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Immunization-example-protocol.json

Public Health and Emergency Response Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Example where the provider indicates the protocol being followed

{
  "resourceType": "Immunization",
  "id": "protocol",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: protocol</p><p><b>identifier</b>: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p><p><b>status</b>: completed</p><p><b>vaccineCode</b>: Twinrix (HepA/HepB) <span>(Details : {http://hl7.org/fhir/sid/cvx code '104' = '104)</span></p><p><b>patient</b>: <a>Patient/example</a></p><p><b>encounter</b>: <a>Encounter/example</a></p><p><b>occurrence</b>: Jun 18, 2018</p><p><b>primarySource</b>: true</p><p><b>location</b>: <a>Location/1</a></p><p><b>manufacturer</b>: <a>Organization/hl7</a></p><p><b>lotNumber</b>: PT123F</p><p><b>expirationDate</b>: Dec 15, 2018</p><p><b>site</b>: left arm <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ActSite code 'LA' = 'left arm', given as 'left arm'})</span></p><p><b>route</b>: Injection, intramuscular <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration code 'IM' = 'Injection, intramuscular', given as 'Injection, intramuscular'})</span></p><p><b>doseQuantity</b>: 5 mg<span> (Details: UCUM code mg = 'mg')</span></p><blockquote><p><b>performer</b></p><p><b>function</b>: Ordering Provider <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'OP' = 'Ordering Provider)</span></p><p><b>actor</b>: <a>Practitioner/example</a></p></blockquote><blockquote><p><b>performer</b></p><p><b>function</b>: Administering Provider <span>(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'AP' = 'Administering Provider)</span></p><p><b>actor</b>: <a>Practitioner/example</a></p></blockquote><p><b>isSubpotent</b>: false</p><p><b>programEligibility</b>: Not Eligible <span>(Details : {http://terminology.hl7.org/CodeSystem/immunization-program-eligibility code 'ineligible' = 'Not Eligible)</span></p><p><b>fundingSource</b>: Private <span>(Details : {http://terminology.hl7.org/CodeSystem/immunization-funding-source code 'private' = 'Private)</span></p><blockquote><p><b>protocolApplied</b></p><p><b>series</b>: 2-dose</p><p><b>targetDisease</b>: Viral hepatitis, type A <span>(Details : {SNOMED CT code '40468003' = '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>: Type B viral hepatitis <span>(Details : {SNOMED CT code '66071002' = 'Type B viral hepatitis)</span></p><p><b>doseNumber</b>: 2</p></blockquote></div>"
  },
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"
    }
  ],
  "status": "completed",
  "vaccineCode": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/sid/cvx",
        "code": "104"
      }
    ],
    "text": "Twinrix (HepA/HepB)"
  },
  "patient": {
    "reference": "Patient/example"
  },
  "encounter": {
    "reference": "Encounter/example"
  },
  "occurrenceDateTime": "2018-06-18",
  "primarySource": true,
  "location": {
    "reference": "Location/1"
  },
  "manufacturer": {
    "reference": "Organization/hl7"
  },
  "lotNumber": "PT123F",
  "expirationDate": "2018-12-15",
  "site": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActSite",
        "code": "LA",
        "display": "left arm"
      }
    ]
  },
  "route": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration",
        "code": "IM",
        "display": "Injection, intramuscular"
      }
    ]
  },
  "doseQuantity": {
    "value": 5,
    "system": "http://unitsofmeasure.org",
    "code": "mg"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "OP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0443",
            "code": "AP"
          }
        ]
      },
      "actor": {
        "reference": "Practitioner/example"
      }
    }
  ],
  "isSubpotent": false,
  "programEligibility": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/immunization-program-eligibility",
          "code": "ineligible"
        }
      ]
    }
  ],
  "fundingSource": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/immunization-funding-source",
        "code": "private"
      }
    ]
  },
  "protocolApplied": [
    {
      "series": "2-dose",
      "targetDisease": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "40468003"
          }
        ]
      },
      "doseNumberPositiveInt": 1
    },
    {
      "series": "3-dose",
      "targetDisease": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "66071002"
          }
        ]
      },
      "doseNumberPositiveInt": 2
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.