R5 Final QA
MedicationsThis page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). 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: 1 | Trial Use | Security Category: Patient | Compartments: Patient |
Describes a comparison of an immunization event against published recommendations to determine if the administration is "valid" in relation to those recommendations.
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.
As the ImmunizationEvaluation resource is focused on the evaluation of a single vaccine administration event, it does not include data regarding the overall patient status relative to the recommendations used in the evaluation. For example, a total of 3 doses of hepatitis B vaccine may be required for patient protection, but an instance of the ImmunizationEvaluation resource will be concerned with only one of the doses (although other instances of ImmunizationEvaluation should exist for the other doses). The ImmunizationRecommendation resource is used to convey the overall patient status (e.g. a dose is due or the patient is complete) relative to the hepatitis B series.
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.
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  ImmunizationEvaluation | TU | DomainResource | Immunization evaluation information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
  identifier | 0..* | Identifier | Business identifier | |
 status | ?!Σ | 1..1 | code | completed | entered-in-error Binding: Immunization Evaluation Status Codes (Required) |
 patient | Σ | 1..1 | Reference(Patient) | Who this evaluation is for |
| date | 0..1 | dateTime | Date evaluation was performed | |
| authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
| targetDisease | Σ | 1..1 | CodeableConcept | The vaccine preventable disease schedule being evaluated Binding: Immunization Target Disease Codes (Example) |
| immunizationEvent | Σ | 1..1 | Reference(Immunization) | Immunization being evaluated |
| doseStatus | Σ | 1..1 | CodeableConcept | Status of the dose relative to published recommendations Binding: Immunization Evaluation Dose Status codes (Example) |
| doseStatusReason | 0..* | CodeableConcept | Reason why the doese is considered valid, invalid or some other status Binding: Immunization Evaluation Dose Status Reason codes (Example) | |
| description | 0..1 | markdown | Evaluation notes | |
| series | 0..1 | string | Name of vaccine series | |
| doseNumber | 0..1 | string | Dose number within series | |
 seriesDoses | 0..1 | string | Recommended number of doses for immunity | |
| Documentation for this format | ||||
See the Extensions for this resource
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..1 CodeableConcept The vaccine preventable disease schedule being evaluated --></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 why the doese is considered valid, invalid or some other status --></doseStatusReason> <description value="[markdown]"/><!-- 0..1 Evaluation notes --> <series value="[string]"/><!-- 0..1 Name of vaccine series --> <doseNumber value="[string]"/><!-- 0..1 Dose number within series --> <seriesDoses value="[string]"/><!-- 0..1 Recommended number of doses for immunity --> </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! The vaccine preventable disease schedule being evaluated
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason why the doese is considered valid, invalid or some other status
"description" : "<markdown>", // Evaluation notes
"series" : "<string>", // Name of vaccine series
"doseNumber" : "<string>", // Dose number within series
"seriesDoses" : "<string>" // Recommended number of doses for immunity
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since R4
| ImmunizationEvaluation | |
| ImmunizationEvaluation.description |
|
| ImmunizationEvaluation.doseNumber |
|
| ImmunizationEvaluation.seriesDoses |
|
| ImmunizationEvaluation.doseNumber[x] |
|
| ImmunizationEvaluation.seriesDoses[x] |
|
See the Full Difference for further information
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| ImmunizationEvaluation | TU | DomainResource | Immunization evaluation information Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
| identifier | 0..* | Identifier | Business identifier | |
| status | ?!Σ | 1..1 | code | completed | entered-in-error Binding: Immunization Evaluation Status Codes (Required) |
| patient | Σ | 1..1 | Reference(Patient) | Who this evaluation is for |
| date | 0..1 | dateTime | Date evaluation was performed | |
| authority | 0..1 | Reference(Organization) | Who is responsible for publishing the recommendations | |
| targetDisease | Σ | 1..1 | CodeableConcept | The vaccine preventable disease schedule being evaluated Binding: Immunization Target Disease Codes (Example) |
| immunizationEvent | Σ | 1..1 | Reference(Immunization) | Immunization being evaluated |
| doseStatus | Σ | 1..1 | CodeableConcept | Status of the dose relative to published recommendations Binding: Immunization Evaluation Dose Status codes (Example) |
| doseStatusReason | 0..* | CodeableConcept | Reason why the doese is considered valid, invalid or some other status Binding: Immunization Evaluation Dose Status Reason codes (Example) | |
| description | 0..1 | markdown | Evaluation notes | |
| series | 0..1 | string | Name of vaccine series | |
| doseNumber | 0..1 | string | Dose number within series | |
| seriesDoses | 0..1 | string | Recommended number of doses for immunity | |
| Documentation for this format | ||||
See the Extensions for this resource
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! The vaccine preventable disease schedule being evaluated
"immunizationEvent" : { Reference(Immunization) }, // R! Immunization being evaluated
"doseStatus" : { CodeableConcept }, // R! Status of the dose relative to published recommendations
"doseStatusReason" : [{ CodeableConcept }], // Reason why the doese is considered valid, invalid or some other status
"description" : "<markdown>", // Evaluation notes
"series" : "<string>", // Name of vaccine series
"doseNumber" : "<string>", // Dose number within series
"seriesDoses" : "<string>" // Recommended number of doses for immunity
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since Release 4
| ImmunizationEvaluation | |
| ImmunizationEvaluation.description |
|
| ImmunizationEvaluation.doseNumber |
|
| ImmunizationEvaluation.seriesDoses |
|
| ImmunizationEvaluation.doseNumber[x] |
|
| ImmunizationEvaluation.seriesDoses[x] |
|
See the Full Difference for further information
Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis
| Path | ValueSet | Type | Documentation |
|---|---|---|---|
| ImmunizationEvaluation.status | ImmunizationEvaluationStatusCodes | Required | The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the current status of the evaluation for vaccine administration event. |
| ImmunizationEvaluation.targetDisease | ImmunizationTargetDiseaseCodes | Example | The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the disease that the dose is being administered against. This value set is provided as a suggestive example and includes SNOMED CT concepts from the 64572001 (Disease) hierarchy. |
| ImmunizationEvaluation.doseStatus | ImmunizationEvaluationDoseStatusCodes | Example | The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the validity of a dose relative to a particular recommended schedule. This value set is provided as a suggestive example. |
| ImmunizationEvaluation.doseStatusReason | ImmunizationEvaluationDoseStatusReasonCodes | Example | The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support describing the reason why an administered dose has been assigned a particular status. Often, this reason describes why a dose is considered invalid. This value set is provided as a suggestive example. |
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. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to 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 | 27 Resources |
| dose-status | token | The status of the dose relative to published recommendations | ImmunizationEvaluation.doseStatus | |
| identifier | token | ID of the evaluation | ImmunizationEvaluation.identifier | 65 Resources |
| immunization-event | reference | The vaccine administration event being evaluated | ImmunizationEvaluation.immunizationEvent (Immunization) | |
| patient | reference | The patient being evaluated | ImmunizationEvaluation.patient (Patient) | 66 Resources |
| status | token | Immunization evaluation status | ImmunizationEvaluation.status | |
| target-disease | token | The vaccine preventable disease being evaluated against | ImmunizationEvaluation.targetDisease |
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0-draft-final generated on Wed, Mar 1, 2023 23:06+1100.
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