Implementation Guide for Portuguese Use Cases

ImmunizationRecommendation PT PS

Tree view

ImmunizationRecommendation	I		ImmunizationRecommendation	There are no (further) constraints on this element Element id ImmunizationRecommendation Short description Guidance or advice relating to an immunization Definition A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification. Data type ImmunizationRecommendation Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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 or SHALL refer to the containing resource `contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act workflow: Request v2: VXU_V04 rim: SubstanceAdministration[moodCode=RMD] w5: clinical.medication
id	Σ	1..1	id	There are no (further) constraints on this element Element id ImmunizationRecommendation.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
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id ImmunizationRecommendation.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 might 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id ImmunizationRecommendation.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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.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 IETF language tag Common Languages (preferred) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id ImmunizationRecommendation.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 can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A rim: Act.text?
contained	I	0..*	Resource	There are no (further) constraints on this element Element id ImmunizationRecommendation.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Constraints dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..0	Identifier	There are no (further) constraints on this element Element id ImmunizationRecommendation.identifier Short description Business identifier Definition Identificadores da recomendação da vacinação. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - 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: Request.identifier w5: FiveWs.identifier rim: .id
patient	Σ I	1..1	Reference(Patient PT PS)	Element id ImmunizationRecommendation.patient Short description Who this profile is for Definition Identifica o utente para quem a recomendação se destina. 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(Patient PT PS) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.subject w5: FiveWs.subject[x] v2: PID-3 rim: .partipication[typeCode=SUBJ].role w5: FiveWs.subject
date	Σ	1..1	dateTime	There are no (further) constraints on this element Element id ImmunizationRecommendation.date Short description Date recommendation(s) created Definition Identifica a data de criação da recomendação. Uma data ou data parcial. O formato é o definido pela ISO8601. A descrição da time zone (UTC) NÃO DEVE ser preenchida. Formatos possíveis: ano; ano e mês; ano, mês e dia. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a workflow: Request.authoredOn v2: OBX-15 rim: .partipication[typeCode=AUTH].time
authority	I	0..0	Reference(Organization PT Core)	There are no (further) constraints on this element Element id ImmunizationRecommendation.authority Short description Who is responsible for protocol Definition Identifica a entidade responsável pelo protocolo. 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(Organization PT Core) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: OBX-5 : OBX-3 = 59779-9 rim: .participation[typeCode=AUT]
recommendation	Σ I	1..*	BackboneElement	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation Short description Vaccine administration recommendations Definition Identifica as recomendações associadas à administração da vacina. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` imr-1: One of vaccineCode or targetDisease SHALL be present `vaccineCode.exists() or targetDisease.exists()` Mappings rim: n/a rim: .outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]
id		0..0	id	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.recommendation.modifierExtension Short description Extensions that cannot be ignored even if unrecognized 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
vaccineCode	Σ	1..1	CodeableConcept PT Core	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode Short description Concept - reference to a terminology or just text Definition Identifica a(s) vacina/imunoglobulina(s) à(s) qual(ais) a recomendação se aplica. 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 PT Core Sliced: Unordered, Open, by id(Value) Binding The type of vaccine administered. Vaccine Administered Value Set (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code v2: OBX-5 : OBX-3 = ( 30956-7 \| 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
vaccine	Σ	0..1	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode:vaccine Short description Concept - reference to a terminology or just text Definition Identifica a(s) vacina(s) à(s) qual(ais) a recomendação se aplica. Comments Value Set Name: Vaccine Data type CodeableConcept PT Core Binding The type of vaccine administered. https://www.ctc.min-saude.pt/catalogos/vacinas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code v2: OBX-5 : OBX-3 = ( 30956-7 \| 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
immunoglobulin	Σ	0..1	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.vaccineCode:immunoglobulin Short description Concept - reference to a terminology or just text Definition Identifica a(s) imunoglobulina(s) à(s) qual(ais) a recomendação se aplica. Comments Value Set Name: Imunoglobulin Data type CodeableConcept PT Core Binding The type of vaccine administered. https://www.ctc.min-saude.pt/catalogos/vacinas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code v2: OBX-5 : OBX-3 = ( 30956-7 \| 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
targetDisease	Σ	0..0	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.targetDisease Short description Concept - reference to a terminology or just text Definition Identifica a doença contra a qual a vacina se destina. Comments Value Set Name: VaccineTargetDisease Data type CodeableConcept PT Core Binding The disease that the recommended vaccination targets. https://www.ctc.min-saude.pt/catalogos/vacinas/ (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = ( 30956-7 \| 38890-0 ) rim: .partipication[typeCode=CSM].role[classCode=ADMM].code
contraindicatedVaccineCode	Σ	0..0	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.contraindicatedVaccineCode Short description Concept - reference to a terminology or just text Definition Indicação de vacinas contra-indicadas para cumprir com a recomendação. 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 PT Core Binding The type of vaccine administered. https://www.ctc.min-saude.pt/catalogos/vacinas/ (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
forecastStatus	Σ ?!	1..1	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus Short description Concept - reference to a terminology or just text Definition Identifica a previsão do estado do utente no sentido de atingir a imunidade. Este elemento indica se um utente necessita de doses adicionais (próxima, em atraso) ou não (contra-indicada, completa, recusada, imune). Comments Value Set Name: ForecastStatus Data type CodeableConcept PT Core Binding The patient's status with respect to a vaccination protocol. https://www.ctc.min-saude.pt/catalogos/vacinas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = 59783-1 rim: .inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code="Immunization Forecast Status"].value
id		0..1	id	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 PT Core	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	id	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.recommendation.forecastStatus.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 reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.recommendation.forecastStatus.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 SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.recommendation.forecastStatus.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 SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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..0	boolean	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	1..1	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastStatus.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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
forecastReason	Σ	0..0	CodeableConcept PT Core	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.forecastReason Short description Concept - reference to a terminology or just text Definition Identifica o motivo associado ao estado de previsão anteriormente descrito. Comments Value Set Name: ForecastReason Data type CodeableConcept PT Core Binding The reason for the patient's status with respect to a vaccination protocol. Immunization Recommendation Reason Codes (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-5 : OBX-3 = 30982-3 rim: N/A
dateCriterion		0..*	BackboneElement	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion Short description Dates governing proposed immunization Definition Recomendação de datas de vacinação, como a data para a próxima vacinação, última data possível para vacinação. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a workflow: Request.occurrence[x] v2: OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1 = Dose is overdue rim: .outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]
id		0..1	id	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.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. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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 ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension Short description Extensions that cannot be ignored even if unrecognized 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
code		1..1	CodeableConcept PT CoreBinding	Element id ImmunizationRecommendation.recommendation.dateCriterion.code Short description Concept - reference to a terminology or just text Definition A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. 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 PT Core Binding Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.). https://www.ctc.min-saude.pt/catalogos/vacinas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: OBX-3 rim: .code
value		1..1	dateTime	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.dateCriterion.value Short description Recommended date Definition Identifica a data recomendada. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: OBX-5 rim: .value
description		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.description Short description Protocol details Definition Identifica a descrição do protocolo. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: OBX-5 : OBX-3 = 30956-7 rim: .text
series		0..0	string	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.series Short description Name of vaccination series Definition Identifica o nome da série de vacinação. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: RXA-5-administered code rim: .title
doseNumber[x]	Σ	0..0		There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.doseNumber[x] Short description Recommended dose number within series Definition Identifica a posição nominal da dose recomendada na série. Comments The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose). Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: OBX-5 : OBX-3 = 30973-2 rim: .inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber
seriesDoses[x]		0..0		There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.seriesDoses[x] Short description Recommended number of doses for immunity Definition Identifica o número de doses recomendado para alcançar imunidade. Comments The use of an integer is prefered if known. A string should only be used in cases where an interger is not available (such as when documenting a recurring booster dose). Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: OBX-5 : OBX-3 = 59782-3 rim: .inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber
supportingImmunization	I	1..*	Reference(Immunization PT PS)	Element id ImmunizationRecommendation.recommendation.supportingImmunization Short description Past immunizations supporting recommendation Definition Identifica informação histórica que suporta a recomendação. 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(Immunization PT PS) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: ? No clear way to associate in HL7 v2 or IG rim: .outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code="immunization"]
supportingPatientInformation	I	0..0	Reference(Resource)	There are no (further) constraints on this element Element id ImmunizationRecommendation.recommendation.supportingPatientInformation Short description Patient observations supporting recommendation Definition Identifica informações do utente que suportam a recomendação, podendo incluir informação sobre reações adversas. 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(Resource) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo v2: OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered rim: .outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]

Binding

Path	Strength	ValueSet	Comment
ImmunizationRecommendation.recommendation.vaccineCode vaccine	required	https://www.ctc.min-saude.pt/catalogos/vacinas	Value Set Name: Vaccine
ImmunizationRecommendation.recommendation.vaccineCode immunoglobulin	required	https://www.ctc.min-saude.pt/catalogos/vacinas	Value Set Name: Imunoglobulin
ImmunizationRecommendation.recommendation.forecastStatus	required	https://www.ctc.min-saude.pt/catalogos/vacinas	Value Set Name: ForecastStatus
ImmunizationRecommendation.recommendation.dateCriterion.code	required	https://www.ctc.min-saude.pt/catalogos/vacinas	Value Set Name: VaccinationDateCriterion

Para mais informações sobre a utilização do elemento system consultar Systems.

Identifiers Type

Estes Identificadores devem ser utilizados no elemento

identifier.type.coding[*]

Regras de implementação

Para além das constraints identificadas pelo FHIR para este recurso devem ser consideradas as constraints que identificamos na tabela infra.

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