{
"description": null,
"_filename": "DwImmunization.StructureDefinition.json",
"package_name": "telus.dw.emr.extract",
"date": "2024-05-03T22:11:40.4165223+00:00",
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"name": "DwImmunization",
"abstract": false,
"type": "Immunization",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "1.0.0",
"status": "draft",
"id": "21058bfb-d3a4-4a00-9eba-737520e4c964",
"kind": "resource",
"url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwImmunization",
"version": null,
"differential": {
"element": [ {
"id": "Immunization.id",
"path": "Immunization.id",
"mustSupport": true
}, {
"id": "Immunization.meta",
"path": "Immunization.meta"
}, {
"id": "Immunization.meta.lastUpdated",
"path": "Immunization.meta.lastUpdated",
"mustSupport": true
}, {
"id": "Immunization.status",
"path": "Immunization.status",
"comment": "PS: \"Refused treatment\" = not-done\r\n\r\nWill generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"mustSupport": true
}, {
"id": "Immunization.statusReason",
"path": "Immunization.statusReason",
"binding": {
"strength": "example",
"valueSet": "https://hl7.fhir.r4.core/4.0.1/files/package/valueset-immunization-status-reason"
},
"comment": "PSS does not handle all reasons, but does handle patient refusal MA has a cancel reason that would need to be mapped into a code.\r\n \" Patient Declined\" and \"Refused treatment\" will map to \"PATOBJ\" \r\n\r\nThis is generally only used for the status of \"not-done\". The reason for performing the immunization event is captured in reasonCode, not here.",
"mustSupport": true
}, {
"id": "Immunization.statusReason.coding.code",
"path": "Immunization.statusReason.coding.code",
"comment": "PS - Code will be PATOBJ when immunization is refused\r\n\r\nNote that FHIR strings SHALL NOT exceed 1MB in size"
}, {
"id": "Immunization.statusReason.coding.display",
"path": "Immunization.statusReason.coding.display",
"comment": "PS - display patient objection when flagged as refused\r\nMA - \r\nNote that FHIR strings SHALL NOT exceed 1MB in size"
}, {
"id": "Immunization.statusReason.text",
"path": "Immunization.statusReason.text",
"comment": "PS - Refused Treatment \r\n\r\nVery often the text is the same as a displayName of one of the codings."
}, {
"id": "Immunization.vaccineCode",
"path": "Immunization.vaccineCode",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding",
"path": "Immunization.vaccineCode.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Immunization.vaccineCode.coding:vaccineIPScoding",
"path": "Immunization.vaccineCode.coding",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips"
},
"sliceName": "vaccineIPScoding",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:vaccineIPScoding.system",
"path": "Immunization.vaccineCode.coding.system",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:vaccineIPScoding.code",
"path": "Immunization.vaccineCode.coding.code",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:vaccineIPScoding.display",
"path": "Immunization.vaccineCode.coding.display",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCTradename",
"path": "Immunization.vaccineCode.coding",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Tradename"
},
"sliceName": "CVCTradename",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCTradename.system",
"path": "Immunization.vaccineCode.coding.system",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCTradename.code",
"path": "Immunization.vaccineCode.coding.code",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCTradename.display",
"path": "Immunization.vaccineCode.coding.display",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCGeneric",
"path": "Immunization.vaccineCode.coding",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-Generic"
},
"sliceName": "CVCGeneric",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCGeneric.system",
"path": "Immunization.vaccineCode.coding.system",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCGeneric.version",
"path": "Immunization.vaccineCode.coding.version",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCGeneric.code",
"path": "Immunization.vaccineCode.coding.code",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:CVCGeneric.display",
"path": "Immunization.vaccineCode.coding.display",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization",
"path": "Immunization.vaccineCode.coding",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips"
},
"comment": "Usage Note: Where there are no immunizations recorded for the patient the \"no known immunization\" code will be provided.\r\n\r\nCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"sliceName": "absentOrUnknownImmunization",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization.system",
"path": "Immunization.vaccineCode.coding.system",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization.version",
"path": "Immunization.vaccineCode.coding.version",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization.code",
"path": "Immunization.vaccineCode.coding.code",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.coding:absentOrUnknownImmunization.display",
"path": "Immunization.vaccineCode.coding.display",
"mustSupport": true
}, {
"id": "Immunization.vaccineCode.text",
"path": "Immunization.vaccineCode.text",
"mustSupport": true
}, {
"id": "Immunization.patient",
"path": "Immunization.patient",
"mustSupport": true
}, {
"id": "Immunization.occurrence[x]",
"path": "Immunization.occurrence[x]",
"mustSupport": true
}, {
"id": "Immunization.occurrence[x].extension:data-absent-reason",
"path": "Immunization.occurrence[x].extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
} ],
"sliceName": "data-absent-reason",
"isModifier": false
}, {
"id": "Immunization.recorded",
"path": "Immunization.recorded",
"mustSupport": true
}, {
"id": "Immunization.primarySource",
"path": "Immunization.primarySource",
"comment": "PS: Started/Performed by external provider = false otherwise it will be true\r\nMA: N/A no way to reliably tell who performed the immunization\r\nReflects the “reliability” of the content.",
"mustSupport": true
}, {
"id": "Immunization.reportOrigin",
"path": "Immunization.reportOrigin",
"comment": "PS: Provider Name where populated \r\nShould not be populated if primarySource = True, not required even if primarySource = False.",
"mustSupport": true
}, {
"id": "Immunization.manufacturer",
"path": "Immunization.manufacturer",
"comment": "PSS - captured as a text field (OMD requirement) - may be populated in display\r\nMA - captured as a text field (OMD requirement) - may be populated in display\r\n\r\nReferences SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository."
}, {
"id": "Immunization.lotNumber",
"path": "Immunization.lotNumber",
"mustSupport": true
}, {
"id": "Immunization.expirationDate",
"path": "Immunization.expirationDate",
"mustSupport": true
}, {
"id": "Immunization.site",
"path": "Immunization.site",
"mustSupport": true
}, {
"id": "Immunization.site.coding",
"path": "Immunization.site.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Immunization.site.coding:siteCVC",
"path": "Immunization.site.coding",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-AnatomicalSite"
},
"sliceName": "siteCVC"
}, {
"id": "Immunization.site.text",
"path": "Immunization.site.text",
"mustSupport": true
}, {
"id": "Immunization.route",
"path": "Immunization.route",
"mustSupport": true
}, {
"id": "Immunization.route.coding",
"path": "Immunization.route.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "Immunization.route.coding:routeCVC",
"path": "Immunization.route.coding",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CVC-RouteOfAdmin"
},
"sliceName": "routeCVC"
}, {
"id": "Immunization.route.coding:routeCVC.system",
"path": "Immunization.route.coding.system",
"mustSupport": true
}, {
"id": "Immunization.route.coding:routeCVC.code",
"path": "Immunization.route.coding.code",
"mustSupport": true
}, {
"id": "Immunization.route.coding:routeCVC.display",
"path": "Immunization.route.coding.display",
"mustSupport": true
}, {
"id": "Immunization.route.text",
"path": "Immunization.route.text",
"mustSupport": true
}, {
"id": "Immunization.doseQuantity",
"path": "Immunization.doseQuantity",
"comment": "PSS - will be provided when entered\r\nMA - will be provided when documented\r\n\r\nThe context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.",
"mustSupport": true
}, {
"id": "Immunization.performer",
"path": "Immunization.performer",
"mustSupport": true
}, {
"id": "Immunization.performer.function",
"path": "Immunization.performer.function",
"comment": "MA - \"Vaccine Administered\" here = AP (administering provider) not provided when \"Vaccine Administered\" =elsewhere\r\nPSS - AP or not provide when \"Performed by External Provider\" \r\n\r\nNot all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination."
}, {
"id": "Immunization.performer.function.coding",
"path": "Immunization.performer.function.coding",
"comment": "PSS - AP for any immunizations given by the clinic Not provided for immunizations given elsewhere and being recorded in the EMR \r\nMA - TBD\r\nCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."
}, {
"id": "Immunization.note",
"path": "Immunization.note",
"comment": "PSS - Will provide notes from comment field in immunization window if present and also provide comments that are appended to the treatment as a separate note \r\nMA - Will provide notes from Observation template and Task Template\r\n\r\nFor systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
"mustSupport": true
}, {
"id": "Immunization.reasonCode",
"path": "Immunization.reasonCode",
"comment": "PSS - Provide documentation from Indication field when documented may be ICD-9, ICD-10 Encode or SNOMED\r\nMA - Provide documentation from reason field whendocumented may be ICD-9 or SNOMED\r\n\r\nNot all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "coding.system",
"type": "value"
} ]
},
"mustSupport": true
}, {
"id": "Immunization.reasonCode:ICD9Code",
"path": "Immunization.reasonCode",
"sliceName": "ICD9Code"
}, {
"id": "Immunization.reasonCode:ICD10Code",
"path": "Immunization.reasonCode",
"sliceName": "ICD10Code"
}, {
"id": "Immunization.reasonCode:SNOMEDCode",
"path": "Immunization.reasonCode",
"sliceName": "SNOMEDCode"
}, {
"id": "Immunization.reasonCode:ENCODECode",
"code": [ {
"system": "https://www.insite-fm.com/encode-fm"
} ],
"path": "Immunization.reasonCode",
"sliceName": "ENCODECode"
}, {
"id": "Immunization.reaction",
"path": "Immunization.reaction",
"comment": "PSS - When a reaction is recorded against a vaccine a reference to the Allergy Resource will be provided. \r\n\r\nA reaction may be an indication of an allergy or intolerance and, if this is determined to be the case, it should be recorded as a new AllergyIntolerance resource instance as most systems will not query against past Immunization.reaction elements."
}, {
"id": "Immunization.protocolApplied",
"path": "Immunization.protocolApplied",
"mustSupport": true
}, {
"id": "Immunization.protocolApplied.series",
"path": "Immunization.protocolApplied.series",
"mustSupport": true
}, {
"id": "Immunization.protocolApplied.doseNumber[x]",
"path": "Immunization.protocolApplied.doseNumber[x]",
"type": [ {
"code": "string"
} ],
"mustSupport": true
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization"
}