R4 Ballot #1 (Mixed Normative/Trial use)
MedicationsThis page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
. Page versions: R5 R4B R4
| Public Health and Emergency Response Work Group | Maturity Level: 0 | Trial Use | Compartments: Patient |
Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.
STU Note: The Public Health work group wants to draw the attention of reviewers and implementers to the following issues for feedback:
- The ImmunizationEvaluation resource can be thought of as a specialization of a generic evaluation against a set of standardized recommendations (for a medication or a procedure, etc.). Is it better to have a single generic evaluation resource that is then profiled for use in specific domains (immunization evaluation, medication evaluation, etc.) or individual, specific resources for each domain which require less profiling and may be easier for domain implementers to understand?
- Should the ImmunizationEvaluation resource be harmonized with the CDS Hooks project?
The ImmunizationEvaluation resource is intended to cover communicating the results of an evaluation of a vaccine administration event (documented using the Immunization resource) against a set of published recommendations (protocols). Evaluating administered doses in a patient's immunization history is central to ensuring that the patient if fully protected against vaccine-preventable diseases. It is also a necessary prerequisite to generating a customized set of immunization recommendations for the patient.
The ImmunizationEvaluation resource communicates the results of an evaluation of an instance of the Immunization resource relative to a set of published recommendations. It is intended to communicate if the vaccine administration event was "valid" or "not valid" relative to the recommendations. Once all vaccine administration events in a patient's record have been evaluated, it is then possible to generate a set of vaccination related recommendations, unique for the patient. These recommendations are communicated using the ImmunizationRecommedation resource.
Through FHIR Release 3, the Immunization resource contained a "protocol" backbone element which functioned as an evaluation of the vaccine administration event. Beginning in Release 4, this new resource replaces the Immunization.protocol element.
This resource is referenced by immunizationrecommendation
Structure
UML Diagram (Legend)
XML Template
<ImmunizationEvaluation xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Business identifier --></identifier> <status value="[code]"/><!-- 1..1 completed | entered-in-error --> <patient><!-- 1..1 Reference(Patient) Who this evaluation is for --></patient> <date value="[dateTime]"/><!-- 0..1 Date evaluation was performed --> <authority><!-- 0..1 Reference(Organization) Who is responsible for publishing the recommendations --></authority> <targetDisease><!-- 1..* CodeableConcept Evaluation target disease --></targetDisease> <immunizationEvent><!-- 1..1 Reference(Immunization) Immunization being evaluated --></immunizationEvent> <doseStatus><!-- 1..1 CodeableConcept Status of the dose relative to published recommendations --></doseStatus> <doseStatusReason><!-- 0..* CodeableConcept Reason for the dose status --></doseStatusReason> <description value="[string]"/><!-- 0..1 Evaluation notes --> <series value="[string]"/><!-- 0..1 Name of vaccine series --> <doseNumber[x]><!-- 0..1 positiveInt|string Dose number within series --></doseNumber[x]> <seriesDoses[x]><!-- 0..1 positiveInt|string Recommended number of doses for immunity --></seriesDoses[x]> </ImmunizationEvaluation>
JSON Template
{
"resourceType" : "ImmunizationEvaluation",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business identifier
"status" : "<code>", // R! completed | entered-in-error
"patient" : { Reference(Patient) }, // R! Who this evaluation is for
"date" : "<dateTime>", // Date evaluation was performed
"authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
"targetDisease" : [{ CodeableConcept }], // R! Evaluation target disease
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason for the dose status
"description" : "<string>", // Evaluation notes
"series" : "<string>", // Name of vaccine series
// doseNumber[x]: Dose number within series. One of these 2:
"doseNumberPositiveInt" : "<positiveInt>",
"doseNumberString" : "<string>",
// seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
"seriesDosesPositiveInt" : "<positiveInt>"
"seriesDosesString" : "<string>"
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Structure
XML Template
<ImmunizationEvaluation xmlns="http://hl7.org/fhir">
JSON Template
{
"resourceType" : "ImmunizationEvaluation",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business identifier
"status" : "<code>", // R! completed | entered-in-error
"patient" : { Reference(Patient) }, // R! Who this evaluation is for
"date" : "<dateTime>", // Date evaluation was performed
"authority" : { Reference(Organization) }, // Who is responsible for publishing the recommendations
"targetDisease" : [{ CodeableConcept }], // R! Evaluation target disease
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason for the dose status
"description" : "<string>", // Evaluation notes
"series" : "<string>", // Name of vaccine series
// doseNumber[x]: Dose number within series. One of these 2:
"doseNumberPositiveInt" : "<positiveInt>",
"doseNumberString" : "<string>",
// seriesDoses[x]: Recommended number of doses for immunity. One of these 2:
"seriesDosesPositiveInt" : "<positiveInt>"
"seriesDosesString" : "<string>"
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis
| Path | Definition | Type | Reference |
|---|---|---|---|
| ImmunizationEvaluation.status | The status of the evaluation being done | Required | Immunization Evaluation Status Codes |
| ImmunizationEvaluation.targetDisease | The vaccine preventable disease the dose is being evaluated against | Example | Immunization Evaluation Target Disease Codes |
| ImmunizationEvaluation.doseStatus | The status of the administered dose relative to the published recommendations for the target disease. | Example | Immunization Evaluation Dose Status codes |
| ImmunizationEvaluation.doseStatusReason | The reason the dose status was assigned | Example | Immunization Evaluation Dose Status Reason codes |
A single vaccine administration event (as communicated via the Immunization resource) may be evaluated against multiple published recommendations, against the same set of published recommendations at different points in time or against published recommendations for different vaccine-preventable diseases. That is a single Immunization record may be linked to multiple ImmunizationEvaluation records.
For example a dose of Twinrix contains antigen against both Hepatitis A and Hepatitis B. The evaluation of such a dose should happen against recommendations for both types of Hepatitis. Furthermore, the dose may be evaluated against both national and local recommendation or may be evaluated against either set of recommendations at multiple points in time (yearly as the patient comes in for standard "well person" appointment with their care provider).
Typically a single "recommendation" is prepared for the patient based on the evaluation of all of the vaccine administration events in the patient's history. This "recommendation" may include individual recommendations for multiple vaccines/vaccine groups. For example, a recommendation may be generated that includes recommendations for both influenza and diphtheria/tetanus vaccinations. Such recommendations use the ImmunizationRecommedation resource.
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Expression | In Common |
| date | date | Date the evaluation was generated | ImmunizationEvaluation.date | |
| dose-status | token | The status of the dose relative to published recommendations | ImmunizationEvaluation.doseStatus | |
| identifier | token | ID of the evaluation | ImmunizationEvaluation.identifier | |
| immunization-event | reference | The vaccine administration event being evaluated | ImmunizationEvaluation.immunizationEvent (Immunization) | |
| patient | reference | The patient being evaluated | ImmunizationEvaluation.patient (Patient) | |
| status | token | Immunization evaluation status | ImmunizationEvaluation.status | |
| target-disease | token | The vaccine preventable disease being evaluated against | ImmunizationEvaluation.targetDisease |
®© HL7.org 2011+. FHIR Mixed Nomative/Trial Use Ballot (v3.3.0-13671) generated on Tue, Apr 3, 2018 12:15+1000. QA Page
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