This version of the PS-CA Implementation Guide has been superseded by a newer version. Other releases of the PS-CA Implementation Guide may be found on a table on the Home Page of this Project.
Immunization (PS-CA)
Additional information on this profile (including the JSON & XML structure and detailed element descriptions) can be found at Immunization (PS-CA)
Profile
Immunization | I | Immunization | There are no (further) constraints on this element Element IdImmunization Immunization event information DefinitionDescribes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
| |
identifier | 0..* | Identifier | There are no (further) constraints on this element Element IdImmunization.identifier Business identifier DefinitionA unique identifier assigned to this immunization record.
| |
status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element IdImmunization.status completed | entered-in-error | not-done DefinitionIndicates the current status of the immunization event. Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of an Immunization. ImmunizationStatusCodes (required)Constraints
|
statusReason | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.statusReason Reason not done DefinitionIndicates the reason the immunization event was not performed. This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here. The reason why a vaccine was not administered. ImmunizationStatusReasonCodes (example)Constraints
| |
vaccineCode | S Σ | 1..1 | CodeableConceptBinding | Element IdImmunization.vaccineCode Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code. Other coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product. DefinitionVaccine that was administered or was to be administered. PS-CA Note: Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. IPS-UV Note: Several kinds of vaccine product coding could be provided. The IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown. Other coded information can be provided as well as:
The value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available. Codes from the Canadian Vaccine Catalogue Generic Value Set. Use of Tradename Value Set is equivalently preferred. CVCGeneric (preferred)Constraints
|
coding | Σ | 0..* | Coding | Element IdImmunization.vaccineCode.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. See usage note regarding the removal of the vaccineGPSCode slice in this release slice in this release and its replacement with the IPS slice in the interim to support validation tooling. Unordered, Open, by $this(Pattern) Constraints
|
vaccineIPSCode | Σ | 0..* | CodingBinding | Element IdImmunization.vaccineCode.coding:vaccineIPSCode Optional slice for representing the code for vaccine from the SNOMED CT IPS code set DefinitionCode for a vaccine that is selected from the SNOMED CT IPS code set. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
|
atcClass | Σ | 0..* | CodingBinding | Element IdImmunization.vaccineCode.coding:atcClass Optional slice for representing the vaccine code from the WHO ATC classification DefinitionWHO ATC classification Allows for alternative encodings within a code system, and translations to other code systems. The IPS-UV considers this slice Must Support in STU1, however the impacts of applying Must Support on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the Must Support flag on optional slices is currently being discussed.
|
CVCTradename | Σ | 0..* | CodingBinding | Element IdImmunization.vaccineCode.coding:CVCTradename Optional slice for representing the codes from the Canadian Vaccine Catalogue Tradenames value set. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
|
CVCGeneric | Σ | 0..* | CodingBinding | Element IdImmunization.vaccineCode.coding:CVCGeneric Optional slice for representing the codes from the Canadian Vaccine Catalogue Generic names value set. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
|
absentOrUnknownImmunization | S Σ | 0..* | CodingBinding | Element IdImmunization.vaccineCode.coding:absentOrUnknownImmunization Optional slice for representing the codes for an Absent or Unknown Immunization DefinitionA reference to a code indicating that there there are no known immunizations or that this information is unknown. Allows for alternative encodings within a code system, and translations to other code systems. This slice is kept as Must Support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping Must Support flags on data absent reason extensions) NoImmunizationInfoUvIps (required) Constraints
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.vaccineCode.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
|
patient | S Σ I | 1..1 | Reference(Patient (PS-CA)) | Element IdImmunization.patient Who was immunized DefinitionThe patient who either received or did not receive the immunization. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
|
reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdImmunization.patient.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
|
type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdImmunization.patient.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
|
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdImmunization.patient.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
|
encounter | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdImmunization.encounter Encounter immunization was part of DefinitionThe visit or admission or other contact between patient and health care provider the immunization was performed as part of. 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.
|
occurrence[x] | S Σ | 1..1 | There are no (further) constraints on this element Element IdImmunization.occurrence[x] Vaccine administration date DefinitionDate vaccine administered or was to be administered. 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. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
| |
extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdImmunization.occurrence[x].extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
|
data-absent-reason | S I | 0..1 | Extension(code) | Element IdImmunization.occurrence[x].extension:data-absent-reason occurrence[x] absence reason Alternate namesextensions, user content DefinitionProvides a reason why the occurrence is missing. 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. http://hl7.org/fhir/StructureDefinition/data-absent-reason Constraints
|
occurrenceDateTime | dateTime | There are no (further) constraints on this element Data Type | ||
occurrenceString | string | There are no (further) constraints on this element Data Type | ||
recorded | 0..1 | dateTime | There are no (further) constraints on this element Element IdImmunization.recorded When the immunization was first captured in the subject's record DefinitionThe date the occurrence of the immunization was first captured in the record - potentially significantly after the occurrence of the event.
| |
primarySource | Σ | 0..1 | boolean | There are no (further) constraints on this element Element IdImmunization.primarySource Indicates context the data was recorded in DefinitionAn indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Reflects the “reliability” of the content.
|
reportOrigin | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.reportOrigin Indicates the source of a secondarily reported record DefinitionThe source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Should not be populated if primarySource = True, not required even if primarySource = False. The source of the data for a record which is not from a primary source. ImmunizationOriginCodes (example)Constraints
| |
location | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element IdImmunization.location Where immunization occurred DefinitionThe service delivery location where the vaccine administration occurred. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
|
manufacturer | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdImmunization.manufacturer Vaccine manufacturer DefinitionName of vaccine manufacturer. 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.
|
lotNumber | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.lotNumber Vaccine lot number DefinitionLot number of the vaccine product. Note that FHIR strings SHALL NOT exceed 1MB in size
| |
expirationDate | 0..1 | date | There are no (further) constraints on this element Element IdImmunization.expirationDate Vaccine expiration date DefinitionDate vaccine batch expires.
| |
site | 0..1 | Data Type: Codeable Concept (PS-CA)Binding | Element IdImmunization.site Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. In the meantime, various code systems in use in Canada are put forward as examples and optional slices have been created to encourage the use of existing Canadian terminology. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. Data Type: Codeable Concept (PS-CA) BindingThe site at which the vaccine was administered. CVCAnatomicalSite (preferred)Constraints
| |
coding | Σ | 0..* | Data Type: Coding (PS-CA) | Element IdImmunization.site.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content Unordered, Open, by $this(Pattern) Constraints
|
siteIPS | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.site.coding:siteIPS Optional slice for representing the site of an immunization from the IPS SNOMED CT value set. DefinitionCode for the site of vimmunization from the IPS SNOMED CT value set. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content TargetSiteCodeUvIps (required) Constraints
|
siteCVC | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.site.coding:siteCVC Optional slice for representing the site of an immunization from the Canadian Vaccine Catalogue Anatomical Site value set. DefinitionCode for the site of immunization from the Canadian Vaccine Catalogue value set. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content
|
HumanSubstanceAdministrationSiteV3 | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.site.coding:HumanSubstanceAdministrationSiteV3 The set of body locations to or through which a drug product may be administered. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content http://terminology.hl7.org/ValueSet/v3-HumanSubstanceAdministrationSite (required) Constraints
|
text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.site.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
|
route | S | 0..1 | Data Type: Codeable Concept (PS-CA)Binding | Element IdImmunization.route Concept - reference to a terminology or just text DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. The IPS-UV specification considers this a Must Support element, however, some systems will not have a field directly representing it. Feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. In the meantime, various code systems in use in Canada are put forward as examples and optional slices have been created to encourage the use of existing Canadian terminology. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. Data Type: Codeable Concept (PS-CA) BindingCVC Route of Administration CVCRouteOfAdmin (preferred)Constraints
|
coding | Σ | 0..* | Data Type: Coding (PS-CA) | Element IdImmunization.route.coding A reference to a code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content Unordered, Open, by $this(Pattern) Constraints
|
routeEDQM | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.route.coding:routeEDQM Optional slice for representing the route of immunization administraction drawn from the EDQM value set. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content
|
routeCVC | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.route.coding:routeCVC Optional slice for representing the route of immunization administraction drawn from the Canadian Vaccine Catalogue Route of Administration value set. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content
|
RouteOfAdministrationV3 | Σ | 0..* | Data Type: Coding (PS-CA)Binding | Element IdImmunization.route.coding:RouteOfAdministrationV3 The path the administered medication takes to get into the body or into contact with the body. DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. While the IPS-UV specification considers this a Must Support element, some systems will not have the ability to support codings for every codeableConcept, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance. Implementors that support codings should still send the codings for codeable concepts if they are available and receivers should not produce failures or rejections if codings are included in the patient summary in the first release (a base tenet of FHIR). Additionally vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content v3.RouteOfAdministration (required) Constraints
|
text | S Σ | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.route.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
|
doseQuantity | I | 0..1 | SimpleQuantity | There are no (further) constraints on this element Element IdImmunization.doseQuantity Amount of vaccine administered DefinitionThe quantity of vaccine product that was administered. 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.
|
performer | Σ | 0..1 | BackboneElement | Element IdImmunization.performer Who performed event DefinitionIndicates who performed the immunization event. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.
|
function | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdImmunization.performer.function What type of performance was done DefinitionDescribes the type of performance (e.g. ordering provider, administering provider, etc.). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The role a practitioner or organization plays in the immunization event. ImmunizationFunctionCodes (extensible)Constraints
|
actor | Σ I | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | There are no (further) constraints on this element Element IdImmunization.performer.actor Individual or organization who was performing DefinitionThe practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send. Reference(Practitioner | PractitionerRole | Organization) Constraints
|
note | Σ | 0..* | Annotation | There are no (further) constraints on this element Element IdImmunization.note Additional immunization notes DefinitionExtra information about the immunization that is not conveyed by the other attributes. 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).
|
reasonCode | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.reasonCode Why immunization occurred DefinitionReasons why the vaccine was administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a vaccine was administered. ImmunizationReasonCodes (example)Constraints
| |
reasonReference | I | 0..* | Reference(Condition | Observation | DiagnosticReport) | There are no (further) constraints on this element Element IdImmunization.reasonReference Why immunization occurred DefinitionCondition, Observation or DiagnosticReport that supports why the immunization was administered. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Condition | Observation | DiagnosticReport) Constraints
|
isSubpotent | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element IdImmunization.isSubpotent Dose potency DefinitionIndication if a dose is considered to be subpotent. By default, a dose should be considered to be potent. Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event. By default, a dose should be considered to be potent.
|
subpotentReason | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.subpotentReason Reason for being subpotent DefinitionReason why a dose is considered to be subpotent. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason why a dose is considered to be subpotent. ImmunizationSubpotentReason (example)Constraints
| |
education | I | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImmunization.education Educational material presented to patient DefinitionEducational material presented to the patient (or guardian) at the time of vaccine administration.
|
documentType | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.education.documentType Educational material document identifier DefinitionIdentifier of the material presented to the patient. Note that FHIR strings SHALL NOT exceed 1MB in size
| |
reference | 0..1 | uri | There are no (further) constraints on this element Element IdImmunization.education.reference Educational material reference pointer DefinitionReference pointer to the educational material given to the patient if the information was on line. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
| |
publicationDate | 0..1 | dateTime | There are no (further) constraints on this element Element IdImmunization.education.publicationDate Educational material publication date DefinitionDate the educational material was published.
| |
presentationDate | 0..1 | dateTime | There are no (further) constraints on this element Element IdImmunization.education.presentationDate Educational material presentation date DefinitionDate the educational material was given to the patient.
| |
programEligibility | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.programEligibility Patient eligibility for a vaccination program DefinitionIndicates a patient's eligibility for a funding program. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The patient's eligibility for a vaccation program. ImmunizationProgramEligibility (example)Constraints
| |
fundingSource | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdImmunization.fundingSource Funding source for the vaccine DefinitionIndicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The source of funding used to purchase the vaccine administered. ImmunizationFundingSource (example)Constraints
| |
reaction | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImmunization.reaction Details of a reaction that follows immunization DefinitionCategorical data indicating that an adverse event is associated in time to an immunization. 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.
| |
date | 0..1 | dateTime | There are no (further) constraints on this element Element IdImmunization.reaction.date When reaction started DefinitionDate of reaction to the immunization.
| |
detail | I | 0..1 | Reference(Observation) | There are no (further) constraints on this element Element IdImmunization.reaction.detail Additional information on reaction DefinitionDetails of the reaction. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
|
reported | 0..1 | boolean | There are no (further) constraints on this element Element IdImmunization.reaction.reported Indicates self-reported reaction DefinitionSelf-reported indicator.
| |
protocolApplied | 0..* | BackboneElement | There are no (further) constraints on this element Element IdImmunization.protocolApplied Protocol followed by the provider DefinitionThe protocol (set of recommendations) being followed by the provider who administered the dose.
| |
series | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.protocolApplied.series Name of vaccine series DefinitionOne possible path to achieve presumed immunity against a disease - within the context of an authority. Note that FHIR strings SHALL NOT exceed 1MB in size
| |
authority | I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element IdImmunization.protocolApplied.authority Who is responsible for publishing the recommendations DefinitionIndicates the authority who published the protocol (e.g. ACIP) that is being followed. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
|
targetDisease | 0..* | CodeableConceptBinding | Element IdImmunization.protocolApplied.targetDisease Vaccine preventatable disease being targetted DefinitionThe vaccine preventable disease the dose is being administered against. IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for this element. In the meantime, various code systems in use in Canada are put forward as examples and optional slices have been created to encourage the use of existing Canadian terminology. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content. The vaccine preventable disease the dose is being administered for. CVCDisease (preferred)Constraints
| |
coding | Σ | 0..* | Coding | Element IdImmunization.protocolApplied.targetDisease.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. See usage note regarding the removal of the targetDiseaseGPS slice in this release and its replacement with the IPS slice in the interim to support validation tooling. Unordered, Open, by $this(Pattern) Constraints
|
targetDiseaseIPSCode | Σ | 0..* | CodingBinding | Element IdImmunization.protocolApplied.targetDisease.coding:targetDiseaseIPSCode Optional slice for representing the code for a disease the vaccination is against the IPS Value Set DefinitionCode for a disease the vaccination is against from the SNOMED CT code set. Allows for alternative encodings within a code system, and translations to other code systems. The IPS slice has replaced the GPS slice in this release to support validation tooling. TargetDiseasesUvIps (required) Constraints
|
targetDiseaseCVC | Σ | 0..* | CodingBinding | Element IdImmunization.protocolApplied.targetDisease.coding:targetDiseaseCVC Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue Disease value set. DefinitionCode for a disease the vaccination is against from the Canadian Vaccine Catalogue Disease value set. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
|
text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdImmunization.protocolApplied.targetDisease.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
|
doseNumber[x] | 1..1 | There are no (further) constraints on this element Element IdImmunization.protocolApplied.doseNumber[x] Dose number within series DefinitionNominal position in a series. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
| ||
doseNumberPositiveInt | positiveInt | There are no (further) constraints on this element Data Type | ||
doseNumberString | string | There are no (further) constraints on this element Data Type | ||
seriesDoses[x] | 0..1 | There are no (further) constraints on this element Element IdImmunization.protocolApplied.seriesDoses[x] Recommended number of doses for immunity DefinitionThe recommended number of doses to achieve immunity. The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
| ||
seriesDosesPositiveInt | positiveInt | There are no (further) constraints on this element Data Type | ||
seriesDosesString | string | There are no (further) constraints on this element Data Type |
Extensions
This profile uses the following extensions:
Immunization.occurrence[x]
: data-absent-reason (Must Support)
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
The following elements are considered Must Support in the Immunization (IPS) profile that are relaxed in this version of the PS-CA profile:
Immunization
Immunization.vaccineCode:vaccineGPSCode
Immunization.vaccineCode:atcClass
Immunization.site
Immunization.performer
and sub-elementsImmunization.protocolApplied.targetDisease:targetDiseaseGPSCode
Note: Systems that support these elements are encouraged to send them in patient summaries
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
Immunization.vaccineCode
- slices added for Canadian Vaccine Catalog Generic (CVCGeneric) and Tradename (CVCTradename) value sets
- CVCGeneric indicated as preferred value set (with CVCTradename as alternate)
Immunization.site
- slices added for Canadian Vaccine Catalog Anatomical Site (CVCAnatomicalSite) and HL7 v3 Human Substance Administration Site
- CVCAnatomicalSite indicated as preferred value set
Immunization.route
- slices added for Canadian Vaccine Catalog Route of Administration (CVCRouteOfAdmin) and HL7 v3.RouteOfAdministration
- CVCRouteOfAdmin indicated as preferred value set
Immunization.protocolApplied.targetDisease
- slice added for Canadian Vaccine Catalog Vaccine Preventable Disease (CVCDisease)
- CVCDisease indicated as preferred value set
Other differences between the IPS and PS-CA Include:
Immunization.vaccineCode
: IPS datatype profiling removedImmunization.patient
: reference target changed to Patient (PS-CA) profileImmunization.site
: IPS datatype profile replaced with Data Type: Codeable Concept (PS-CA) profileImmunization.route
: IPS datatype profile replaced with Data Type: Codeable Concept (PS-CA) profile