2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Profile: DAFImmunization

Profile for Defines constraints and extensions on the Immunization resource for use in querying and retrieving patient's immunization information. : U.S. Data Access Framework (DAF) Immunization Profile

{
  "resourceType": "Profile",
  "id": "immunization-daf-dafimmunization",
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "url": "http://hl7.org/fhir/Profile/immunization-daf-dafimmunization",
  "name": "U.S. Data Access Framework (DAF) Immunization Profile",
  "publisher": "U.S. Office of the National Coordinator (ONC)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.healthit.gov"
        }
      ]
    }
  ],
  "description": "Defines constraints and extensions on the Immunization resource for use in querying and retrieving patient's immunization information. : U.S. Data Access Framework (DAF) Immunization Profile",
  "status": "draft",
  "date": "2014-08-21",
  "mapping": [
    {
      "identity": "quick",
      "uri": "http://wiki.siframework.org/CQF",
      "name": "Quality Improvement and Clinical Knowledge (QUICK)"
    }
  ],
  "type": "Immunization",
  "base": "http://hl7.org/fhir/Profile/Immunization",
  "snapshot": {
    "element": [
      {
        "path": "Immunization",
        "name": "DAFImmunization",
        "short": "Immunization event information",
        "definition": "Immunization event information.",
        "min": 1,
        "max": "1",
        "mapping": [
          {
            "identity": "v2",
            "map": "VXU_V04"
          },
          {
            "identity": "rim",
            "map": "SubstanceAdministration"
          },
          {
            "identity": "quick",
            "map": "ImmunizationPerformanceOccurrence"
          }
        ]
      },
      {
        "path": "Immunization.id",
        "short": "Logical id of this artefact",
        "definition": "The logical id of the resource, as used in the url for the resoure. 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. Bundles always have an id, though it is usually a generated UUID.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "id"
          }
        ]
      },
      {
        "path": "Immunization.meta",
        "short": "Metadata about the resource",
        "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Meta"
          }
        ]
      },
      {
        "path": "Immunization.implicitRules",
        "short": "A set of rules under which this content was created",
        "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
        "comments": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "uri"
          }
        ],
        "isModifier": true
      },
      {
        "path": "Immunization.language",
        "short": "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\n\nNot 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).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "code"
          }
        ],
        "binding": {
          "name": "Language",
          "isExtensible": false,
          "conformance": "required",
          "description": "A human language",
          "referenceUri": "http://tools.ietf.org/html/bcp47"
        }
      },
      {
        "path": "Immunization.text",
        "short": "Text summary of the resource, for human interpretation",
        "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
        "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
        "synonym": [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Narrative"
          }
        ],
        "condition": [
          "dom-1"
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "Act.text?"
          }
        ]
      },
      {
        "path": "Immunization.contained",
        "short": "Contained, inline 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.",
        "synonym": [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Resource"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.extension",
        "short": "Additional Content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.identifier",
        "short": "Business identifier",
        "definition": "A unique identifier assigned to this immunization record.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/id"
          },
          {
            "identity": "rim",
            "map": ".id"
          },
          {
            "identity": "quick",
            "map": "identifier"
          }
        ]
      },
      {
        "path": "Immunization.date",
        "short": "Vaccination administration date",
        "definition": "Date vaccine administered or was to be administered.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/effectiveTime/value"
          },
          {
            "identity": "v2",
            "map": "RXA-3-date/time start of administration"
          },
          {
            "identity": "rim",
            "map": ".effectiveTime"
          },
          {
            "identity": "quick",
            "map": "performanceTime"
          }
        ]
      },
      {
        "path": "Immunization.vaccineType",
        "short": "Vaccine Product Type (bind to CVX)",
        "definition": "Vaccine Product Type (bind to CVX).",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "VaccineTypesCVX",
          "isExtensible": true,
          "conformance": "preferred",
          "description": "This identifies the CVX code system",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/daf-cvx"
          }
        },
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/realmCode/code"
          },
          {
            "identity": "v2",
            "map": "RXA-5-administered code"
          },
          {
            "identity": "rim",
            "map": ".code"
          },
          {
            "identity": "quick",
            "map": "vaccine"
          }
        ]
      },
      {
        "path": "Immunization.patient",
        "short": "Who was immunized?",
        "definition": "The patient who either received or did not receive the immunization.",
        "synonym": [
          "Patient"
        ],
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/patient-daf-dafpatient"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "PID-3-patient ID list"
          },
          {
            "identity": "rim",
            "map": ".partipication[ttypeCode=].role"
          },
          {
            "identity": "quick",
            "map": "subject"
          }
        ]
      },
      {
        "path": "Immunization.wasNotGiven",
        "short": "Was immunization given?",
        "definition": "Indicates if the vaccination was or was not given.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "constraint": [
          {
            "key": "imm-2",
            "name": "Given administration",
            "severity": "error",
            "human": "If immunization was administered (wasNotGiven=false) then explanation.reasonNotGiven SHALL be absent.",
            "xpath": "not(f:wasNotGiven/@value='false' and exists(f:explanation/f:reasonNotGiven))"
          },
          {
            "key": "imm-1",
            "name": "Not given administration",
            "severity": "error",
            "human": "If immunization was not administred (wasNotGiven=true) then there SHALL be no reaction nor explanation.reason present",
            "xpath": "not(f:wasNotGiven/@value='true' and (count(f:reaction) > 0 or exists(f:explanation/reason)))"
          }
        ],
        "isModifier": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "[actionNegationInd=true].reasonCode"
          }
        ]
      },
      {
        "path": "Immunization.reported",
        "short": "Is this a self-reported record?",
        "definition": "True if this administration was reported rather than directly administered.",
        "comments": "May need source of reported info (e.g. parent), but leave out for now.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-9"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)"
          },
          {
            "identity": "quick",
            "map": "reported"
          }
        ]
      },
      {
        "path": "Immunization.performer",
        "short": "Who administered vaccine?",
        "definition": "Clinician who administered the vaccine.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Practitioner"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/performer/assignedEntity/assignedPerson/name"
          },
          {
            "identity": "v2",
            "map": "RXA-10-administering provider"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=PRF].COCT_MT090102UV"
          },
          {
            "identity": "quick",
            "map": "performedBy"
          }
        ]
      },
      {
        "path": "Immunization.requester",
        "short": "Who ordered vaccination?",
        "definition": "Clinician who ordered the vaccination.",
        "comments": "Other participants - delegate to Provenance resource.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Practitioner"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "ORC-12-ordering provider"
          },
          {
            "identity": "rim",
            "map": "outboundRelationship.target[classCode=SBADM].participation[typeCode=AUT].COCT_MT090102UV"
          },
          {
            "identity": "quick",
            "map": "orderedBy"
          }
        ]
      },
      {
        "path": "Immunization.encounter",
        "short": "Encounter administered as part of",
        "definition": "The visit or admission or other contact between patient and health care provider the immunization was performed as part of.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Encounter"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "PV1-19-Visit Number"
          },
          {
            "identity": "rim",
            "map": "component->EncounterEvent"
          }
        ]
      },
      {
        "path": "Immunization.manufacturer",
        "short": "Vaccine Manufacturer",
        "definition": "Vaccine Manufacturer.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Organization"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacuturerOrganization/name"
          },
          {
            "identity": "v2",
            "map": "RXA-17-substance manufacturer name"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=ORG]"
          }
        ]
      },
      {
        "path": "Immunization.location",
        "short": "Where did vaccination occur?",
        "definition": "The service delivery location where the vaccine administration occurred.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Location"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-27-administered-at (or RXA-11-administered-at location, deprecated as of v2.7)"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=LOC].COCT_MT240000UV"
          }
        ]
      },
      {
        "path": "Immunization.lotNumber",
        "short": "Vaccine lot number",
        "definition": "Lot number of the  vaccine product.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/consumable/manfacturedProduct/manufacturedMaterial/lotNumberText"
          },
          {
            "identity": "v2",
            "map": "RXA-15-substance lot number"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].id"
          },
          {
            "identity": "quick",
            "map": "vaccine.lotNumber"
          }
        ]
      },
      {
        "path": "Immunization.expirationDate",
        "short": "Vaccine expiration date",
        "definition": "Date vaccine batch expires.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "date"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-16-substance expiration date"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].expirationTime"
          },
          {
            "identity": "quick",
            "map": "vaccine.expiry"
          }
        ]
      },
      {
        "path": "Immunization.site",
        "short": "Body site vaccine  was administered",
        "definition": "Body site where vaccine was administered.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "ImmunizationSite",
          "isExtensible": true,
          "conformance": "example",
          "description": "The site at which the vaccine was administered",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/immunization-site"
          }
        },
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/approachSiteCode/code"
          },
          {
            "identity": "v2",
            "map": "RXR-2-administration site"
          },
          {
            "identity": "rim",
            "map": "observation.targetSiteCode"
          },
          {
            "identity": "quick",
            "map": "dosage.approachBodySite.anatomicalLocation"
          }
        ]
      },
      {
        "path": "Immunization.route",
        "short": "How vaccine entered body",
        "definition": "The path by which the vaccine product is taken into the body.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "ImmunizationRoute",
          "isExtensible": true,
          "conformance": "example",
          "description": "The route by which the vaccine was administered",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/immunization-route"
          }
        },
        "mapping": [
          {
            "identity": "cda",
            "map": "ClinicalDocument/component/StructuredBody/component/section/entry/substanceAdministration/routeCode/code"
          },
          {
            "identity": "v2",
            "map": "RXR-1-route"
          },
          {
            "identity": "rim",
            "map": ".routeCode"
          },
          {
            "identity": "quick",
            "map": "dosage.route"
          }
        ]
      },
      {
        "path": "Immunization.doseQuantity",
        "short": "Amount of vaccine administered",
        "definition": "The quantity of vaccine product that was administered.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-6-administered amount / RXA-7.1-administered units.code"
          },
          {
            "identity": "rim",
            "map": ".doseQuantity"
          },
          {
            "identity": "quick",
            "map": "dosage.doseQuantity"
          }
        ]
      },
      {
        "path": "Immunization.explanation",
        "short": "Administration / non-administration reasons",
        "definition": "Reasons why a vaccine was or was not administered.",
        "min": 0,
        "max": "1",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "quick",
            "map": "indication"
          }
        ]
      },
      {
        "path": "Immunization.explanation.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.explanation.extension",
        "short": "Additional Content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.explanation.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.explanation.reason",
        "short": "Why immunization occurred",
        "definition": "Reasons why a vaccine was administered.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "ImmunizationReason",
          "isExtensible": true,
          "conformance": "example",
          "description": "The reason why a vaccine was administered",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/immunization-reason"
          }
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "[actionNegationInd=false].reasonCode"
          },
          {
            "identity": "quick",
            "map": "indication.reason"
          }
        ]
      },
      {
        "path": "Immunization.explanation.reasonNotGiven",
        "short": "Why immunization did not occur",
        "definition": "Reason why a vaccine was not administered.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "name": "NoImmunizationReason",
          "isExtensible": true,
          "conformance": "example",
          "description": "The reason why a vaccine was not administered",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/no-immunization-reason"
          }
        },
        "mapping": [
          {
            "identity": "v2",
            "map": "RXA-18"
          },
          {
            "identity": "rim",
            "map": "[actionNegationInd=true].reasonCode"
          }
        ]
      },
      {
        "path": "Immunization.reaction",
        "short": "Details of a reaction that follows immunization",
        "definition": "Categorical data indicating that an adverse event is associated in time to an immunization.",
        "min": 0,
        "max": "*",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "OBX-3"
          },
          {
            "identity": "rim",
            "map": "Observation[classCode=obs].code"
          }
        ]
      },
      {
        "path": "Immunization.reaction.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.reaction.extension",
        "short": "Additional Content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.reaction.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.reaction.date",
        "short": "When did reaction start?",
        "definition": "Date of reaction to the immunization.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the V2.x VXU message - most likely would appear in OBX segments if at all\n)"
          },
          {
            "identity": "rim",
            "map": ".effectiveTime"
          }
        ]
      },
      {
        "path": "Immunization.reaction.detail",
        "short": "Additional information on reaction",
        "definition": "Details of the reaction.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Observation"
          }
        ],
        "mapping": [
          {
            "identity": "v2",
            "map": "OBX-5"
          },
          {
            "identity": "rim",
            "map": ".value"
          }
        ]
      },
      {
        "path": "Immunization.reaction.reported",
        "short": "Was reaction self-reported?",
        "definition": "Self-reported indicator.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "(no such concept seems to exist for allergy/adverse reaction in V2.x)"
          },
          {
            "identity": "rim",
            "map": ".participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol",
        "short": "What protocol was followed",
        "definition": "Contains information about the protocol(s) under which the vaccine was administered.",
        "min": 0,
        "max": "*",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "(V2.x doesn't seem to provide for this)"
          },
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM]"
          },
          {
            "identity": "quick",
            "map": "protocol"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "xml:id (or equivalent in JSON)",
        "definition": "unique id for the element within a resource (for internal references).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "id"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.extension",
        "short": "Additional Content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.modifierExtension",
        "short": "Extensions that cannot be ignored",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comments": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "synonym": [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseSequence",
        "short": "What dose number within series?",
        "definition": "Nominal position in a series.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "integer"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].sequenceNumber"
          },
          {
            "identity": "quick",
            "map": "protocol.doseSequence"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.description",
        "short": "Details of vaccine protocol",
        "definition": "Contains the description about the protocol under which the vaccine was administered.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text"
          },
          {
            "identity": "quick",
            "map": "protocol.description"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.authority",
        "short": "Who is responsible for protocol",
        "definition": "Indicates the authority who published the protocol?  E.g. ACIP.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Organization"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].participation[typeCode=AUT].COCT_MT090200UV"
          },
          {
            "identity": "quick",
            "map": "protocol.authority"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.series",
        "short": "Name of vaccine series",
        "definition": "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM]"
          },
          {
            "identity": "quick",
            "map": "protocol.series"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.seriesDoses",
        "short": "Recommended number of doses for immunity",
        "definition": "The recommended number of doses to achieve immunity.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "integer"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship[typeCode=INST].target[classCode=SBADM].inboundRelationship[typeCode=COMP].source[classCode=SBADM].text"
          },
          {
            "identity": "quick",
            "map": "protocol.seriesDoses"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseTarget",
        "short": "Disease immunized against",
        "definition": "The targeted disease.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "VaccinationProtocolDoseTarget",
          "isExtensible": true,
          "conformance": "example",
          "description": "The disease target of the vaccination protocol",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/vaccination-protocol-dose-target"
          }
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "outboundRelationship.target[classCode=OBS].code"
          },
          {
            "identity": "quick",
            "map": "protocol.doseTarget"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseStatus",
        "short": "Does dose count towards immunity?",
        "definition": "Indicates if the immunization event should \"count\" against  the protocol.",
        "comments": "May need to differentiate between status declarations by a provider vs. a CDS engine.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "name": "VaccinationProtocolDoseStatus",
          "isExtensible": true,
          "conformance": "example",
          "description": "The status of the vaccination protocol (i.e. should this count)",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/vaccination-protocol-dose-status"
          }
        },
        "mapping": [
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].value"
          },
          {
            "identity": "quick",
            "map": "protocol.doseStatus"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseStatusReason",
        "short": "Why does does count/not count?",
        "definition": "Provides an explanation as to why a immunization event should or should not count against the protocol.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "name": "VaccinationProtocolDoseStatusReason",
          "isExtensible": true,
          "conformance": "example",
          "description": "The reason for the determining if a vaccination should count or why vaccination should not count.",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/vaccination-protocol-dose-status-reason"
          }
        },
        "mapping": [
          {
            "identity": "rim",
            "map": ".participation[typeCode=CSM].role[classCode=INST].scopedRole.scoper[classCode=MMAT].playedRole[classCode=INGR].scopedRole.scoper[classCode=MMAT].playedRole[classCode=HLTHCHRT].participation[typeCode=SBJ].observation[classCode=OBS].reasonCode"
          },
          {
            "identity": "quick",
            "map": "protocol.doseStatusReason"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "path": "Immunization",
        "name": "DAFImmunization",
        "min": 1,
        "max": "1",
        "mapping": [
          {
            "identity": "quick",
            "map": "ImmunizationPerformanceOccurrence"
          }
        ]
      },
      {
        "path": "Immunization.identifier",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "identifier"
          }
        ]
      },
      {
        "path": "Immunization.date",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "performanceTime"
          }
        ]
      },
      {
        "path": "Immunization.vaccineType",
        "short": "Vaccine Product Type (bind to CVX)",
        "definition": "Vaccine Product Type (bind to CVX).",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "name": "VaccineTypesCVX",
          "isExtensible": true,
          "conformance": "preferred",
          "description": "This identifies the CVX code system",
          "referenceReference": {
            "reference": "http://hl7.org/fhir/vs/daf-cvx"
          }
        },
        "mapping": [
          {
            "identity": "quick",
            "map": "vaccine"
          }
        ]
      },
      {
        "path": "Immunization.patient",
        "synonym": [
          "Patient"
        ],
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/patient-daf-dafpatient"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "subject"
          }
        ]
      },
      {
        "path": "Immunization.reported",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "reported"
          }
        ]
      },
      {
        "path": "Immunization.performer",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Practitioner"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "performedBy"
          }
        ]
      },
      {
        "path": "Immunization.requester",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Practitioner"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "orderedBy"
          }
        ]
      },
      {
        "path": "Immunization.manufacturer",
        "short": "Vaccine Manufacturer",
        "definition": "Vaccine Manufacturer.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Organization"
          }
        ],
        "mustSupport": true
      },
      {
        "path": "Immunization.lotNumber",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "vaccine.lotNumber"
          }
        ]
      },
      {
        "path": "Immunization.expirationDate",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "date"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "vaccine.expiry"
          }
        ]
      },
      {
        "path": "Immunization.site",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "dosage.approachBodySite.anatomicalLocation"
          }
        ]
      },
      {
        "path": "Immunization.route",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "dosage.route"
          }
        ]
      },
      {
        "path": "Immunization.doseQuantity",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "dosage.doseQuantity"
          }
        ]
      },
      {
        "path": "Immunization.explanation",
        "min": 0,
        "max": "1",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "indication"
          }
        ]
      },
      {
        "path": "Immunization.explanation.reason",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "indication.reason"
          }
        ]
      },
      {
        "path": "Immunization.reaction",
        "min": 0,
        "max": "*",
        "mustSupport": true
      },
      {
        "path": "Immunization.reaction.date",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "path": "Immunization.reaction.detail",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Observation"
          }
        ]
      },
      {
        "path": "Immunization.reaction.reported",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": true
      },
      {
        "path": "Immunization.vaccinationProtocol",
        "min": 0,
        "max": "*",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseSequence",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "integer"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.doseSequence"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.description",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.description"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.authority",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "profile": "http://hl7.org/fhir/Profile/Organization"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.authority"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.series",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.series"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.seriesDoses",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "integer"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.seriesDoses"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseTarget",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.doseTarget"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseStatus",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.doseStatus"
          }
        ]
      },
      {
        "path": "Immunization.vaccinationProtocol.doseStatusReason",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mapping": [
          {
            "identity": "quick",
            "map": "protocol.doseStatusReason"
          }
        ]
      }
    ]
  }
}