This is a pre-release (ballot version) of what is now QICore STU 3. For a full list of available versions, see the Directory of published versions .

QICore-ImmunizationRecommendation

{
  "resourceType" : "StructureDefinition",
  "id" : "qicore-immunizationrec",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation">ImmunizationRecommendation</a><a name="ImmunizationRecommendation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.id">id</a><a name="ImmunizationRecommendation.id"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#id">id</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.patient">patient</a><a name="ImmunizationRecommendation.patient"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="qicore-patient.html">QICore-Patient</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation">recommendation</a><a name="ImmunizationRecommendation.recommendation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.date">date</a><a name="ImmunizationRecommendation.recommendation.date"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.vaccineCode">vaccineCode</a><a name="ImmunizationRecommendation.recommendation.vaccineCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="http://hl7.org/fhir/us/core/ValueSet-us-core-cvx.html">Vaccine Administered Value Set (CVX)</a> (<a href="http://hl7.org/fhir/STU3/terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant.">preferred</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.doseNumber">doseNumber</a><a name="ImmunizationRecommendation.recommendation.doseNumber"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#positiveInt">positiveInt</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck011.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.protocol">protocol</a><a name="ImmunizationRecommendation.recommendation.protocol"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.4" href="http://hl7.org/fhir/STU3/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.protocol.authority">authority</a><a name="ImmunizationRecommendation.recommendation.protocol.authority"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="qicore-organization.html">QICore-Organization</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.supportingImmunization">supportingImmunization</a><a name="ImmunizationRecommendation.recommendation.supportingImmunization"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="qicore-immunization.html">QICore-Immunization</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_reference.png" alt="." style="background-color: white; background-color: inherit" title="Reference to another Resource" class="hierarchy"/> <a href="qicore-immunizationrec-definitions.html#ImmunizationRecommendation.recommendation.supportingPatientInformation">supportingPatientInformation</a><a name="ImmunizationRecommendation.recommendation.supportingPatientInformation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.4">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.4">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="qicore-observation.html">QICore-Observation</a>), <a href="http://hl7.org/fhir/STU3/references.html">Reference</a>(<a href="qicore-allergyintolerance.html">QICore-AllergyIntolerance</a>)</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/STU3/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/STU3/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationrec",
  "version" : "0.1",
  "name" : "QICore-ImmunizationRecommendation",
  "status" : "draft",
  "date" : "2017-08-21T00:00:00+10:00",
  "publisher" : "Health Level Seven International (Clinical Quality Information - QICore)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/special/committees/CQI"
        }
      ]
    }
  ],
  "description" : "Profile of ImmunizationRecommendation for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "fhirVersion" : "3.0.1",
  "mapping" : [
    {
      "identity" : "qdm",
      "uri" : "http://www.healthit.gov/quality-data-model",
      "name" : "Quality Data Model"
    },
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/w5",
      "name" : "W5 Mapping"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "ImmunizationRecommendation",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "ImmunizationRecommendation",
        "path" : "ImmunizationRecommendation",
        "short" : "Guidance or advice relating to an immunization",
        "definition" : "A patient's point-in-time immunization and recommendation (i.e. forecasting a patient's immunization eligibility according to a published schedule) with optional supporting justification.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation",
          "min" : 0,
          "max" : "*"
        },
        "constraint" : [
          {
            "key" : "dom-2",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression" : "contained.contained.empty()",
            "xpath" : "not(parent::f:contained and f:contained)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-1",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain any narrative",
            "expression" : "contained.text.empty()",
            "xpath" : "not(parent::f:contained and f:text)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-4",
            "severity" : "error",
            "human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-3",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
            "expression" : "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
            "xpath" : "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
            "source" : "DomainResource"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Entity. Role, or Act"
          },
          {
            "identity" : "v2",
            "map" : "VXU_V04"
          },
          {
            "identity" : "rim",
            "map" : "SubstanceAdministration[moodCode=RMD]"
          },
          {
            "identity" : "w5",
            "map" : "clinical.medication"
          },
          {
            "identity" : "qdm",
            "map" : "Immunization, Order"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.id",
        "path" : "ImmunizationRecommendation.id",
        "short" : "Logical id of this artifact",
        "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "id"
          }
        ],
        "mustSupport" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.meta",
        "path" : "ImmunizationRecommendation.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",
        "base" : {
          "path" : "Resource.meta",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Meta"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "ImmunizationRecommendation.implicitRules",
        "path" : "ImmunizationRecommendation.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.",
        "comment" : "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.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.implicitRules",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "isModifier" : true,
        "isSummary" : true
      },
      {
        "id" : "ImmunizationRecommendation.language",
        "path" : "ImmunizationRecommendation.language",
        "short" : "Language of the resource content",
        "definition" : "The base language in which the resource is written.",
        "comment" : "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).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.language",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
              "valueReference" : {
                "reference" : "http://hl7.org/fhir/ValueSet/all-languages"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "Language"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "extensible",
          "description" : "A human language.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/languages"
          }
        }
      },
      {
        "id" : "ImmunizationRecommendation.text",
        "path" : "ImmunizationRecommendation.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.",
        "comment" : "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.",
        "alias" : [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Narrative"
          }
        ],
        "condition" : [
          "dom-1"
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Act.text?"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.contained",
        "path" : "ImmunizationRecommendation.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.",
        "comment" : "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.",
        "alias" : [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.contained",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Resource"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.extension",
        "path" : "ImmunizationRecommendation.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.modifierExtension",
        "path" : "ImmunizationRecommendation.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.identifier",
        "path" : "ImmunizationRecommendation.identifier",
        "short" : "Business identifier",
        "definition" : "A unique identifier assigned to this particular recommendation record.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation.identifier",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".id"
          },
          {
            "identity" : "w5",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.patient",
        "path" : "ImmunizationRecommendation.patient",
        "short" : "Who this profile is for",
        "definition" : "The patient the recommendations are for.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.patient",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "PID-3"
          },
          {
            "identity" : "rim",
            "map" : ".partipication[typeCode=SUBJ].role"
          },
          {
            "identity" : "w5",
            "map" : "who.focus"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation",
        "path" : "ImmunizationRecommendation.recommendation",
        "short" : "Vaccine administration recommendations",
        "definition" : "Vaccine administration recommendations.",
        "min" : 1,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation",
          "min" : 1,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          },
          {
            "key" : "imr-1",
            "severity" : "error",
            "human" : "One of vaccineCode or targetDisease SHALL be present",
            "expression" : "vaccineCode.exists() or targetDisease.exists()",
            "xpath" : "exists(f:vaccineCode) or exists(f:targetDisease)",
            "source" : "ImmunizationRecommendation.recommendation"
          }
        ],
        "mustSupport" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".outboundRelationship[typeCode='COMP'].target[classCode=SBADM, moodCode=RMD]"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.id",
        "path" : "ImmunizationRecommendation.recommendation.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.extension",
        "path" : "ImmunizationRecommendation.recommendation.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.modifierExtension",
        "path" : "ImmunizationRecommendation.recommendation.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.date",
        "path" : "ImmunizationRecommendation.recommendation.date",
        "short" : "Date recommendation created",
        "definition" : "The date the immunization recommendation was created.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.date",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-15"
          },
          {
            "identity" : "rim",
            "map" : ".partipication[typeCode=AUTH].time"
          },
          {
            "identity" : "qdm",
            "map" : "authorDatetime"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.vaccineCode",
        "path" : "ImmunizationRecommendation.recommendation.vaccineCode",
        "short" : "Vaccine recommendation applies to",
        "definition" : "Vaccine that pertains to the recommendation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.vaccineCode",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "binding" : {
          "strength" : "preferred",
          "description" : "This identifies the CVX code system",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 e { 30956-7 | 38890-0 }"
          },
          {
            "identity" : "rim",
            "map" : ".partipication[typeCode=CSM].role[classCode=ADMM].code"
          },
          {
            "identity" : "qdm",
            "map" : "code"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.targetDisease",
        "path" : "ImmunizationRecommendation.recommendation.targetDisease",
        "short" : "Disease to be immunized against",
        "definition" : "The targeted disease for the recommendation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.targetDisease",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "TargetDisease"
            }
          ],
          "strength" : "example",
          "description" : "The disease that the recommended vaccination targets",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/immunization-recommendation-target-disease"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 e { 30956-7 | 38890-0 }"
          },
          {
            "identity" : "rim",
            "map" : ".partipication[typeCode=CSM].role[classCode=ADMM].code"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.doseNumber",
        "path" : "ImmunizationRecommendation.recommendation.doseNumber",
        "short" : "Recommended dose number",
        "definition" : "The next recommended dose number (e.g. dose 2 is the next recommended dose).",
        "comment" : "May need other dose concepts such as administered vs. valid.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.doseNumber",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "positiveInt"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 = 30973-2"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=INT]].sequenceNumber"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.forecastStatus",
        "path" : "ImmunizationRecommendation.recommendation.forecastStatus",
        "short" : "Vaccine administration status",
        "definition" : "Vaccine administration status.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.forecastStatus",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ImmunizationRecommendationStatus"
            }
          ],
          "strength" : "example",
          "description" : "The patient's status with respect to a vaccination protocol",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/immunization-recommendation-status"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 = 59783-1"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=SUBJ] .source[classCode=OBS, moodCode=EVN, code="Immunization Forecast Status"].value"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion",
        "short" : "Dates governing proposed immunization",
        "definition" : "Vaccine date recommendations.  For example, earliest date to administer, latest date to administer, etc.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.dateCriterion",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-3: 30980-7 = Next dose recommended, 59777-3 = Latest next dose should be given, 59778-1 = Dose is overdue"
          },
          {
            "identity" : "rim",
            "map" : ".outboundRelationship[typeCode='LIMIT'].target[classCode=OBS, moodCode=EVN, isCriterionInd=true]"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion.id",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion.extension",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion.code",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion.code",
        "short" : "Type of date",
        "definition" : "Date classification of recommendation.  For example, earliest date to give, latest date to give, etc.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.dateCriterion.code",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ImmunizationRecommendationDateCriterion"
            }
          ],
          "strength" : "example",
          "description" : "Classifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/immunization-recommendation-date-criterion"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-3"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.dateCriterion.value",
        "path" : "ImmunizationRecommendation.recommendation.dateCriterion.value",
        "short" : "Recommended date",
        "definition" : "The date whose meaning is specified by dateCriterion.code.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.dateCriterion.value",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5"
          },
          {
            "identity" : "rim",
            "map" : ".value"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol",
        "path" : "ImmunizationRecommendation.recommendation.protocol",
        "short" : "Protocol used by recommendation",
        "definition" : "Contains information about the protocol under which the vaccine was administered.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.protocol",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=INST].source[classCode=SBADM, moodCode=DEF]"
          },
          {
            "identity" : "qdm",
            "map" : "reason"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.id",
        "path" : "ImmunizationRecommendation.recommendation.protocol.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.extension",
        "path" : "ImmunizationRecommendation.recommendation.protocol.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.modifierExtension",
        "path" : "ImmunizationRecommendation.recommendation.protocol.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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.doseSequence",
        "path" : "ImmunizationRecommendation.recommendation.protocol.doseSequence",
        "short" : "Dose number within sequence",
        "definition" : "Indicates the nominal position in a series of the next dose.  This is the recommended dose number as per a specified protocol.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.protocol.doseSequence",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "positiveInt"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 = 30973-2"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=COMP, .source[classCode=SBADM, moodCode=DEF]].sequenceNumber"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.description",
        "path" : "ImmunizationRecommendation.recommendation.protocol.description",
        "short" : "Protocol details",
        "definition" : "Contains the description about the protocol under which the vaccine was administered.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.protocol.description",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 = 30956-7"
          },
          {
            "identity" : "rim",
            "map" : ".text"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.authority",
        "path" : "ImmunizationRecommendation.recommendation.protocol.authority",
        "short" : "Who is responsible for protocol",
        "definition" : "Indicates the authority who published the protocol.  For example, ACIP.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.protocol.authority",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX-5 : OBX-3 = 59779-9"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=AUT]"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.series",
        "path" : "ImmunizationRecommendation.recommendation.protocol.series",
        "short" : "Name of vaccination series",
        "definition" : "One possible path to achieve presumed immunity against a disease - within the context of an authority.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.protocol.series",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "RXA-5-administered code"
          },
          {
            "identity" : "rim",
            "map" : ".title"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.supportingImmunization",
        "path" : "ImmunizationRecommendation.recommendation.supportingImmunization",
        "short" : "Past immunizations supporting recommendation",
        "definition" : "Immunization event history that supports the status and recommendation.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.supportingImmunization",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "? No clear way to associate in HL7 v2 or IG"
          },
          {
            "identity" : "rim",
            "map" : ".outboundRelationship[typeCode=RSON].target[classCode=SBADM, moodCode=EVN, code="immunization"]"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.supportingPatientInformation",
        "path" : "ImmunizationRecommendation.recommendation.supportingPatientInformation",
        "short" : "Patient observations supporting recommendation",
        "definition" : "Patient Information that supports the status and recommendation.  This includes patient observations, adverse reactions and allergy/intolerance information.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "ImmunizationRecommendation.recommendation.supportingPatientInformation",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX If OBX is associated with ( RXA : RXA-5-administered code = '998^No vaccine administered^CVX'), could contain the reason the vaccine was not administered"
          },
          {
            "identity" : "rim",
            "map" : ".outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "ImmunizationRecommendation",
        "path" : "ImmunizationRecommendation",
        "mustSupport" : false,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "Immunization, Order"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.id",
        "path" : "ImmunizationRecommendation.id",
        "mustSupport" : false,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.patient",
        "path" : "ImmunizationRecommendation.patient",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "ImmunizationRecommendation.recommendation",
        "path" : "ImmunizationRecommendation.recommendation",
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.date",
        "path" : "ImmunizationRecommendation.recommendation.date",
        "mustSupport" : true,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "authorDatetime"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.vaccineCode",
        "path" : "ImmunizationRecommendation.recommendation.vaccineCode",
        "mustSupport" : true,
        "isModifier" : false,
        "binding" : {
          "strength" : "preferred",
          "description" : "This identifies the CVX code system",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/us/core/ValueSet/us-core-cvx"
          }
        },
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "code"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.doseNumber",
        "path" : "ImmunizationRecommendation.recommendation.doseNumber",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol",
        "path" : "ImmunizationRecommendation.recommendation.protocol",
        "mustSupport" : false,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qdm",
            "map" : "reason"
          }
        ]
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.protocol.authority",
        "path" : "ImmunizationRecommendation.recommendation.protocol.authority",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.supportingImmunization",
        "path" : "ImmunizationRecommendation.recommendation.supportingImmunization",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "ImmunizationRecommendation.recommendation.supportingPatientInformation",
        "path" : "ImmunizationRecommendation.recommendation.supportingPatientInformation",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      }
    ]
  }
}