R6 Ballot (2nd Draft)

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Example Immunization/protocol (XML)

Public Health Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

Raw XML (canonical form + also see XML Format Specification)

Example where the provider indicates the protocol being followed (id = "protocol")

<?xml version="1.0" encoding="UTF-8"?>

<!--  Authored by Joginder Madra  --><Immunization xmlns="http://hl7.org/fhir">
  <id value="protocol"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/> 
  </identifier> 
  <status value="completed"/> 
  <vaccineCode> 
    <coding> 
      <system value="http://hl7.org/fhir/sid/cvx"/> 
      <code value="104"/> 
    </coding> 
    <text value="Twinrix (HepA/HepB)"/> 
  </vaccineCode> 
  <manufacturer> 
    <reference> 
      <reference value="Organization/hl7"/> 
    </reference> 
  </manufacturer> 
  <lotNumber value="PT123F"/> 
  <expirationDate value="2018-12-15"/> 
  <patient> 
    <reference value="Patient/example"/> 
  </patient> 
  <encounter> 
    <reference value="Encounter/example"/> 
  </encounter> 
  <occurrenceDateTime value="2018-06-18"/> 
  <primarySource value="true"/> 
  <location> 
    <reference value="Location/1"/> 
  </location> 
  <site> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/> 
      <code value="LA"/> 
      <display value="left arm"/> 
    </coding> 
  </site> 
  <route> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/> 
      <code value="IM"/> 
      <display value="Injection, intramuscular"/> 
    </coding> 
  </route> 
  <doseQuantity> 
    <value value="5"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="mg"/> 
  </doseQuantity> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="OP"/> 
      </coding> 
    </function> 
    <actor> 
      <reference value="Practitioner/example"/> 
    </actor> 
  </performer> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="AP"/> 
      </coding> 
    </function> 
    <actor> 
      <reference value="Practitioner/example"/> 
    </actor> 
  </performer> 
  <isSubpotent value="false"/> 
  <programEligibility> 
    <program> 
      <text value="VFC"/> 
    </program> 
    <programStatus> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/> 
        <code value="ineligible"/> 
      </coding> 
    </programStatus> 
  </programEligibility> 
  <fundingSource> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/> 
      <code value="private"/> 
    </coding> 
  </fundingSource> 
  <protocolApplied> 
    <series value="2-dose"/> 
    <targetDisease> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="40468003"/> 
      </coding> 
    </targetDisease> 
    <doseNumber value="1"/> 
  </protocolApplied> 
  <protocolApplied> 
    <series value="3-dose"/> 
    <targetDisease> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="66071002"/> 
      </coding> 
    </targetDisease> 
    <doseNumber value="2"/> 
    <seriesDoses value="3"/> 
  </protocolApplied> 
</Immunization> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.