{
  "description": "This profile defines a set of constraints to the FHIR Immunization resource for use in Ontario Patient Summaries (PS-ON).  It refines constraints applied to the Immunization resource by the PS-CA project to represent a record of immunization in the patient summary. It is informed by the constraints of the [Immunization-UV-IPS profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Immunization-uv-ips.html) and the [Canadian Baseline  Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-immunization.html) to allow for cross-border and cross-jurisdiction sharing of Medication Summary information. It describes the event of a patient being administered a vaccination or a record of a vaccination as reported by a patient, a clinician or another party.",
  "_filename": "ImmunizationPSON.json",
  "package_name": "ca.on.patient-summary",
  "date": "2021-10-04T11:30:20+00:00",
  "derivation": "constraint",
  "publisher": "Ontario Health",
  "fhirVersion": "4.0.1",
  "name": "ImmunizationPSON",
  "abstract": false,
  "type": "Immunization",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "Immunization (PS-ON)",
  "package_version": "0.0.1-alpha",
  "status": "draft",
  "id": "ea02aeb5-72f0-4973-83eb-6c5e0b3206de",
  "kind": "resource",
  "url": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-immunization",
  "version": "0.0.1",
  "differential": {
    "element": [ {
      "id": "Immunization",
      "path": "Immunization",
      "short": "Immunization Profile",
      "definition": "The Immunization Profile is based upon the core FHIR Immunization Resource"
    }, {
      "id": "Immunization.id",
      "path": "Immunization.id",
      "definition": "Logical id of this artifact"
    }, {
      "id": "Immunization.meta",
      "min": 1,
      "path": "Immunization.meta",
      "mustSupport": true
    }, {
      "id": "Immunization.meta.profile",
      "min": 1,
      "path": "Immunization.meta.profile",
      "mustSupport": true
    }, {
      "id": "Immunization.status",
      "path": "Immunization.status",
      "mustSupport": true
    }, {
      "path": "Immunization.vaccineCode",
      "min": 1,
      "definition": "Vaccine that was administered or was to be administered.",
      "short": "Vaccine that was administered or was to be administered. IPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunised is provided; or the known absent/unknown code.\n\nOther coded information can be provided as well as: the Pharmaceutical and medicinal product identifiers, when available, or equivalent coded concepts; the WHO ATC codes; or any other kind of code that that identifies, classifies or cluster the administered product.",
      "slicing": {
        "rules": "open",
        "description": "Discriminated by bound value set",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ]
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-uv-ips",
        "description": "The type of vaccine for particular disease or diseases against which the patient has been immunised."
      },
      "max": "1",
      "id": "Immunization.vaccineCode",
      "comment": "PS-CA Note: Work is underway to define the pan-Canadian terminology that will be preferred and/or socialized for vaccine.code. IPS-UV Note: Several kinds of vaccine product coding could be provided.\n\nThe IPS assumes that either the type of the vaccine for particular disease or diseases (e.g. MMR vaccine) against which the patient has been immunized is provided; or the known absent/unknown.\n\nOther coded information can be provided as well as:\n  1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 1, [Substance(s)]. Example: Amoxicillin and Clavulanate Potassium; or any other equivalent coded concept.\n  1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 2 [Substance(s) + Strength + reference strength]. Example: Amoxicillin 875 mg and Clavulanate Potassium 125 mg; or any other equivalent coded concept.\n  1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 3 [Substance(s) + administrable dose form]. Example: Amoxicillin and Clavulanate Potassium, Oral Tablet; or any other equivalent coded concept.\n  1. The IDMP Pharmaceutical Product Identifier (PhPID), Level 4 [Substance(s) + strength + reference strength + administrable dose form]. Example: Amoxicillin 875 mg and clavulanate potassium 125 mg, oral tablet; or any other equivalent coded concept.\n  1. The IDMP Medicinal Product Identifier (MPID) or any equivalent Medicinal Product Identifier. IDMP MPID uniquely identifies a Medicinal Product, reflecting (but not replacing) any other authorization numbers allocated by a regulator. MPID implies one (set of) PhPID. The MPID shall use a common segment pattern related to a Medicinal Product, which, when each segment is valued shall define a specific MPID concept.\n  1. The IDMP Packaged Medicinal Product Identifier (PCID) or any equivalent Packaged Medicinal Product Identifier. Uniquely identifies a Medicinal Product based on its packaging. This implies one MPID can be associated with more than one PCID, if the same Medicinal Product has more than one type of package.\n  1. Any other kind of code that that identifies, classifies or clusters the administered product (e.g. the medicinal product or the product class).\n\nThe value sets used for the PhPID, MPID and PCID identifiers are provisional and include only few equivalent concepts used for exemplification purposes, they will be updated with real IDMP identifiers when they will become available."
    }, {
      "path": "Immunization.vaccineCode",
      "min": 0,
      "definition": "Code for a vaccine that is selected from the SNOMED CT GPS code set.",
      "short": "Optional slice for representing the code for vaccine from the SNOMED CT GPS code set",
      "mustSupport": false,
      "sliceName": "vaccineGPSCode",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/vaccines-gps-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "vaccineGPS"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode:vaccineGPSCode",
      "comment": "The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed."
    }, {
      "path": "Immunization.vaccineCode",
      "min": 0,
      "definition": "WHO ATC classification",
      "short": "Optional slice for representing the vaccine code from the WHO ATC classification",
      "mustSupport": false,
      "sliceName": "atcClass",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/whoatc-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "WHO ATC"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode:atcClass",
      "comment": "The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed."
    }, {
      "id": "Immunization.vaccineCode:Generic",
      "max": "1",
      "path": "Immunization.vaccineCode",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://cvc.canimmunize.ca/v3/ValueSet/Generic"
      },
      "sliceName": "Generic",
      "mustSupport": true
    }, {
      "id": "Immunization.vaccineCode:Tradename",
      "max": "1",
      "path": "Immunization.vaccineCode",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://cvc.canimmunize.ca/v3/ValueSet/Tradename"
      },
      "sliceName": "Tradename",
      "mustSupport": true
    }, {
      "path": "Immunization.vaccineCode",
      "min": 0,
      "definition": "A reference to a code indicating that there there are no known immunizations or that this information is unknown.",
      "short": "Optional slice for representing the codes for an Absent or Unknown Immunization",
      "mustSupport": true,
      "sliceName": "absentOrUnknownImmunization",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-immunizations-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Absent Unknown Immunization"
        } ]
      },
      "max": "1",
      "id": "Immunization.vaccineCode:absentOrUnknownImmunization",
      "comment": "This slice is kept as must support to ensure that systems proving conformance can show that they can produce a value indicating that an immunization is absent or unknown (similar to approach with keeping must support flags on data absent reason extensions)"
    }, {
      "id": "Immunization.patient",
      "path": "Immunization.patient",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Immunization.patient.reference",
      "min": 1,
      "path": "Immunization.patient.reference",
      "mustSupport": true
    }, {
      "id": "Immunization.occurrence[x]",
      "max": "1",
      "min": 1,
      "path": "Immunization.occurrence[x]",
      "mustSupport": true
    }, {
      "id": "Immunization.occurrence[x].extension:data-absent-reason",
      "max": "1",
      "path": "Immunization.occurrence[x].extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ]
      } ],
      "short": "occurrence[x] absence reason",
      "sliceName": "data-absent-reason",
      "definition": "Provides a reason why the occurrence is missing.",
      "mustSupport": true
    }, {
      "id": "Immunization.lotNumber",
      "path": "Immunization.lotNumber",
      "mustSupport": false
    }, {
      "id": "Immunization.site",
      "path": "Immunization.site",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ]
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "https://cvc.canimmunize.ca/v3/ValueSet/AnatomicalSite"
      },
      "mustSupport": true
    }, {
      "id": "Immunization.route",
      "path": "Immunization.route",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ]
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "https://cvc.canimmunize.ca/v3/ValueSet/RouteOfAdmin",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ImmunizationRoute"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Immunization.performer",
      "max": "1",
      "path": "Immunization.performer",
      "comment": "While the IPS-UV specification considers this a MS element, some systems will not have a field directly representing performer, further feedback is required on whether these systems are still expected to be able to demonstrate they can construct this element when developing the patient summary instance",
      "mustSupport": false
    }, {
      "id": "Immunization.protocolApplied.targetDisease",
      "path": "Immunization.protocolApplied.targetDisease",
      "type": [ {
        "code": "CodeableConcept",
        "profile": [ "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-codeableconcept" ]
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-uv-ips"
      },
      "slicing": {
        "rules": "open",
        "description": "Discriminated by bound value set",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Immunization.protocolApplied.targetDisease:targetDiseaseGPSCode",
      "path": "Immunization.protocolApplied.targetDisease",
      "short": "Optional slice for representing the code for a disease the vaccination is against from the SNOMED CT GPS code set.",
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/targetDiseases-gps-uv-ips",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "TargetDiseasesGpsUvIps"
        } ]
      },
      "comment": "The IPS-UV considers this slice MS in STU1, however the impacts of applying MS on terminology slices have been brought forward to the IPS-UV FHIR authors and removal of the MS flag on optional slices is currently being discussed.",
      "sliceName": "targetDiseaseGPSCode",
      "definition": "Code for a disease the vaccination is against from the SNOMED CT GPS code set."
    }, {
      "id": "Immunization.protocolApplied.targetDisease:CVC",
      "path": "Immunization.protocolApplied.targetDisease",
      "short": "Optional slice for representing the code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set.",
      "binding": {
        "strength": "preferred",
        "valueSet": "https://cvc.canimmunize.ca/v3/ValueSet/Disease",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "TargetDiseasesCVC"
        } ]
      },
      "sliceName": "targetDiseaseCVC",
      "definition": "Code for a disease the vaccination is against from the Canadian Vaccine Catalogue code set code set.",
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization"
}