QI-Core Implementation Guide: STU 3.2 (v3.2.0 for FHIR 3.0.1)

This page is part of the Quality Improvement Core Framework (v3.2.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

D.4.1.4 StructureDefinition: - Detailed Descriptions

Definitions for the StructureDefinition-qicore-immunizationrec Profile.

1. ImmunizationRecommendation
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.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
2. ImmunizationRecommendation.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. ImmunizationRecommendation.meta
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.

Control0..1
TypeMeta
4. ImmunizationRecommendation.implicitRules
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.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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.

5. ImmunizationRecommendation.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource 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).

6. ImmunizationRecommendation.text
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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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.

7. ImmunizationRecommendation.contained
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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

8. ImmunizationRecommendation.extension
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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

9. ImmunizationRecommendation.modifierExtension
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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

10. ImmunizationRecommendation.identifier
Definition

A unique identifier assigned to this particular recommendation record.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
11. ImmunizationRecommendation.patient
Definition

The patient the recommendations are for.

Control1..1
TypeReference(QICore-Patient)
Must Supporttrue
12. ImmunizationRecommendation.recommendation
Definition

Vaccine administration recommendations.

Control1..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
imr-1: One of vaccineCode or targetDisease SHALL be present (: vaccineCode.exists() or targetDisease.exists())
13. ImmunizationRecommendation.recommendation.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
14. ImmunizationRecommendation.recommendation.extension
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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

15. ImmunizationRecommendation.recommendation.modifierExtension
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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

16. ImmunizationRecommendation.recommendation.date
Definition

The date the immunization recommendation was created.

Control1..1
TypedateTime
Must Supporttrue
17. ImmunizationRecommendation.recommendation.vaccineCode
Definition

Vaccine that pertains to the recommendation.

Control0..1
BindingThis identifies the CVX code system
The codes SHOULD be taken from Vaccine Administered Value Set (CVX)
TypeCodeableConcept
Must Supporttrue
18. ImmunizationRecommendation.recommendation.targetDisease
Definition

The targeted disease for the recommendation.

Control0..1
BindingThe disease that the recommended vaccination targets
For example codes, see Immunization Recommendation Target Disease Codes
TypeCodeableConcept
19. ImmunizationRecommendation.recommendation.doseNumber
Definition

The next recommended dose number (e.g. dose 2 is the next recommended dose).

Control0..1
TypepositiveInt
Must Supporttrue
Comments

May need other dose concepts such as administered vs. valid.

20. ImmunizationRecommendation.recommendation.forecastStatus
Definition

Vaccine administration status.

Control1..1
BindingThe patient's status with respect to a vaccination protocol
For example codes, see Immunization Recommendation Status Codes
TypeCodeableConcept
21. ImmunizationRecommendation.recommendation.dateCriterion
Definition

Vaccine date recommendations. For example, earliest date to administer, latest date to administer, etc.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
22. ImmunizationRecommendation.recommendation.dateCriterion.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
23. ImmunizationRecommendation.recommendation.dateCriterion.extension
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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

24. ImmunizationRecommendation.recommendation.dateCriterion.modifierExtension
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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

25. ImmunizationRecommendation.recommendation.dateCriterion.code
Definition

Date classification of recommendation. For example, earliest date to give, latest date to give, etc.

Control1..1
BindingClassifies date criterion with respect to conveying information about a patient's vaccination status (e.g. due date, latest to give date, etc.)
For example codes, see Immunization Recommendation Date Criterion Codes
TypeCodeableConcept
26. ImmunizationRecommendation.recommendation.dateCriterion.value
Definition

The date whose meaning is specified by dateCriterion.code.

Control1..1
TypedateTime
27. ImmunizationRecommendation.recommendation.protocol
Definition

Contains information about the protocol under which the vaccine was administered.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
28. ImmunizationRecommendation.recommendation.protocol.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
29. ImmunizationRecommendation.recommendation.protocol.extension
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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

30. ImmunizationRecommendation.recommendation.protocol.modifierExtension
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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

31. ImmunizationRecommendation.recommendation.protocol.doseSequence
Definition

Indicates the nominal position in a series of the next dose. This is the recommended dose number as per a specified protocol.

Control0..1
TypepositiveInt
32. ImmunizationRecommendation.recommendation.protocol.description
Definition

Contains the description about the protocol under which the vaccine was administered.

Control0..1
Typestring
33. ImmunizationRecommendation.recommendation.protocol.authority
Definition

Indicates the authority who published the protocol. For example, ACIP.

Control0..1
TypeReference(QICore-Organization)
34. ImmunizationRecommendation.recommendation.protocol.series
Definition

One possible path to achieve presumed immunity against a disease - within the context of an authority.

Control0..1
Typestring
35. ImmunizationRecommendation.recommendation.supportingImmunization
Definition

Immunization event history that supports the status and recommendation.

Control0..*
TypeReference(QICore-Immunization)
36. ImmunizationRecommendation.recommendation.supportingPatientInformation
Definition

Patient Information that supports the status and recommendation. This includes patient observations, adverse reactions and allergy/intolerance information.

Control0..*
TypeReference(QICore-Observation | QICore-AllergyIntolerance)