Australian Digital Health Agency Medicare Records FHIR Implementation Guide 2.2.0

Australian Digital Health Agency Medicare Records FHIR Implementation Guide. This is the current published version. It is based on FHIR® version 3.0.2. See the Directory of published versions for a list of available versions.

StructureDefinition: ADHA Australian Immunisation Register Immunization - Detailed Descriptions

Definitions for the profile.

1. Immunization
Definition

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

Control0..*
2. Immunization.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
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.

3. Immunization.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control1..1
TypeMeta
InvariantsDefined on this element
inv-dh-imm-01: One profile shall be 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air' (: profile.where($this='http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air').exists())
4. Immunization.meta.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
5. Immunization.meta.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

SlicingThis element introduces a set of slices on Immunization.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. Immunization.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

Control0..1
Typeid
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

7. Immunization.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

Control0..1
Typeinstant
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

8. Immunization.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Control1..*
Typeuri
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

9. Immunization.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Control0..*
BindingThe codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System
TypeCoding
Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

10. Immunization.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..*
BindingFor example codes, see Common Tags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones
TypeCoding
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

11. Immunization.implicitRules
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.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

12. Immunization.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable A human language
Additional BindingsPurpose
All LanguagesMax Binding
Typecode
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).

13. Immunization.text
Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrativehtmlxhtmldisplay
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

14. Immunization.contained
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.

Control0..*
TypeResource
Alternate Namesinline resourcesanonymous resourcescontained resources
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.

15. Immunization.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Immunization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. Immunization.extension:serialNumber
SliceNameserialNumber
Definition

Serial number for the vial of vaccine used in an administration.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(VaccineSerialNumber) (Extension Type: string)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
17. Immunization.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensionsuser content
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.

18. Immunization.identifier
Definition

A unique identifier assigned to this immunization record.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
TypeIdentifier
Must Supporttrue
19. Immunization.status
Definition

Indicates the current status of the vaccination event.

Control1..1
BindingThe codes SHALL be taken from Immunization Status Codes A set of codes indicating the current status of an Immunizatio
Typecode
Is Modifiertrue
Must Supporttrue
Comments

Will generally be set to show that the immunization has been completed.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Fixed Valuecompleted
20. Immunization.notGiven
Definition

Indicates if the vaccination was or was not given.

Control1..1
Typeboolean
Is Modifiertrue
Must Supporttrue
Comments

This element is labeled as a modifier because it indicates that an immunization didn't happen.

Fixed Valuefalse
21. Immunization.vaccineCode
Definition

Vaccine that was administered or was to be administered.

Control1..1
BindingThe codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/australian-vaccine-1
TypeCodeableConcept
Must Supporttrue
22. Immunization.patient
Definition

The patient who either received or did not receive the immunization.

Control1..1
TypeReference(AUBasePatient))
Must Supporttrue
23. Immunization.encounter
Definition

The visit or admission or other contact between patient and health care provider the immunization was performed as part of.

Control0..1
TypeReference(Encounter))
24. Immunization.date
Definition

Date vaccine administered or was to be administered.

Control1..1
TypedateTime
Must Supporttrue
Comments

When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.

25. Immunization.primarySource
Definition

An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.

Control1..1
Typeboolean
Must Supporttrue
Comments

Reflects the “reliability” of the content.

Fixed Valuetrue
26. Immunization.reportOrigin
Definition

The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.

Control0..1
BindingFor example codes, see Immunization Origin Codes The source of the data for a record which is not from a primary source
TypeCodeableConcept
Comments

Should not be populated if primarySource = True, will not be required even if primarySource = False.

27. Immunization.location
Definition

The service delivery location where the vaccine administration occurred.

Control0..1
TypeReference(Location))
28. Immunization.manufacturer
Definition

Name of vaccine manufacturer.

Control0..1
TypeReference(Organization))
29. Immunization.lotNumber
Definition

Lot number of the vaccine product.

Control0..1
Typestring
Must Supporttrue
30. Immunization.expirationDate
Definition

Date vaccine batch expires.

Control0..1
Typedate
31. Immunization.site
Definition

Body site where vaccine was administered.

Control0..1
BindingFor example codes, see Codes for Immunization Site of Administration The site at which the vaccine was administere
TypeCodeableConcept
32. Immunization.route
Definition

The path by which the vaccine product is taken into the body.

Control0..1
BindingFor example codes, see Immunization Route Codes The route by which the vaccine was administere
TypeCodeableConcept
33. Immunization.doseQuantity
Definition

The quantity of vaccine product that was administered.

Control0..1
TypeQuantity(SimpleQuantity)
34. Immunization.practitioner
Definition

Indicates who or what performed the event.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
35. Immunization.practitioner.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
36. Immunization.practitioner.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

37. Immunization.practitioner.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensionsuser contentmodifiers
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.

38. Immunization.practitioner.role
Definition

Describes the type of performance (e.g. ordering provider, administering provider, etc.).

Control0..1
BindingThe codes SHALL be taken from Immunization Role Codes; other codes may be used where these codes are not suitable The role a practitioner plays in the immunization even
TypeCodeableConcept
39. Immunization.practitioner.actor
Definition

The device, practitioner, etc. who performed the action.

Control1..1
TypeReference(Practitioner))
40. Immunization.note
Definition

Extra information about the immunization that is not conveyed by the other attributes.

Control0..*
TypeAnnotation
41. Immunization.explanation
Definition

Reasons why a vaccine was or was not administered.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
42. Immunization.explanation.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
43. Immunization.explanation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

44. Immunization.explanation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensionsuser contentmodifiers
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.

45. Immunization.explanation.reason
Definition

Reasons why a vaccine was administered.

Control0..*
BindingFor example codes, see Immunization Reason Codes The reason why a vaccine was administere
TypeCodeableConcept
46. Immunization.explanation.reasonNotGiven
Definition

Reason why a vaccine was not administered.

Control0..*
BindingFor example codes, see Immunization Reasons for Not Immunizing Codes The reason why a vaccine was not administere
TypeCodeableConcept
47. Immunization.reaction
Definition

Categorical data indicating that an adverse event is associated in time to an immunization.

Control0..*
TypeBackboneElement
Comments

A reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
48. Immunization.reaction.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
49. Immunization.reaction.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

50. Immunization.reaction.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensionsuser contentmodifiers
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.

51. Immunization.reaction.date
Definition

Date of reaction to the immunization.

Control0..1
TypedateTime
52. Immunization.reaction.detail
Definition

Details of the reaction.

Control0..1
TypeReference(Observation))
53. Immunization.reaction.reported
Definition

Self-reported indicator.

Control0..1
Typeboolean
54. Immunization.vaccinationProtocol
Definition

Contains information about the protocol(s) under which the vaccine was administered.

Control1..1
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
55. Immunization.vaccinationProtocol.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
56. Immunization.vaccinationProtocol.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensionsuser content
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.

57. Immunization.vaccinationProtocol.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensionsuser contentmodifiers
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.

58. Immunization.vaccinationProtocol.doseSequence
Definition

Nominal position in a series.

Control0..1
TypepositiveInt
Must Supporttrue
59. Immunization.vaccinationProtocol.description
Definition

Contains the description about the protocol under which the vaccine was administered.

Control0..1
Typestring
60. Immunization.vaccinationProtocol.authority
Definition

Indicates the authority who published the protocol. E.g. ACIP.

Control0..1
TypeReference(Organization))
61. Immunization.vaccinationProtocol.series
Definition

One possible path to achieve presumed immunity against a disease - within the context of an authority.

Control0..1
Typestring
62. Immunization.vaccinationProtocol.seriesDoses
Definition

The recommended number of doses to achieve immunity.

Control0..1
TypepositiveInt
63. Immunization.vaccinationProtocol.targetDisease
Definition

The targeted disease.

Control1..*
BindingFor example codes, see Vaccination Protocol Dose Target Codes The disease target of the vaccination protoco
TypeCodeableConcept
Must Supporttrue
64. Immunization.vaccinationProtocol.doseStatus
Definition

Indicates if the immunization event should "count" against the protocol.

Control1..1
BindingFor example codes, see Vaccination Protocol Dose Status codes The status of the vaccination protocol (i.e. should this count
TypeCodeableConcept
Comments

May need to differentiate between status declarations by a provider vs. a CDS engine.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/v3/NullFlavor"/>
    <code value="NAVU"/>
  </coding>
</valueCodeableConcept>
65. Immunization.vaccinationProtocol.doseStatusReason
Definition

Provides an explanation as to why an immunization event should or should not count against the protocol.

Control0..1
BindingFor example codes, see Vaccination Protocol Dose Status Reason codes The reason for the determining if a vaccination should count or why vaccination should not count
TypeCodeableConcept