{
  "description": null,
  "_filename": "KBVPRMIOVaccinationObservationImmunizationStatus.json",
  "package_name": "KBV.MIO.Impfpass",
  "date": "2020-05-19",
  "derivation": "constraint",
  "publisher": "Kassenärztliche Bundesvereinigung (KBV)",
  "fhirVersion": "4.0.1",
  "name": "KBV_PR_MIO_Vaccination_Observation_Immunization_Status",
  "abstract": false,
  "copyright": "Copyright © [2020], Kassenärztliche Bundesvereinigung (KBV). All rights reserved.",
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "1.1.0-Kommentierung",
  "status": "active",
  "id": "f0562c0e-7625-4930-a54b-396ee229e680",
  "kind": "resource",
  "url": "https://fhir.kbv.de/StructureDefinition/KBV_PR_MIO_Vaccination_Observation_Immunization_Status",
  "version": "1.1.0",
  "differential": {
    "element": [ {
      "id": "Observation",
      "path": "Observation",
      "short": "Titer",
      "comment": "In der Regel werden für die meisten Impfungen bzw. impfpräventablen Erkrankungen keine Titerbestimmungen empfohlen - wenn diese jedoch angezeigt sind und durchgeführt werden, kann hier dokumentiert werden, welcher Titer bestimmt wurde und ob die Immunität anzunehmen ist.",
      "constraint": [ {
        "key": "issued",
        "human": "Das Untersuchungsdatum muss mindestens JJJJ-MM Stellen haben",
        "source": "Observation",
        "severity": "error",
        "expression": "issued.toString().length()>=7"
      }, {
        "key": "Code",
        "human": "Wenn der Code 26268376005 oder 268375009 oder 440662009 oder 440661002 ausgewählt wurde, dann kann die Immunität angegeben werden, ansonsten muss die Immunität angegeben werden.",
        "severity": "error",
        "expression": "code.coding.where(system='http://snomed.info/sct' and (code!='268376005' and code!='268375009' and code!='440662009' and code!='440661002')).exists() implies interpretation.exists()"
      } ],
      "definition": "In diesem Profil können Ergebnisse von Titer-Untersuchungen/Antikörper-Bestimmungen von impfpräventablen Erkrankungen dokumentiert werden, vor allem zur Kontrolle des Impferfolgs. Dafür wird dokumentiert, welche Titer-Bestimmung durchgeführt wurde, ob überhaupt eine Nachweisbarkeit gegeben ist und ob sich aus dem bestimmten Wert eine Immunität ableiten lässt."
    }, {
      "id": "Observation.meta",
      "min": 1,
      "path": "Observation.meta"
    }, {
      "id": "Observation.meta.versionId",
      "max": "0",
      "path": "Observation.meta.versionId"
    }, {
      "id": "Observation.meta.lastUpdated",
      "max": "0",
      "path": "Observation.meta.lastUpdated"
    }, {
      "id": "Observation.meta.source",
      "max": "0",
      "path": "Observation.meta.source"
    }, {
      "id": "Observation.meta.profile",
      "max": "1",
      "min": 1,
      "path": "Observation.meta.profile",
      "fixedCanonical": "https://fhir.kbv.de/StructureDefinition/KBV_PR_MIO_Vaccination_Observation_Immunization_Status|1.1.0"
    }, {
      "id": "Observation.meta.security",
      "max": "0",
      "path": "Observation.meta.security"
    }, {
      "id": "Observation.meta.tag",
      "max": "0",
      "path": "Observation.meta.tag"
    }, {
      "id": "Observation.implicitRules",
      "max": "0",
      "path": "Observation.implicitRules"
    }, {
      "id": "Observation.language",
      "max": "0",
      "path": "Observation.language"
    }, {
      "id": "Observation.contained",
      "max": "0",
      "path": "Observation.contained"
    }, {
      "id": "Observation.identifier",
      "max": "0",
      "path": "Observation.identifier"
    }, {
      "id": "Observation.basedOn",
      "max": "0",
      "path": "Observation.basedOn"
    }, {
      "id": "Observation.partOf",
      "max": "0",
      "path": "Observation.partOf"
    }, {
      "id": "Observation.status",
      "path": "Observation.status",
      "fixedCode": "final"
    }, {
      "id": "Observation.category",
      "max": "0",
      "path": "Observation.category"
    }, {
      "id": "Observation.code",
      "path": "Observation.code",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding",
      "max": "2",
      "min": 1,
      "path": "Observation.code.coding",
      "slicing": {
        "rules": "closed",
        "discriminator": [ {
          "path": "system",
          "type": "value"
        } ]
      },
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT",
      "max": "1",
      "min": 1,
      "path": "Observation.code.coding",
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_MIO_Vaccination_Lab_ImmuneReaction_Test_Presence_Snomed_All|1.1.0"
      },
      "sliceName": "snomedCT",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.system",
      "min": 1,
      "path": "Observation.code.coding.system",
      "fixedUri": "http://snomed.info/sct",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.version",
      "min": 1,
      "path": "Observation.code.coding.version",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.code",
      "min": 1,
      "path": "Observation.code.coding.code",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.display",
      "min": 1,
      "path": "Observation.code.coding.display",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.display.extension",
      "path": "Observation.code.coding.display.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.code.coding:snomedCT.display.extension:anzeigenameCodeSnomed",
      "max": "1",
      "min": 1,
      "path": "Observation.code.coding.display.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Terminology_German|1.1.1" ]
      } ],
      "sliceName": "anzeigenameCodeSnomed",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:snomedCT.display.extension:anzeigenameCodeSnomed.extension",
      "path": "Observation.code.coding.display.extension.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.code.coding:snomedCT.display.extension:anzeigenameCodeSnomed.extension:content",
      "path": "Observation.code.coding.display.extension.extension",
      "sliceName": "content"
    }, {
      "id": "Observation.code.coding:snomedCT.display.extension:anzeigenameCodeSnomed.extension:content.value[x]:valueString",
      "path": "Observation.code.coding.display.extension.extension.value[x]",
      "short": "Anzeigename",
      "sliceName": "valueString",
      "definition": "In diesem Attribut sollen die entsprechende deutsche Bezeichnung des Loinc oder Snomed-Codes aus der Conceptmap eingetragen werden, also in diesem Fall den Displaynamen des Targetsystems aus https://fhir.kbv.de/ConceptMap/KBV_CM_MIO_Vaccination_Lab_ImmuneReaction_Test_Presence_German"
    }, {
      "id": "Observation.code.coding:loinc",
      "max": "1",
      "path": "Observation.code.coding",
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_MIO_Vaccination_Lab_ImmuneReaction_Test_Presence|1.1.0"
      },
      "sliceName": "loinc",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:loinc.system",
      "min": 1,
      "path": "Observation.code.coding.system",
      "fixedUri": "http://loinc.org",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:loinc.version",
      "min": 1,
      "path": "Observation.code.coding.version",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:loinc.code",
      "min": 1,
      "path": "Observation.code.coding.code",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:loinc.display",
      "min": 1,
      "path": "Observation.code.coding.display",
      "mustSupport": true
    }, {
      "id": "Observation.code.coding:loinc.display.extension",
      "path": "Observation.code.coding.display.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.code.coding:loinc.display.extension:anzeigenameCodeLoinc",
      "max": "1",
      "min": 1,
      "path": "Observation.code.coding.display.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Terminology_German|1.1.1" ]
      } ],
      "sliceName": "anzeigenameCodeLoinc"
    }, {
      "id": "Observation.code.coding:loinc.display.extension:anzeigenameCodeLoinc.extension",
      "path": "Observation.code.coding.display.extension.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.code.coding:loinc.display.extension:anzeigenameCodeLoinc.extension:content",
      "path": "Observation.code.coding.display.extension.extension",
      "sliceName": "content"
    }, {
      "id": "Observation.code.coding:loinc.display.extension:anzeigenameCodeLoinc.extension:content.value[x]:valueString",
      "path": "Observation.code.coding.display.extension.extension.value[x]",
      "short": "Anzeigename",
      "sliceName": "valueString",
      "definition": "In diesem Attribut sollen die entsprechende deutsche Bezeichnung des Loinc oder Snomed-Codes aus der Conceptmap eingetragen werden, also in diesem Fall den Displaynamen des Targetsystems aus https://fhir.kbv.de/ConceptMap/KBV_CM_MIO_Vaccination_Lab_ImmuneReaction_Test_Presence_German"
    }, {
      "id": "Observation.code.text",
      "max": "0",
      "path": "Observation.code.text"
    }, {
      "id": "Observation.subject",
      "min": 1,
      "path": "Observation.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://fhir.kbv.de/StructureDefinition/KBV_PR_MIO_Vaccination_Patient|1.1.0" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Observation.subject.reference",
      "min": 1,
      "path": "Observation.subject.reference"
    }, {
      "id": "Observation.subject.type",
      "max": "0",
      "path": "Observation.subject.type"
    }, {
      "id": "Observation.subject.identifier",
      "max": "0",
      "path": "Observation.subject.identifier"
    }, {
      "id": "Observation.subject.display",
      "max": "0",
      "path": "Observation.subject.display"
    }, {
      "id": "Observation.focus",
      "max": "0",
      "path": "Observation.focus"
    }, {
      "id": "Observation.encounter",
      "max": "0",
      "path": "Observation.encounter"
    }, {
      "id": "Observation.effective[x]",
      "max": "0",
      "path": "Observation.effective[x]"
    }, {
      "id": "Observation.issued",
      "min": 1,
      "path": "Observation.issued",
      "short": "Datum der Untersuchung",
      "mapping": [ {
        "map": "Titer.Datum der Untersuchung",
        "identity": "MIO-Impfpass"
      } ],
      "definition": "Dieses Element beschreibt das Datum, wann die Laboruntersuchung des Titers durchgeführt wurde.",
      "mustSupport": true
    }, {
      "id": "Observation.performer",
      "max": "0",
      "path": "Observation.performer"
    }, {
      "id": "Observation.value[x]",
      "max": "0",
      "path": "Observation.value[x]"
    }, {
      "id": "Observation.dataAbsentReason",
      "max": "0",
      "path": "Observation.dataAbsentReason"
    }, {
      "id": "Observation.interpretation",
      "max": "1",
      "path": "Observation.interpretation",
      "short": "Nachweisbarkeit",
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_MIO_Vaccination_Lab_Titer_Immunity|1.1.0"
      },
      "mapping": [ {
        "map": "Titer.Immunität",
        "identity": "MIO-Impfpass"
      } ],
      "definition": "Die Nachweisbarkeit beschreibt das Erreichen der Nachweisgrenze und damit das Ergebnis des Tests. Das Ergebnis ist im Sinne von Positiv/Negativ anzugeben, dazu ist ein Code der LOINC Answer-List zu verwenden. Das Ergebnis erlaubt noch keine Aussage über die Immunität.",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding",
      "max": "1",
      "min": 1,
      "path": "Observation.interpretation.coding",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding.system",
      "min": 1,
      "path": "Observation.interpretation.coding.system",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding.version",
      "min": 1,
      "path": "Observation.interpretation.coding.version",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding.code",
      "min": 1,
      "path": "Observation.interpretation.coding.code",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding.display",
      "min": 1,
      "path": "Observation.interpretation.coding.display",
      "mustSupport": true
    }, {
      "id": "Observation.interpretation.coding.display.extension",
      "path": "Observation.interpretation.coding.display.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.interpretation.coding.display.extension:anzeigenameCodeSnomed",
      "max": "1",
      "path": "Observation.interpretation.coding.display.extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "https://fhir.kbv.de/StructureDefinition/KBV_EX_Base_Terminology_German|1.1.1" ]
      } ],
      "sliceName": "anzeigenameCodeSnomed"
    }, {
      "id": "Observation.interpretation.coding.display.extension:anzeigenameCodeSnomed.extension",
      "path": "Observation.interpretation.coding.display.extension.extension",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      }
    }, {
      "id": "Observation.interpretation.coding.display.extension:anzeigenameCodeSnomed.extension:content",
      "path": "Observation.interpretation.coding.display.extension.extension",
      "sliceName": "content"
    }, {
      "id": "Observation.interpretation.coding.display.extension:anzeigenameCodeSnomed.extension:content.value[x]:valueString",
      "path": "Observation.interpretation.coding.display.extension.extension.value[x]",
      "short": "Anzeige",
      "sliceName": "valueString",
      "definition": "In diesem Attribut sollen die entsprechende deutsche Bezeichnung des Snomed-Codes aus der Conceptmap eingetragen werden, also in diesem Fall den Displaynamen des Targetsystems aus https://fhir.kbv.de/ConceptMap/KBV_CM_MIO_Vaccination_Lab_Titer_Immunity_German"
    }, {
      "id": "Observation.interpretation.coding.userSelected",
      "max": "0",
      "path": "Observation.interpretation.coding.userSelected"
    }, {
      "id": "Observation.interpretation.text",
      "max": "0",
      "path": "Observation.interpretation.text"
    }, {
      "id": "Observation.note",
      "max": "1",
      "path": "Observation.note",
      "short": "Ergänzende Angaben zur Titerbestimmung",
      "mapping": [ {
        "map": "Titer.Ergänzende Angaben zur Titerbestimmung",
        "identity": "MIO-Impfpass"
      } ],
      "definition": "Ergänzende Angaben zur Titerbestimmung",
      "mustSupport": true
    }, {
      "id": "Observation.note.author[x]",
      "max": "0",
      "path": "Observation.note.author[x]"
    }, {
      "id": "Observation.note.time",
      "max": "0",
      "path": "Observation.note.time"
    }, {
      "id": "Observation.bodySite",
      "max": "0",
      "path": "Observation.bodySite"
    }, {
      "id": "Observation.method",
      "max": "0",
      "path": "Observation.method"
    }, {
      "id": "Observation.specimen",
      "max": "0",
      "path": "Observation.specimen"
    }, {
      "id": "Observation.device",
      "max": "0",
      "path": "Observation.device"
    }, {
      "id": "Observation.referenceRange",
      "max": "0",
      "path": "Observation.referenceRange"
    }, {
      "id": "Observation.hasMember",
      "max": "0",
      "path": "Observation.hasMember"
    }, {
      "id": "Observation.derivedFrom",
      "max": "0",
      "path": "Observation.derivedFrom"
    }, {
      "id": "Observation.component",
      "max": "0",
      "path": "Observation.component"
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation"
}