QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide - Downloaded Version 7.0.2 See the Directory of published versions

## Example Immunization: Immunization general example

Page standards status: Informative

Profile: QICore Immunization

identifier: Uniform Resource Identifier (URI)/urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234

status: Completed

vaccineCode: Fluvax (Influenza)

patient: Jim Chalmers Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))

encounter: Encounter: status = in-progress; class = inpatient encounter (ActCode#IMP); type = Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.

occurrence: 2013-01-01

recorded: 2013-01-10

primarySource: true

location: Location South Wing, second floor

manufacturer: Organization Health Level Seven International

lotNumber: AAJN11K

expirationDate: 2015-02-15

site: left arm

route: Injection, intramuscular

doseQuantity: 5 mg (Details: UCUM codemg = 'mg')

> performer

> function: Ordering Provider

> actor: Practitioner Adam Careful

> performer

> function: Administering Provider

> actor: Practitioner Adam Careful

note:

> Notes on adminstration of vaccine

reasonCode: Procedure to meet occupational requirement (regime/therapy)

### Reactions

- | Date | Detail | Reported
* | 2013-01-10 | Observation Hemoglobin [Mass/volume] in Venous blood | true

### ProtocolApplieds

- | Series | Authority | TargetDisease | DoseNumber[x] | SeriesDoses[x]
* | Vaccination Series 1 | Organization Health Level Seven International | Gestational rubella syndrome | 1 | 2