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Ontario Immunization Repository Implementation Guide -v1.0.0-draft1
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    1. Index
    2. FHIR Artifacts
    3. Interactions
    4. Submit Immunization Document Bundle

For a full list of available versions, see the Directory of published versions

4.1.1. Submit Immunization Document Bundle

The Submit Immunization interaction is used to transfer immunization records to the IR. This encompasses both Create and Update.

4.1.1.1. Scope

This transaction involves a request by a Point of Service system to transfer an Immunization Bundle, including a Composition and other linked resources to the IR Solution. The request is received by the IR which stores the received Bundle and returns an HTTP response code and an OperationOutcome resource if applicable.

For example, a user at a HIC site records an Immunization in a Point of Care System. The Point of Care System will extract and assemble the immunization record as per the Ontario Immunization Repository HL7 FHIR Implementation Guide specification and submit it to the IR, where it is available for viewing by other IR Consumers.

4.1.1.2. Interaction Diagram

diagramSubmitImmunization

Actor: Client Application

Role: Submits an immunization document bundle containing a Composition and linked resources that may be populated with data to the IR Solution.

Actor: IR Solution

Role: Receives and stores Immunization document Bundles from the Client Application.

4.1.1.3. Specification

The FHIR IR specification is based on the HL7 FHIR R4 Create operation.

Immunization Create Request

The Create Request will create a new immunization record based upon information available from the immunization source, if one does not already exist in the repository. If there is already an existing record, the newly submitted version will replace the existing version in the repository.

The Immunization Document Bundle Create Request creates a new resource in a server-assigned location. The create interaction is performed by an HTTP POST command as shown:

POST [base-submit]/Bundle/

Immunization Create Response

  • OperationOutcome

Immunization Conditional Update Request

The Conditional Update Request will update an existing immunization record based upon information available from the immunization record source.

PUT [base-submit]/Bundle?[search parameters]

The following parameters shall be used for conditional update:

  • identifier (Source Submitter ID + Immunization Record ID)

Immunization Conditional Updated Response

  • OperationOutcome

Example Create Bundle Message

HTTP Method:

POST

Headers:

Content-Type: application/fhir+json

Address:

[base-submit]/Bundle/

Message Body:

[Link to Example Bundle]

4.1.1.4. Supported Profiles

Profile Immunization Scenario
Bundle (Document) ✓
Composition ✓
Immunization (Submission) ✓
Patient (Submission) ✓
Practitioner (Submission) ✓
PractitionerRole (Submission) ✓
Organization (Submission) ✓
Location (Submission) ✓
OperationOutcome ✓

4.1.1.5. Extensions

Extension URL Element Description
basedON Immunization.extension References to the MedicationRequest profile on which the immunization is based.

4.1.1.6. Expected Behavior

Legend
code = OperationOutcome.issue.code
severity = OperationOutcome.issue.severity
details.coding.code=OperationOutcome.issue.details.coding.code
details.coding.display=OperationOutcome.issue.details.coding.display
details.text = OperationOutcome.issue.details.coding.text
diagnostics = OperationOutcome.issue.diagnostics


HTTP Status Scenario Description severity code details.coding.code details.coding.display details.text/diagnostics
200 OK Resource successfully updated
201 Created Resource successfully created (there might be informational or warning findings)
201 Created Ontario HCN existence in provincial registry warning business-rule FHIR_PTNT_2002 HCN does not exist in PCR
201 Created Ontario HCN validity warning business-rule FHIR_PTNT_2003 Multiple patients for provided HCN
201 Created Hospital MRN existence in provincial registry warning business-rule FHIR_PTNT_2007 Hospital MRN does not exist in PCR
201 Created Hospital MRN validity warning business-rule FHIR_PTNT_2008 Multiple patients found for hospital MRN
201 Created Provider status in provincial registry warning business-rule FHIR_PROV_2002 Provider is not active in PPR
201 Created Contributed provider first or middle name validity warning business-rule FHIR_PROV_2006 submitted provider first or middle name %s does not match the provider first or middle name in provincial provider registry %s
400 Bad Request Missing security token error required Missing required security token: PIN
401 Unauthorized Failed authentication error security Authorization is required for the interaction that was attempted
409 Conflict Conflict with the current state of a resource error processing Can not create resource of type [X] as it would create a duplicate unique index matching query [X]
412 Precondition Failed Access to the target resource has been denied error processing Failed to UPDATE resource with match URL [X] because this search matched [X] resources
422 Content validation Ontario HCN format validation error business-rule FHIR_PTNT_2001 Invalid Ontario HCN
422 Content validation PCR DOB existence in provincial registry error business-rule FHIR_PTNT_2004 PCR DOB does not exist
422 Content validation Contributed patient DOB validity error business-rule FHIR_PTNT_2005 Patient DOB does not match PCR DOB
422 Content validation Hospital MRN format validity error business-rule FHIR_PTNT_2006 Hospital MRN format invalid
422 Content validation Pharmacy MRN format validity error business-rule FHIR_PTNT_2009 Pharmacy MRN format invalid
422 Content validation Anonymous records not accepted error business-rule FHIR_PTNT_2010 Anonymous records for Harm Reduction are not accepted by IR. No action required.
422 Content validation DOB existence in provincial registry error business-rule FHIR_PTNT_2011 DOB does not exist in PCR for provided MRN
422 Content validation Contributed patient DOB for the MRN validity error business-rule FHIR_PTNT_2012 Patient DOB provided does not match DOB in PCR for this MRN
422 Content validation Patient DOB present in contributed record error business-rule FHIR_PTNT_1001 Medication administration patient does not have DOB
422 Content validation Patient has up to three phone numbers error business-rule FHIR_PTNT_1002 Patient cannot have more than three phone numbers
422 Content validation Patient has one to three addresses error business-rule FHIR_PTNT_1003 Patient must have at least one address and a maximum of three
422 Content validation Provider existence in provincial registry error business-rule FHIR_PROV_2001 Provider does not exist in PPR
422 Content validation Organization status in provincial registry error business-rule FHIR_PROV_2003 Organization.identifier: <> Pharmacy is inactive in PPR
422 Content validation Contributed provider last name validity error business-rule FHIR_PROV_2005 submitted provider last name, %s, does not match the provider last name in the provincial provider registry, %s
422 Content validation Organization contact mandatory error business-rule FHIR_ORG_1001 Organization phone and fax mandatory for medication dispenses
422 Content validation Organization address mandatory error business-rule FHIR_ORG_1002 Organization address mandatory for medication dispenses
422 Content validation Organization submitted not allowed for contributor error business-rule FHIR_ORG_2001 Organization submitted not allowed for contributor
422 Content validation Missing required attribute error business-rule FHIR_IG_1000 Determined by IG $validate operation
422 Content validation Missing required attribute error business-rule IN_0048 When $validate does not return 200 ok in cdf_datain_fhir_ig_validation_processor
429 Too Many Requests Rate Limit error throttled Too Many Requests
500 Internal Server Error Unhandled Exception fatal exception Internal Error
Version: 1.0.0-draft1 FHIR Version: R4.0.1

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