccine manufacturer. EMR Support:
CHR: Free-text field from the Manufacturer field in the Injections UI; emitted as manufacturer.display only (no resolvable Organization resource). PSS - captured as a text field (OMD requirement) - may be populated in display MA - captured as a text field (OMD requirement) - may be populated in display The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| lotNumber | S | 0..1 | string | Element idImmunization.lotNumberShort description Vaccine lot number DefinitionLot number of the vaccine product. EMR Support:
CHR: The lot number of the vaccine. Note that some users may also enter the expiry date in this field. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| expirationDate | S | 0..1 | date | Element idImmunization.expirationDateShort description Vaccine expiration date DefinitionDate vaccine batch expires. EMR Support:
CHR: There is no dedicated expiry date field; this is populated when the expiry date has been explicitly recorded (it may also appear in the lot number field). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| site | S | 0..1 | CodeableConcept | Element idImmunization.siteShort description Body site vaccine was administered DefinitionBody site where vaccine was administered. EMR Support:
CHR: Populated when the injection site is documented. Standard sites include left/right deltoid, left/right forearm, and left/right gluteus. Other sites are provided as text only without a coded value. The site at which the vaccine was administered. CodesForImmunizationSiteOfAdministration (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.site.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.site.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | Element idImmunization.site.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Type) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| siteCVC | Σ | 0..* | CodingBinding | Element idImmunization.site.coding:siteCVCShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. https://fhir.infoway-inforoute.ca/ValueSet/immunizationadministrationanatomicalsitecode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.site.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| route | S | 0..1 | CodeableConcept | Element idImmunization.routeShort description How vaccine entered body DefinitionThe path by which the vaccine product is taken into the body. EMR Support:
CHR: Populated when the route of administration is documented. If the route is not available in the standard list, "Other" is selected and the actual route may be recorded in the comments field. The route by which the vaccine was administered. ImmunizationRouteCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.route.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.route.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | Element idImmunization.route.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Type) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| routeCVC | Σ | 0..* | CodingBinding | Element idImmunization.route.coding:routeCVCShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. https://fhir.infoway-inforoute.ca/ValueSet/immunizationrouteofadministrationcode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.route.coding:routeCVC.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.route.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| doseQuantity | S C | 0..1 | SimpleQuantity | Element idImmunization.doseQuantityShort description Amount of vaccine administered DefinitionThe quantity of vaccine product that was administered. EMR Support:
CHR: Dose amount and unit when documented (Dose / Unit fields in the Injections UI). Note: the separate Strength field is a qualitative free-text descriptor of the vaccine product, not a structured quantity — it does NOT feed doseQuantity; it is folded into vaccineCode.text instead. PSS - will be provided when entered MA - will be provided when documented 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| performer | S Σ | 0..* | BackboneElement | Element idImmunization.performerShort description Who performed event DefinitionIndicates who performed the immunization event. EMR Support:
CHR: Only populated when the vaccine was administered at the clinic. Not provided when the immunization was performed by an external provider. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| function | Σ | 0..1 | CodeableConceptBinding | Element idImmunization.performer.functionShort description What type of performance was done DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.). MA - "Vaccine Administered" here = AP (administering provider) not provided when "Vaccine Administered" =elsewhere PSS - AP or not provide when "Performed by External Provider" 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. The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.function.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.performer.function.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | Element idImmunization.performer.function.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. PSS - AP for any immunizations given by the clinic Not provided for immunizations given elsewhere and being recorded in the EMR MA - TBD 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.performer.function.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| actor | Σ C | 1..1 | Reference(DwOrganization | DwPractitioner | DwPractitionerRole) | Element idImmunization.performer.actorShort description Individual or organization who was performing DefinitionThe practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send. Reference(DwOrganization | DwPractitioner | DwPractitionerRole) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| note | S Σ | 0..* | Annotation | Element idImmunization.noteShort description Additional immunization notes DefinitionExtra information about the immunization that is not conveyed by the other attributes. EMR Support:
CHR: Populated from the Comments field and the Instructions field on the injection record. Note: the Instructions field is labelled "legacy: no longer used" in older mapping documents — that label is incorrect. When the immunization was administered by an external provider, the external provider's name may also be included as a note. PSS - Will provide notes from comment field in immunization window if present and also provide comments that are appended to the treatment as a separate note MA - Will provide notes from Observation template and Task Template For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| reasonCode | S | 0..* | CodeableConcept | Element idImmunization.reasonCodeShort description Why immunization occurred DefinitionReasons why the vaccine was administered. EMR Support:
CHR: Does not capture a clinical indication for administering the vaccine. Note: PATOBJ (patient objection/refusal) is a status reason, not a clinical indication — it belongs in statusReason only and must NOT be placed in reasonCode. PSS - Provide documentation from Indication field when documented may be ICD-9, ICD-10 Encode or SNOMED MA - Provide documentation from reason field when documented may be ICD-9 or SNOMED 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. Unordered, Open, by coding.system(Value) BindingThe reason why a vaccine was administered. ImmunizationReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| ICD9Code | 0..* | CodeableConcept | Element idImmunization.reasonCode:ICD9CodeShort description Why immunization occurred DefinitionReasons why the vaccine was administered. 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. The reason why a vaccine was administered. ImmunizationReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | CodingBinding | Element idImmunization.reasonCode:ICD9Code.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD9CM (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| system | Σ | 1..1 | uriFixed Value | Element idImmunization.reasonCode:ICD9Code.coding.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
http://terminology.hl7.org/CodeSystem/icd9cmMappings
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.coding.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD9Code.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| ICD10Code | 0..* | CodeableConcept | Element idImmunization.reasonCode:ICD10CodeShort description Why immunization occurred DefinitionReasons why the vaccine was administered. 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. The reason why a vaccine was administered. ImmunizationReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| system | Σ | 1..1 | uriFixed Value | Element idImmunization.reasonCode:ICD10Code.coding.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
http://hl7.org/fhir/sid/icd-10Mappings
| ||
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.coding.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ICD10Code.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| SNOMEDCode | 0..* | CodeableConcept | Element idImmunization.reasonCode:SNOMEDCodeShort description Why immunization occurred DefinitionReasons why the vaccine was administered. 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. The reason why a vaccine was administered. ImmunizationReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| coding | Σ | 0..* | CodingBinding | Element idImmunization.reasonCode:SNOMEDCode.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. https://fhir.infoway-inforoute.ca/ValueSet/healthconditioncode (preferred) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| system | Σ | 1..1 | uriFixed Value | Element idImmunization.reasonCode:SNOMEDCode.coding.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
http://snomed.info/sctMappings
| ||
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.coding.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:SNOMEDCode.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| ENCODECode | 0..* | CodeableConcept | Element idImmunization.reasonCode:ENCODECodeShort description Why immunization occurred DefinitionReasons why the vaccine was administered. 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. The reason why a vaccine was administered. ImmunizationReasonCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.codingShort description Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| system | Σ | 1..1 | uriFixed Value | Element idImmunization.reasonCode:ENCODECode.coding.systemShort description Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
https://www.insite-fm.com/encode-fmMappings
| ||
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.versionShort description Version of the system - if relevant DefinitionThe 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.codeShort description Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.displayShort description Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.coding.userSelectedShort description If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reasonCode:ENCODECode.textShort description Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| reasonReference | C | 0..* | Reference(Condition | DiagnosticReport | Observation) | There are no (further) constraints on this element Element idImmunization.reasonReferenceShort description Why immunization occurred DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered. 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. Reference(Condition | DiagnosticReport | Observation) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| isSubpotent | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.isSubpotentShort description Dose potency DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. By default, a dose should be considered to be potent. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| subpotentReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.subpotentReasonShort description Reason for being subpotent DefinitionReason why a dose is considered to be subpotent. 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. The reason why a dose is considered to be subpotent. ImmunizationSubpotentReason (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| education | C | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.educationShort description Educational material presented to patient DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.education.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| documentType | 0..1 | string | There are no (further) constraints on this element Element idImmunization.education.documentTypeShort description Educational material document identifier DefinitionIdentifier of the material presented to the patient. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| reference | 0..1 | uri | There are no (further) constraints on this element Element idImmunization.education.referenceShort description Educational material reference pointer DefinitionReference pointer to the educational material given to the patient if the information was on line. see http://en.wikipedia.org/wiki/Uniform_resource_identifier The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| publicationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.publicationDateShort description Educational material publication date DefinitionDate the educational material was published. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| presentationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.education.presentationDateShort description Educational material presentation date DefinitionDate the educational material was given to the patient. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| programEligibility | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.programEligibilityShort description Patient eligibility for a vaccination program DefinitionIndicates a patient's eligibility for a funding program. 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. The patient's eligibility for a vaccation program. ImmunizationProgramEligibility (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| fundingSource | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idImmunization.fundingSourceShort description Funding source for the vaccine DefinitionIndicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). 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. The source of funding used to purchase the vaccine administered. ImmunizationFundingSource (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| reaction | 0..* | BackboneElement | Element idImmunization.reactionShort description Details of a reaction that follows immunization DefinitionCategorical data indicating that an adverse event is associated in time to an immunization. EMR Support:
PSS - When a reaction is recorded against a vaccine a reference to the Allergy Resource will be provided. A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.reaction.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| |||
| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.reaction.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| date | 0..1 | dateTime | There are no (further) constraints on this element Element idImmunization.reaction.dateShort description When reaction started DefinitionDate of reaction to the immunization. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| detail | C | 0..1 | Reference(Observation) | There are no (further) constraints on this element Element idImmunization.reaction.detailShort description Additional information on reaction DefinitionDetails of the reaction. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| reported | 0..1 | boolean | There are no (further) constraints on this element Element idImmunization.reaction.reportedShort description Indicates self-reported reaction DefinitionSelf-reported indicator. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| protocolApplied | 0..* | BackboneElement | There are no (further) constraints on this element Element idImmunization.protocolAppliedShort description Protocol followed by the provider DefinitionThe protocol (set of recommendations) being followed by the provider who administered the dose. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| |||
| id | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.extensionShort description Additional content defined by implementations Alternate namesextensions, user content 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idImmunization.protocolApplied.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| series | 0..1 | string | There are no (further) constraints on this element Element idImmunization.protocolApplied.seriesShort description Name of vaccine series DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| authority | C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idImmunization.protocolApplied.authorityShort description Who is responsible for publishing the recommendations DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed. 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. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| targetDisease | 0..* | CodeableConcept | There are no (further) constraints on this element Element idImmunization.protocolApplied.targetDiseaseShort description Vaccine preventatable disease being targetted DefinitionThe vaccine preventable disease the dose is being administered against. 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. The vaccine preventable disease the dose is being administered for. ImmunizationTargetDiseaseCodes (example) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| doseNumber[x] | 1..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.doseNumber[x]Short description Dose number within series DefinitionNominal position in a series. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| doseNumberPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||||
| doseNumberString | string | There are no (further) constraints on this element Data type | ||||
| seriesDoses[x] | 0..1 | There are no (further) constraints on this element Element idImmunization.protocolApplied.seriesDoses[x]Short description Recommended number of doses for immunity DefinitionThe recommended number of doses to achieve immunity. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| seriesDosesPositiveInt | positiveInt | There are no (further) constraints on this element Data type | ||||
| seriesDosesString | string | There are no (further) constraints on this element Data type |
Usage note
status
FHIR MA PSS CHR Not Done Refused treatment immunization.statusReason - This will be provided when a pateint refuses or declines an immunization.
immunization.vaccineCode.coding - For patients with no documented immunizations we will provide the absentOrUnknownImmunization code for "no known immunizations".
immunization.vaccineCode.text - This will provide the vaccine name as recorded in the EMR.
immunization.reportOrigin - This will be populated when recorded in the EMR.
immunization.reasonCode - This will be provided when documented in the EMR.
Bundle
Examples
CHR UI Navigation
The following table shows where each FHIR element comes from in CHR: the UI path a clinician follows to enter or view the data.
| FHIR Path | CHR Name | CHR UI Navigation |
|---|---|---|
Immunization |
Immunization (Type) | Patients → select patient → chart → Injections → Add injection → Type: Immunization |
Immunization.status |
Status (Completed / Refused / Not Done) | Patients → select patient → chart → Injections → Add / select injection → Type: Immunization |
Immunization.statusReason |
Refused | Patients → select patient → chart → Injections → Add / select injection |
Immunization.vaccineCode |
Injection Name / Drug Code / Trade Name / Strength | Patients → select patient → chart → Injections → Add / select injection |
Immunization.doseQuantity |
Dose / Unit | Patients → select patient → chart → Injections → Add / select injection |
Immunization.route |
Route | Patients → select patient → chart → Injections → Add / select injection |
Immunization.site |
Site Given | Patients → select patient → chart → Injections → Add / select injection |
Immunization.lotNumber |
Lot Number | Patients → select patient → chart → Injections → Add / select injection |
Immunization.expirationDate |
Expiry Date | Patients → select patient → chart → Injections → Add / select injection |
Immunization.performer |
Injected By | Patients → select patient → chart → Injections → Add / select injection |
Immunization.occurrenceDateTime |
Injected Date / Time | Patients → select patient → chart → Injections → Add / select injection |
Immunization.reportOrigin |
External | Patients → select patient → chart → Injections → Add / select injection |
Immunization.manufacturer |
Manufacturer | Patients → select patient → chart → Injections → Add / select injection |
Immunization.note |
Comments / Serum | Patients → select patient → chart → Injections → Add / select injection |
MA UI Navigation
The following table shows where each FHIR element comes from in MA: the UI path a clinician follows to enter or view the data.
| FHIR Path | MA Name | MA UI Navigation |
|---|---|---|
Immunization.status |
Immunization Status | Menu → Patients → select patient → Immunizations → Add / select entry |
Immunization.statusReason |
Cancel Reason | Menu → Patients → select patient → Immunizations → Add / select entry → Cancel Reason dropdown |
Immunization.vaccineCode |
Vaccine Name / Type | Menu → Patients → select patient → Immunizations → Add / select entry → Type field |
Immunization.occurrenceDateTime |
Immunization Date | Menu → Patients → select patient → Immunizations → Add / select entry → Immunization Date field |
Immunization.recorded |
Start Date / Created Date | Menu → Patients → select patient → Immunizations → Add / select entry |
Immunization.primarySource |
Vaccine Administered (Here / Elsewhere) | Menu → Patients → select patient → Immunizations → Add / select entry → Vaccine Administered dropdown |
Immunization.manufacturer |
Manufacturer | Menu → Patients → select patient → Immunizations → Add / select entry → Manufacturer field |
Immunization.lotNumber |
Lot # | Menu → Patients → select patient → Immunizations → Add / select entry → Lot # field |
Immunization.site |
Injection Site / Site | Menu → Patients → select patient → Immunizations → Add / select entry → Injection Site or Site field |
Immunization.route |
Route / Method | Menu → Patients → select patient → Immunizations → Add / select entry → Route or Method field |
Immunization.doseQuantity |
Dose | Menu → Patients → select patient → Immunizations → Add / select entry → Dose field |
Immunization.doseQuantity.unit |
Dose Unit of Measure | Menu → Patients → select patient → Immunizations → Add / select entry → Dose Unit of Measure field |
Immunization.performer |
Performer (Owner) | Menu → Patients → select patient → Immunizations → Add / select entry |
Immunization.reasonCode |
Indication / Reason | Menu → Patients → select patient → Immunizations → Add / select entry → Indication field |
Immunization.note |
Comments / Task Notes | Menu → Patients → select patient → Immunizations → Add / select entry → Notes / Comments field |