HL7 FHIR® CareConnect Baseline Profiles for STU3 (Draft Standard for Trial Use)

Important Announcement regarding CareConnect STU3

As of 19/09/2023, CareConnect has been deprecated and all development on the CareConnect FHIR assets has ceased.
Therefore, vendors looking to start new implementations or looking to update existing implementations should use UK Core R4 based solutions. Vendors continuing to implement CareConnect based solutions do so at their own risk and on the understanding that no maintenance or support will be available.

StructureDefinition-CareConnect-Immunization

This Immunization Resource describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party, and may include vaccine reaction information and what vaccination protocol was followed.

Snapshot View

Immunization	I		Immunization	There are no (further) constraints on this element Element id Immunization Short description Immunization event information Definition Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed. Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` imm-2: If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent. `(notGiven = true) or explanation.reasonNotGiven.empty()` imm-1: If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present `(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())` Mappings rim: Entity. Role, or Act v2: VXU_V04 rim: SubstanceAdministration w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id Immunization.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	Element id Immunization.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
parentPresent	I	0..1	Extension(boolean)	Element id Immunization.extension:parentPresent Short description Was a parent present at the Immunization Alternate names extensions, user content Definition Was a parent present at the Immunization. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(boolean) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ParentPresent-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
recordedDate	I	0..1	Extension(dateTime)	Element id Immunization.extension:recordedDate Short description The date that the Vaccination was recorded Alternate names extensions, user content Definition The date that the event was recorded on the system. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(dateTime) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DateRecorded-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
vaccinationProcedure	I	0..1	Extension(CodeableConcept)	Element id Immunization.extension:vaccinationProcedure Short description An extension to hold an immunization procedure code Alternate names extensions, user content Definition An extension to hold an immunization procedure code. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-VaccinationProcedure-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Immunization.identifier Short description Business identifier Definition A unique identifier assigned to this immunization record. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id w5: id
id		0..1	string	There are no (further) constraints on this element Element id Immunization.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Immunization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
status	Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed Definition Indicates the current status of the vaccination event. Comments Will generally be set to show that the immunization has been completed. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A set of codes indicating the current status of an Immunization Immunization Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.status rim: statusCode w5: status
notGiven	Σ ?!	1..1	boolean	There are no (further) constraints on this element Element id Immunization.notGiven Short description Flag for whether immunization was given Definition Indicates if the vaccination was or was not given. Comments This element is labeled as a modifier because it indicates that an immunization didn't happen. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.notDone rim: [actionNegationInd=true].reasonCode w5: status
vaccineCode		1..1	CodeableConceptBinding	Element id Immunization.vaccineCode Short description Vaccine product administered Definition Vaccine that was administered or was to be administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The code for vaccine product administered Care Connect Vaccine Code (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code w5: what
patient	I	1..1	Reference(CareConnect-Patient-1)	Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Patient-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject v2: PID-3 rim: .partipication[ttypeCode=].role w5: who.focus
encounter	I	0..1	Reference(CareConnect-Encounter-1)	Element id Immunization.encounter Short description Encounter administered as part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Encounter-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context v2: PV1-19 rim: component->EncounterEvent w5: context
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.date Short description Vaccination administration date Definition Date vaccine administered or was to be administered. Comments When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.occurrence.occurrenceDateTime v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value w5: when.init
primarySource		1..1	boolean	Element id Immunization.primarySource Short description Indicates context the data was recorded in Definition An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U) w5: who.source
reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record Definition The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Comments Should not be populated if primarySource = True, will not be required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. Immunization Origin Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member) w5: who.source
location	I	0..1	Reference(CareConnect-Location-1)	Element id Immunization.location Short description Where vaccination occurred Definition The service delivery location where the vaccine administration occurred. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Location-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV w5: where
manufacturer	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
lotNumber		0..1	string	There are no (further) constraints on this element Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The site at which the vaccine was administered Codes for Immunization Site of Administration (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.site.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.site.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.site.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The route by which the vaccine was administered Immunization Route Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	Element id Immunization.route.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Binding A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.route.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.route.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.route.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseQuantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXA-6 / RXA-7.1 rim: .doseQuantity
practitioner	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.practitioner Short description Who performed event Definition Indicates who or what performed the event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.practitioner.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
role	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.practitioner.role Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The role a practitioner plays in the immunization event Immunization Role Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.role rim: .participation.functionCode
actor	Σ I	1..1	Reference(CareConnect-Practitioner-1)	Element id Immunization.practitioner.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Practitioner-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor rim: .player w5: who.actor
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id Immunization.note Short description Vaccination notes Definition Extra information about the immunization that is not conveyed by the other attributes. Comments 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). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: Event.note rim: note
id		0..1	string	There are no (further) constraints on this element Element id Immunization.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
author[x]	Σ	0..1		There are no (further) constraints on this element Element id Immunization.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)	Data type Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Immunization.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id Immunization.note.text Short description The annotation - text content Definition The text of the annotation. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.text
explanation		0..1	BackboneElement	There are no (further) constraints on this element Element id Immunization.explanation Short description Administration/non-administration reasons Definition Reasons why a vaccine was or was not administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Immunization.explanation.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reason		0..*	CodeableConcept	Element id Immunization.explanation.reason Short description Why immunization occurred Definition Reasons why a vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was administered Care Connect Immunization Explanation Reason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCodeableConcept rim: [actionNegationInd=false].reasonCode
reasonNotGiven		0..*	CodeableConceptBinding	Element id Immunization.explanation.reasonNotGiven Short description Why immunization did not occur Definition Reason why a vaccine was not administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was not administered Care Connect Reason Immunization Not Administered (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.notDoneReason v2: RXA-18 rim: [actionNegationInd=true].reasonCode
reaction		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-3 rim: Observation[classCode=obs].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime
detail	I	0..1	Reference(CareConnect-Observation-1)	Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Observation-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 rim: .value
reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (no such concept seems to exist for allergy/adverse reaction in HL7 v2) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
vaccinationProtocol		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol Short description What protocol was followed Definition Contains information about the protocol(s) under which the vaccine was administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (HL7 v2 doesn't seem to provide for this) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
doseSequence		1..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseSequence Short description Dose number within series Definition Nominal position in a series. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].sequenceNumber
description		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.description Short description Details of vaccine protocol Definition Contains the description about the protocol under which the vaccine was administered. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
authority	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.vaccinationProtocol.authority Short description Who is responsible for protocol Definition Indicates the authority who published the protocol. E.g. ACIP. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].participation[typeCode=AUT].COCT_MT090200UV
series		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
seriesDoses		0..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.seriesDoses Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
targetDisease		1..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease Short description Disease immunized against Definition The targeted disease. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The disease target of the vaccination protocol Vaccination Protocol Dose Target Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: outboundRelationship.target[classCode=OBS].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.vaccinationProtocol.targetDisease.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatus		1..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus Short description Indicates if dose counts towards immunity Definition Indicates if the immunization event should "count" against the protocol. Comments May need to differentiate between status declarations by a provider vs. a CDS engine. Data type CodeableConcept Binding The status of the vaccination protocol (i.e. should this count) Vaccination Protocol Dose Status codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].value
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatusReason Short description Why dose does (not) count Definition Provides an explanation as to why an immunization event should or should not count against the protocol. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason for the determining if a vaccination should count or why vaccination should not count. Vaccination Protocol Dose Status Reason codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].reasonCode

Differential View

Immunization	I		Immunization	There are no (further) constraints on this element Element id Immunization Short description Immunization event information Definition Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed. Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` imm-2: If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent. `(notGiven = true) or explanation.reasonNotGiven.empty()` imm-1: If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present `(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())` Mappings rim: Entity. Role, or Act v2: VXU_V04 rim: SubstanceAdministration w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id Immunization.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	Element id Immunization.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
parentPresent	I	0..1	Extension(boolean)	Element id Immunization.extension:parentPresent Short description Was a parent present at the Immunization Alternate names extensions, user content Definition Was a parent present at the Immunization. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(boolean) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ParentPresent-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
recordedDate	I	0..1	Extension(dateTime)	Element id Immunization.extension:recordedDate Short description The date that the Vaccination was recorded Alternate names extensions, user content Definition The date that the event was recorded on the system. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(dateTime) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DateRecorded-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
vaccinationProcedure	I	0..1	Extension(CodeableConcept)	Element id Immunization.extension:vaccinationProcedure Short description An extension to hold an immunization procedure code Alternate names extensions, user content Definition An extension to hold an immunization procedure code. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-VaccinationProcedure-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Immunization.identifier Short description Business identifier Definition A unique identifier assigned to this immunization record. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id w5: id
id		0..1	string	There are no (further) constraints on this element Element id Immunization.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Immunization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
status	Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed Definition Indicates the current status of the vaccination event. Comments Will generally be set to show that the immunization has been completed. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A set of codes indicating the current status of an Immunization Immunization Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.status rim: statusCode w5: status
notGiven	Σ ?!	1..1	boolean	There are no (further) constraints on this element Element id Immunization.notGiven Short description Flag for whether immunization was given Definition Indicates if the vaccination was or was not given. Comments This element is labeled as a modifier because it indicates that an immunization didn't happen. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.notDone rim: [actionNegationInd=true].reasonCode w5: status
vaccineCode		1..1	CodeableConceptBinding	Element id Immunization.vaccineCode Short description Vaccine product administered Definition Vaccine that was administered or was to be administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The code for vaccine product administered Care Connect Vaccine Code (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code w5: what
patient	I	1..1	Reference(CareConnect-Patient-1)	Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Patient-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject v2: PID-3 rim: .partipication[ttypeCode=].role w5: who.focus
encounter	I	0..1	Reference(CareConnect-Encounter-1)	Element id Immunization.encounter Short description Encounter administered as part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Encounter-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context v2: PV1-19 rim: component->EncounterEvent w5: context
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.date Short description Vaccination administration date Definition Date vaccine administered or was to be administered. Comments When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.occurrence.occurrenceDateTime v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value w5: when.init
primarySource		1..1	boolean	Element id Immunization.primarySource Short description Indicates context the data was recorded in Definition An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U) w5: who.source
reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record Definition The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Comments Should not be populated if primarySource = True, will not be required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. Immunization Origin Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member) w5: who.source
location	I	0..1	Reference(CareConnect-Location-1)	Element id Immunization.location Short description Where vaccination occurred Definition The service delivery location where the vaccine administration occurred. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Location-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV w5: where
manufacturer	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
lotNumber		0..1	string	There are no (further) constraints on this element Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The site at which the vaccine was administered Codes for Immunization Site of Administration (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.site.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.site.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.site.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The route by which the vaccine was administered Immunization Route Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	Element id Immunization.route.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Binding A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.route.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.route.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.route.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseQuantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXA-6 / RXA-7.1 rim: .doseQuantity
practitioner	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.practitioner Short description Who performed event Definition Indicates who or what performed the event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.practitioner.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
role	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.practitioner.role Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The role a practitioner plays in the immunization event Immunization Role Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.role rim: .participation.functionCode
actor	Σ I	1..1	Reference(CareConnect-Practitioner-1)	Element id Immunization.practitioner.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Practitioner-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor rim: .player w5: who.actor
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id Immunization.note Short description Vaccination notes Definition Extra information about the immunization that is not conveyed by the other attributes. Comments 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). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: Event.note rim: note
id		0..1	string	There are no (further) constraints on this element Element id Immunization.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
author[x]	Σ	0..1		There are no (further) constraints on this element Element id Immunization.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)	Data type Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Immunization.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id Immunization.note.text Short description The annotation - text content Definition The text of the annotation. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.text
explanation		0..1	BackboneElement	There are no (further) constraints on this element Element id Immunization.explanation Short description Administration/non-administration reasons Definition Reasons why a vaccine was or was not administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Immunization.explanation.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reason		0..*	CodeableConcept	Element id Immunization.explanation.reason Short description Why immunization occurred Definition Reasons why a vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was administered Care Connect Immunization Explanation Reason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCodeableConcept rim: [actionNegationInd=false].reasonCode
reasonNotGiven		0..*	CodeableConceptBinding	Element id Immunization.explanation.reasonNotGiven Short description Why immunization did not occur Definition Reason why a vaccine was not administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was not administered Care Connect Reason Immunization Not Administered (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.notDoneReason v2: RXA-18 rim: [actionNegationInd=true].reasonCode
reaction		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-3 rim: Observation[classCode=obs].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime
detail	I	0..1	Reference(CareConnect-Observation-1)	Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Observation-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 rim: .value
reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (no such concept seems to exist for allergy/adverse reaction in HL7 v2) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
vaccinationProtocol		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol Short description What protocol was followed Definition Contains information about the protocol(s) under which the vaccine was administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (HL7 v2 doesn't seem to provide for this) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
doseSequence		1..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseSequence Short description Dose number within series Definition Nominal position in a series. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].sequenceNumber
description		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.description Short description Details of vaccine protocol Definition Contains the description about the protocol under which the vaccine was administered. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
authority	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.vaccinationProtocol.authority Short description Who is responsible for protocol Definition Indicates the authority who published the protocol. E.g. ACIP. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].participation[typeCode=AUT].COCT_MT090200UV
series		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
seriesDoses		0..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.seriesDoses Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
targetDisease		1..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease Short description Disease immunized against Definition The targeted disease. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The disease target of the vaccination protocol Vaccination Protocol Dose Target Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: outboundRelationship.target[classCode=OBS].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.vaccinationProtocol.targetDisease.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatus		1..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus Short description Indicates if dose counts towards immunity Definition Indicates if the immunization event should "count" against the protocol. Comments May need to differentiate between status declarations by a provider vs. a CDS engine. Data type CodeableConcept Binding The status of the vaccination protocol (i.e. should this count) Vaccination Protocol Dose Status codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].value
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatusReason Short description Why dose does (not) count Definition Provides an explanation as to why an immunization event should or should not count against the protocol. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason for the determining if a vaccination should count or why vaccination should not count. Vaccination Protocol Dose Status Reason codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].reasonCode

Hybrid View

Immunization	I		Immunization	There are no (further) constraints on this element Element id Immunization Short description Immunization event information Definition Describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party and may include vaccine reaction information and what vaccination protocol was followed. Data type Immunization Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` imm-2: If immunization was administered (notGiven=false) then explanation.reasonNotGiven SHALL be absent. `(notGiven = true) or explanation.reasonNotGiven.empty()` imm-1: If immunization was not administered (notGiven=true) then there SHALL be no reaction nor explanation.reason present `(notGiven = true).not() or (reaction.empty() and explanation.reason.empty())` Mappings rim: Entity. Role, or Act v2: VXU_V04 rim: SubstanceAdministration w5: clinical.medication
id	Σ	0..1	id	There are no (further) constraints on this element Element id Immunization.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Immunization.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Immunization.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Immunization.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Immunization.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	Element id Immunization.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
parentPresent	I	0..1	Extension(boolean)	Element id Immunization.extension:parentPresent Short description Was a parent present at the Immunization Alternate names extensions, user content Definition Was a parent present at the Immunization. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(boolean) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ParentPresent-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
recordedDate	I	0..1	Extension(dateTime)	Element id Immunization.extension:recordedDate Short description The date that the Vaccination was recorded Alternate names extensions, user content Definition The date that the event was recorded on the system. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(dateTime) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DateRecorded-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
vaccinationProcedure	I	0..1	Extension(CodeableConcept)	Element id Immunization.extension:vaccinationProcedure Short description An extension to hold an immunization procedure code Alternate names extensions, user content Definition An extension to hold an immunization procedure code. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(CodeableConcept) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-VaccinationProcedure-1 Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Immunization.identifier Short description Business identifier Definition A unique identifier assigned to this immunization record. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Event.identifier rim: .id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id w5: id
id		0..1	string	There are no (further) constraints on this element Element id Immunization.identifier.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.identifier.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Immunization.identifier.use Short description usual \| official \| temp \| secondary (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: CX.5 rim: Role.code or implied by context
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Immunization.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval\|Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.empty() or end.empty() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
status	Σ ?!	1..1	codeBinding	Element id Immunization.status Short description completed Definition Indicates the current status of the vaccination event. Comments Will generally be set to show that the immunization has been completed. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Data type code Binding A set of codes indicating the current status of an Immunization Immunization Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.status rim: statusCode w5: status
notGiven	Σ ?!	1..1	boolean	There are no (further) constraints on this element Element id Immunization.notGiven Short description Flag for whether immunization was given Definition Indicates if the vaccination was or was not given. Comments This element is labeled as a modifier because it indicates that an immunization didn't happen. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.notDone rim: [actionNegationInd=true].reasonCode w5: status
vaccineCode		1..1	CodeableConceptBinding	Element id Immunization.vaccineCode Short description Vaccine product administered Definition Vaccine that was administered or was to be administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The code for vaccine product administered Care Connect Vaccine Code (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.code v2: RXA-5 rim: .code cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code w5: what
patient	I	1..1	Reference(CareConnect-Patient-1)	Element id Immunization.patient Short description Who was immunized Definition The patient who either received or did not receive the immunization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Patient-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.subject v2: PID-3 rim: .partipication[ttypeCode=].role w5: who.focus
encounter	I	0..1	Reference(CareConnect-Encounter-1)	Element id Immunization.encounter Short description Encounter administered as part of Definition The visit or admission or other contact between patient and health care provider the immunization was performed as part of. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Encounter-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.context v2: PV1-19 rim: component->EncounterEvent w5: context
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.date Short description Vaccination administration date Definition Date vaccine administered or was to be administered. Comments When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.occurrence.occurrenceDateTime v2: RXA-3 rim: .effectiveTime cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value w5: when.init
primarySource		1..1	boolean	Element id Immunization.primarySource Short description Indicates context the data was recorded in Definition An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Comments Reflects the “reliability” of the content. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Default value true Mappings rim: n/a v2: RXA-9 rim: immunization.uncertaintycode (if primary source=false, uncertainty=U) w5: who.source
reportOrigin		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.reportOrigin Short description Indicates the source of a secondarily reported record Definition The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Comments Should not be populated if primarySource = True, will not be required even if primarySource = False. Data type CodeableConcept Binding The source of the data for a record which is not from a primary source. Immunization Origin Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXA-9 rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member) w5: who.source
location	I	0..1	Reference(CareConnect-Location-1)	Element id Immunization.location Short description Where vaccination occurred Definition The service delivery location where the vaccine administration occurred. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Location-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-27 (or RXA-11, deprecated as of v2.7) rim: .participation[typeCode=LOC].COCT_MT240000UV w5: where
manufacturer	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.manufacturer Short description Vaccine manufacturer Definition Name of vaccine manufacturer. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: RXA-17 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG] cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name
lotNumber		0..1	string	There are no (further) constraints on this element Element id Immunization.lotNumber Short description Vaccine lot number Definition Lot number of the vaccine product. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-15 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText
expirationDate		0..1	date	There are no (further) constraints on this element Element id Immunization.expirationDate Short description Vaccine expiration date Definition Date vaccine batch expires. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: RXA-16 rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime
site		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.site Short description Body site vaccine was administered Definition Body site where vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The site at which the vaccine was administered Codes for Immunization Site of Administration (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-2 rim: observation.targetSiteCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.site.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.site.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.site.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.site.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.site.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.site.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.site.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
route		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.route Short description How vaccine entered body Definition The path by which the vaccine product is taken into the body. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The route by which the vaccine was administered Immunization Route Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: RXR-1 rim: .routeCode cda: ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.route.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.route.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	Element id Immunization.route.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Binding A code from the SNOMED Clinical Terminology UK coding system that describes the e-Prescribing route of administration. Care Connect Medication Dosage Route (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.route.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.route.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.route.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.route.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.route.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseQuantity	I	0..1	SimpleQuantity	There are no (further) constraints on this element Element id Immunization.doseQuantity Short description Amount of vaccine administered Definition The quantity of vaccine product that was administered. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type SimpleQuantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` sqty-1: The comparator is not used on a SimpleQuantity `comparator.empty()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values v2: RXA-6 / RXA-7.1 rim: .doseQuantity
practitioner	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.practitioner Short description Who performed event Definition Indicates who or what performed the event. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a workflow: Event.performer v2: ORC-12 / RXA-10 rim: .participation[typeCode=PRF].role[scoper.determinerCode=INSTANCE]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.practitioner.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.practitioner.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
role	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Immunization.practitioner.role Short description What type of performance was done Definition Describes the type of performance (e.g. ordering provider, administering provider, etc.). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The role a practitioner plays in the immunization event Immunization Role Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.performer.role rim: .participation.functionCode
actor	Σ I	1..1	Reference(CareConnect-Practitioner-1)	Element id Immunization.practitioner.actor Short description Individual who was performing Definition The device, practitioner, etc. who performed the action. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Practitioner-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Event.performer.actor rim: .player w5: who.actor
note	Σ	0..*	Annotation	There are no (further) constraints on this element Element id Immunization.note Short description Vaccination notes Definition Extra information about the immunization that is not conveyed by the other attributes. Comments 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). Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act workflow: Event.note rim: note
id		0..1	string	There are no (further) constraints on this element Element id Immunization.note.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.note.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
author[x]	Σ	0..1		There are no (further) constraints on this element Element id Immunization.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.participant[typeCode=AUT].role
authorString			string	Data type string
authorReference			Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)	Data type Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element id Immunization.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.effectiveTime
text		1..1	string	There are no (further) constraints on this element Element id Immunization.note.text Short description The annotation - text content Definition The text of the annotation. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Act.text
explanation		0..1	BackboneElement	There are no (further) constraints on this element Element id Immunization.explanation Short description Administration/non-administration reasons Definition Reasons why a vaccine was or was not administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id Immunization.explanation.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.explanation.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reason		0..*	CodeableConcept	Element id Immunization.explanation.reason Short description Why immunization occurred Definition Reasons why a vaccine was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was administered Care Connect Immunization Explanation Reason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.reasonCodeableConcept rim: [actionNegationInd=false].reasonCode
reasonNotGiven		0..*	CodeableConceptBinding	Element id Immunization.explanation.reasonNotGiven Short description Why immunization did not occur Definition Reason why a vaccine was not administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason why a vaccine was not administered Care Connect Reason Immunization Not Administered (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Event.notDoneReason v2: RXA-18 rim: [actionNegationInd=true].reasonCode
reaction		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.reaction Short description Details of a reaction that follows immunization Definition Categorical data indicating that an adverse event is associated in time to an immunization. Comments 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. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-3 rim: Observation[classCode=obs].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.reaction.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.reaction.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
date		0..1	dateTime	There are no (further) constraints on this element Element id Immunization.reaction.date Short description When reaction started Definition Date of reaction to the immunization. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all) rim: .effectiveTime
detail	I	0..1	Reference(CareConnect-Observation-1)	Element id Immunization.reaction.detail Short description Additional information on reaction Definition Details of the reaction. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Observation-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 rim: .value
reported		0..1	boolean	There are no (further) constraints on this element Element id Immunization.reaction.reported Short description Indicates self-reported reaction Definition Self-reported indicator. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (no such concept seems to exist for allergy/adverse reaction in HL7 v2) rim: .participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
vaccinationProtocol		0..*	BackboneElement	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol Short description What protocol was followed Definition Contains information about the protocol(s) under which the vaccine was administered. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: (HL7 v2 doesn't seem to provide for this) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
doseSequence		1..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseSequence Short description Dose number within series Definition Nominal position in a series. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].sequenceNumber
description		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.description Short description Details of vaccine protocol Definition Contains the description about the protocol under which the vaccine was administered. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
authority	I	0..1	Reference(CareConnect-Organization-1)	Element id Immunization.vaccinationProtocol.authority Short description Who is responsible for protocol Definition Indicates the authority who published the protocol. E.g. ACIP. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(CareConnect-Organization-1) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].participation[typeCode=AUT].COCT_MT090200UV
series		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.series Short description Name of vaccine series Definition One possible path to achieve presumed immunity against a disease - within the context of an authority. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM]
seriesDoses		0..1	positiveInt	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.seriesDoses Short description Recommended number of doses for immunity Definition The recommended number of doses to achieve immunity. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a rim: outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text
targetDisease		1..*	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease Short description Disease immunized against Definition The targeted disease. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The disease target of the vaccination protocol Vaccination Protocol Dose Target Codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: outboundRelationship.target[classCode=OBS].code
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	Element id Immunization.vaccinationProtocol.targetDisease.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Sliced: Unordered, Open, by system(Value) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
snomedCT	Σ	0..1	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
snomedCTDescriptionID	I	0..1	Extension(Complex)	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.extension:snomedCTDescriptionID Short description The SNOMED CT Description ID for the display Alternate names extensions, user content Definition The SNOMED CT Description ID for the display. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Complex) Extension URL https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Fixed value http://snomed.info/sct Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.coding:snomedCT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.targetDisease.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatus		1..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus Short description Indicates if dose counts towards immunity Definition Indicates if the immunization event should "count" against the protocol. Comments May need to differentiate between status declarations by a provider vs. a CDS engine. Data type CodeableConcept Binding The status of the vaccination protocol (i.e. should this count) Vaccination Protocol Dose Status codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].value
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order 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. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings may not exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings may not exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatus.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
doseStatusReason		0..1	CodeableConcept	There are no (further) constraints on this element Element id Immunization.vaccinationProtocol.doseStatusReason Short description Why dose does (not) count Definition Provides an explanation as to why an immunization event should or should not count against the protocol. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The reason for the determining if a vaccination should count or why vaccination should not count. Vaccination Protocol Dose Status Reason codes (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: .participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].reasonCode

Table View

Immunization		..
Immunization.extension		0..
Immunization.extension	Extension	0..1
Immunization.extension	Extension	0..1
Immunization.extension	Extension	0..
Immunization.identifier		..
Immunization.identifier.system		1..
Immunization.identifier.value		1..
Immunization.identifier.assigner	Reference(CareConnect-Organization-1)	..
Immunization.status		..
Immunization.vaccineCode		..
Immunization.patient	Reference(CareConnect-Patient-1)	..
Immunization.encounter	Reference(CareConnect-Encounter-1)	..
Immunization.primarySource		..
Immunization.location	Reference(CareConnect-Location-1)	..
Immunization.manufacturer	Reference(CareConnect-Organization-1)	..
Immunization.site		..
Immunization.site.coding		..
Immunization.site.coding		..1
Immunization.site.coding.extension		0..
Immunization.site.coding.extension	Extension	0..
Immunization.site.coding.system		1..
Immunization.site.coding.code		1..
Immunization.site.coding.display		1..
Immunization.route		..
Immunization.route.coding		..
Immunization.route.coding		..1
Immunization.route.coding.extension		0..
Immunization.route.coding.extension	Extension	0..
Immunization.route.coding.system		1..
Immunization.route.coding.code		1..
Immunization.route.coding.display		1..
Immunization.practitioner		..
Immunization.practitioner.actor	Reference(CareConnect-Practitioner-1)	..
Immunization.note		..
Immunization.note.author[x]	Reference(RelatedPerson \| CareConnect-Practitioner-1 \| CareConnect-Patient-1), string	..
Immunization.explanation		..
Immunization.explanation.reason		..
Immunization.explanation.reasonNotGiven		..
Immunization.reaction		..
Immunization.reaction.detail	Reference(CareConnect-Observation-1)	..
Immunization.vaccinationProtocol		..
Immunization.vaccinationProtocol.doseSequence		1..
Immunization.vaccinationProtocol.authority	Reference(CareConnect-Organization-1)	..
Immunization.vaccinationProtocol.targetDisease		..
Immunization.vaccinationProtocol.targetDisease.coding		..
Immunization.vaccinationProtocol.targetDisease.coding		..1
Immunization.vaccinationProtocol.targetDisease.coding.extension		0..
Immunization.vaccinationProtocol.targetDisease.coding.extension	Extension	0..
Immunization.vaccinationProtocol.targetDisease.coding.system		1..
Immunization.vaccinationProtocol.targetDisease.coding.code		1..
Immunization.vaccinationProtocol.targetDisease.coding.display		1..
Immunization.vaccinationProtocol.doseStatus		..
Immunization.vaccinationProtocol.doseStatus.coding		..
Immunization.vaccinationProtocol.doseStatus.coding.system		1..
Immunization.vaccinationProtocol.doseStatus.coding.code		1..
Immunization.vaccinationProtocol.doseStatus.coding.display		1..

Examples

Profile specific implementation guidance:

There is no specific guidance for this profile.