| Australian Digital Health Agency Medicare Records FHIR Implementation Guide 2.1.0

Australian Digital Health Agency Medicare Records FHIR Implementation Guide. The current version which supersedes this version is 2.2.0. It is based on FHIR® version 3.0.2. See the Directory of published versions for a list of available versions.

#### StructureDefinition: ADHA Australian Immunisation Register Immunization - Detailed Descriptions

Definitions for the profile.

1. Immunization
Definition | 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 and may include vaccine reaction information and what vaccination protocol was followed.
Control | 0..*
2. Immunization.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Immunization.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Control | 1..1
Type | Meta
Invariants | Defined on this element inv-dh-imm-01: One profile shall be 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air' (: profile.where($this='http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/immunization-air').exists())
4. Immunization.meta.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
5. Immunization.meta.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing | This element introduces a set of slices on Immunization.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
6. Immunization.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.
Control | 0..1
Type | id
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
7. Immunization.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Control | 0..1
Type | instant
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.
8. Immunization.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Control | 1..*
Type | uri
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
9. Immunization.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Control | 0..*
Binding | The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System
Type | Coding
Comments | The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
10. Immunization.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Control | 0..*
Binding | For example codes, see Common Tags Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones
Type | Coding
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
11. Immunization.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
12. Immunization.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable A human language
Additional Bindings | Purpose
All Languages | Max Binding
Type | code
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
13. Immunization.text
Definition | A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrativehtmlxhtmldisplay
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
14. Immunization.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resourcesanonymous resourcescontained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
15. Immunization.extension
Definition | An Extension
Control | 0..*
Type | Extension
Slicing | This element introduces a set of slices on Immunization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
16. Immunization.extension:serialNumber
SliceName | serialNumber
Definition | Serial number for the vial of vaccine used in an administration.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(VaccineSerialNumber) (Extension Type: string)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
17. Immunization.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
18. Immunization.identifier
Definition | A unique identifier assigned to this immunization record.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Must Support | true
19. Immunization.status
Definition | Indicates the current status of the vaccination event.
Control | 1..1
Binding | The codes SHALL be taken from Immunization Status Codes A set of codes indicating the current status of an Immunizatio
Type | code
Is Modifier | true
Must Support | true
Comments | Will generally be set to show that the immunization has been completed. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Fixed Value | completed
20. Immunization.notGiven
Definition | Indicates if the vaccination was or was not given.
Control | 1..1
Type | boolean
Is Modifier | true
Must Support | true
Comments | This element is labeled as a modifier because it indicates that an immunization didn't happen.
Fixed Value | false
21. Immunization.vaccineCode
Definition | Vaccine that was administered or was to be administered.
Control | 1..1
Binding | The codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/australian-vaccine-1
Type | CodeableConcept
Must Support | true
22. Immunization.patient
Definition | The patient who either received or did not receive the immunization.
Control | 1..1
Type | Reference(AUBasePatient))
Must Support | true
23. Immunization.encounter
Definition | The visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Control | 0..1
Type | Reference(Encounter))
24. Immunization.date
Definition | Date vaccine administered or was to be administered.
Control | 1..1
Type | dateTime
Must Support | true
Comments | When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known. Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given.
25. Immunization.primarySource
Definition | An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded.
Control | 1..1
Type | boolean
Must Support | true
Comments | Reflects the “reliability” of the content.
Fixed Value | true
26. Immunization.reportOrigin
Definition | The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine.
Control | 0..1
Binding | For example codes, see Immunization Origin Codes The source of the data for a record which is not from a primary source
Type | CodeableConcept
Comments | Should not be populated if primarySource = True, will not be required even if primarySource = False.
27. Immunization.location
Definition | The service delivery location where the vaccine administration occurred.
Control | 0..1
Type | Reference(Location))
28. Immunization.manufacturer
Definition | Name of vaccine manufacturer.
Control | 0..1
Type | Reference(Organization))
29. Immunization.lotNumber
Definition | Lot number of the vaccine product.
Control | 0..1
Type | string
Must Support | true
30. Immunization.expirationDate
Definition | Date vaccine batch expires.
Control | 0..1
Type | date
31. Immunization.site
Definition | Body site where vaccine was administered.
Control | 0..1
Binding | For example codes, see Codes for Immunization Site of Administration The site at which the vaccine was administere
Type | CodeableConcept
32. Immunization.route
Definition | The path by which the vaccine product is taken into the body.
Control | 0..1
Binding | For example codes, see Immunization Route Codes The route by which the vaccine was administere
Type | CodeableConcept
33. Immunization.doseQuantity
Definition | The quantity of vaccine product that was administered.
Control | 0..1
Type | Quantity(SimpleQuantity)
34. Immunization.practitioner
Definition | Indicates who or what performed the event.
Control | 0..*
Type | BackboneElement
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
35. Immunization.practitioner.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
36. Immunization.practitioner.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
37. Immunization.practitioner.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensionsuser contentmodifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
38. Immunization.practitioner.role
Definition | Describes the type of performance (e.g. ordering provider, administering provider, etc.).
Control | 0..1
Binding | The codes SHALL be taken from Immunization Role Codes; other codes may be used where these codes are not suitable The role a practitioner plays in the immunization even
Type | CodeableConcept
39. Immunization.practitioner.actor
Definition | The device, practitioner, etc. who performed the action.
Control | 1..1
Type | Reference(Practitioner))
40. Immunization.note
Definition | Extra information about the immunization that is not conveyed by the other attributes.
Control | 0..*
Type | Annotation
41. Immunization.explanation
Definition | Reasons why a vaccine was or was not administered.
Control | 0..1
Type | BackboneElement
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
42. Immunization.explanation.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
43. Immunization.explanation.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
44. Immunization.explanation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensionsuser contentmodifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
45. Immunization.explanation.reason
Definition | Reasons why a vaccine was administered.
Control | 0..*
Binding | For example codes, see Immunization Reason Codes The reason why a vaccine was administere
Type | CodeableConcept
46. Immunization.explanation.reasonNotGiven
Definition | Reason why a vaccine was not administered.
Control | 0..*
Binding | For example codes, see Immunization Reasons for Not Immunizing Codes The reason why a vaccine was not administere
Type | CodeableConcept
47. Immunization.reaction
Definition | Categorical data indicating that an adverse event is associated in time to an immunization.
Control | 0..*
Type | BackboneElement
Comments | A 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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
48. Immunization.reaction.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
49. Immunization.reaction.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
50. Immunization.reaction.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensionsuser contentmodifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
51. Immunization.reaction.date
Definition | Date of reaction to the immunization.
Control | 0..1
Type | dateTime
52. Immunization.reaction.detail
Definition | Details of the reaction.
Control | 0..1
Type | Reference(Observation))
53. Immunization.reaction.reported
Definition | Self-reported indicator.
Control | 0..1
Type | boolean
54. Immunization.vaccinationProtocol
Definition | Contains information about the protocol(s) under which the vaccine was administered.
Control | 1..1
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
55. Immunization.vaccinationProtocol.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
56. Immunization.vaccinationProtocol.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
57. Immunization.vaccinationProtocol.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensionsuser contentmodifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
58. Immunization.vaccinationProtocol.doseSequence
Definition | Nominal position in a series.
Control | 0..1
Type | positiveInt
Must Support | true
59. Immunization.vaccinationProtocol.description
Definition | Contains the description about the protocol under which the vaccine was administered.
Control | 0..1
Type | string
60. Immunization.vaccinationProtocol.authority
Definition | Indicates the authority who published the protocol. E.g. ACIP.
Control | 0..1
Type | Reference(Organization))
61. Immunization.vaccinationProtocol.series
Definition | One possible path to achieve presumed immunity against a disease - within the context of an authority.
Control | 0..1
Type | string
62. Immunization.vaccinationProtocol.seriesDoses
Definition | The recommended number of doses to achieve immunity.
Control | 0..1
Type | positiveInt
63. Immunization.vaccinationProtocol.targetDisease
Definition | The targeted disease.
Control | 1..*
Binding | For example codes, see Vaccination Protocol Dose Target Codes The disease target of the vaccination protoco
Type | CodeableConcept
Must Support | true
64. Immunization.vaccinationProtocol.doseStatus
Definition | Indicates if the immunization event should "count" against the protocol.
Control | 1..1
Binding | For example codes, see Vaccination Protocol Dose Status codes The status of the vaccination protocol (i.e. should this count
Type | CodeableConcept
Comments | May need to differentiate between status declarations by a provider vs. a CDS engine.
Pattern Value | <valueCodeableConcept xmlns="http://hl7.org/fhir"> <coding> <system value="http://hl7.org/fhir/v3/NullFlavor"/> <code value="NAVU"/> </coding> </valueCodeableConcept>
65. Immunization.vaccinationProtocol.doseStatusReason
Definition | Provides an explanation as to why an immunization event should or should not count against the protocol.
Control | 0..1
Binding | For example codes, see Vaccination Protocol Dose Status Reason codes The reason for the determining if a vaccination should count or why vaccination should not count
Type | CodeableConcept