Immunization-example-protocol.xml

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

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

<Immunization xmlns="http://hl7.org/fhir">
  <id value="protocol"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative</b> </p> <p> <b> identifier</b> : id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p> <p> <b> status</b> : completed</p> <p> <b> vaccineCode</b> : <span> Twinrix (HepA/HepB)</span> </p> <p> <b> manufacturer</b> : <a> Generated Summary: name: Health Level Seven International; alias: HL7 International; Phone:
           (+1) 734-677-7777, Fax: (+1) 734-677-6622, hq@HL7.org</a> </p> <p> <b> lotNumber</b> : PT123F</p> <p> <b> expirationDate</b> : 2018-12-15</p> <p> <b> patient</b> : <a> Generated Summary: Medical record number: 12345 (USUAL); active; Peter James Chalmers
           (OFFICIAL), Jim , Peter James Windsor (MAIDEN); , Phone: (03) 5555 6473, Phone: (03) 3410
           5613, Phone: (03) 5555 8834; gender: male; birthDate: 1974-12-25; </a> </p> <p> <b> encounter</b> : <a> Generated Summary: status: in-progress; <span> inpatient encounter</span> </a> </p> <p> <b> occurrence</b> : 2018-06-18</p> <p> <b> primarySource</b> : true</p> <p> <b> location</b> : <a> Generated Summary: id: B1-S.F2; status: active; name: South Wing, second floor; alias:
           BU MC, SW, F2, alias: Burgers University Medical Center, South Wing, second floor; description:
           Second floor of the Old South Wing, formerly in use by Psychiatry; mode: instance; Phone:
           2328, Fax: 2329, second wing admissions, http://sampleorg.com/southwing; <span> Wing</span> </a> </p> <p> <b> site</b> : <span> left arm</span> </p> <p> <b> route</b> : <span> Injection, intramuscular</span> </p> <p> <b> doseQuantity</b> : 5 mg</p> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : <span> Ordering Provider</span> </p> <p> <b> actor</b> : <a> Generated Summary: id: 23; active; Adam Careful </a> </p> </blockquote> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : <span> Administering Provider</span> </p> <p> <b> actor</b> : <a> Generated Summary: id: 23; active; Adam Careful </a> </p> </blockquote> <p> <b> isSubpotent</b> : false</p> <p> <b> programEligibility</b> : <span> Not Eligible</span> </p> <p> <b> fundingSource</b> : <span> Private</span> </p> <blockquote> <p> <b> protocolApplied</b> </p> <p> <b> series</b> : 2-dose</p> <p> <b> targetDisease</b> : <span> Viral hepatitis, type A</span> </p> <p> <b> doseNumber</b> : 1</p> </blockquote> <blockquote> <p> <b> protocolApplied</b> </p> <p> <b> series</b> : 3-dose</p> <p> <b> targetDisease</b> : <span> Type B viral hepatitis</span> </p> <p> <b> doseNumber</b> : 2</p> <p> <b> seriesDoses</b> : 3</p> </blockquote> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/> 
  </identifier> 
  <status value="completed"/> 
  <vaccineCode> 
    <coding> 
      <system value="http://hl7.org/fhir/sid/cvx"/> 
      <code value="104"/> 
    </coding> 
    <text value="Twinrix (HepA/HepB)"/> 
  </vaccineCode> 
  <manufacturer> 
    <reference value="Organization/hl7"/> 
  </manufacturer> 
  <lotNumber value="PT123F"/> 
  <expirationDate value="2018-12-15"/> 
  <patient> 
    <reference value="Patient/example"/> 
  </patient> 
  <encounter> 
    <reference value="Encounter/example"/> 
  </encounter> 
  <occurrenceDateTime value="2018-06-18"/> 
  <primarySource value="true"/> 
  <location> 
    <reference value="Location/1"/> 
  </location> 
  <site> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/> 
      <code value="LA"/> 
      <display value="left arm"/> 
    </coding> 
  </site> 
  <route> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/> 
      <code value="IM"/> 
      <display value="Injection, intramuscular"/> 
    </coding> 
  </route> 
  <doseQuantity> 
    <value value="5"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="mg"/> 
  </doseQuantity> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="OP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <performer> 
    <function> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/> 
        <code value="AP"/> 
      </coding> 
    </function> 
      <actor> 
         <reference value="Practitioner/example"/> 
      </actor> 
  </performer> 
  <isSubpotent value="false"/> 
  <programEligibility> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/> 
      <code value="ineligible"/> 
    </coding> 
  </programEligibility> 
  <fundingSource> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/> 
      <code value="private"/> 
    </coding> 
  </fundingSource> 
  <protocolApplied> 
    <series value="2-dose"/> 
    <targetDisease> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="40468003"/> 
      </coding> 
    </targetDisease> 
    <doseNumber value="1"/> 
  </protocolApplied> 
  <protocolApplied> 
    <series value="3-dose"/> 
    <targetDisease> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="66071002"/> 
      </coding> 
    </targetDisease> 
    <doseNumber value="2"/> 
    <seriesDoses value="3"/> 
  </protocolApplied> 
</Immunization>