MyHealtheVet use of PGHD
0.2.10-beta - ci-build United States of America flag

MyHealtheVet use of PGHD - Local Development build (v0.2.10-beta) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: VA MHV Immunization ( Experimental )

Official URL: https://johnmoehrke.github.io/MHV-PGHD/StructureDefinition/VA.MHV.immunization Version: 0.2.10-beta
Standards status: Informative Computable Name: MHVimmunization

A profile on the Immunization that declares how MHV will Create in PGHD for an immunization.

Proposed mapping not yet approved for implementation

Given that MyHealtheVet has access to medical record (Vista and Cerner) of immunizations, there should be logic keeping a patient from entering a duplicate immunization.

  • Derived off of US-Core Immunization
  • must be marked with MHV app tag
  • must point at the patient
  • must have status of completed (can not enter not-done or entered-in-error)
  • must have a code.text or code.coding from a valueset from the UI
    • codes from given valueSet
  • must have a date (occuranceDateTime) the vaccine was administered from the UI
  • must indicate the date this record is being recorded into PGHD
  • must be indicated this data are not official record (primarySource=false)
  • must indicate this is being recorded from patient recollection
  • any reaction is recorded as a contained observation
  • may have a comment note
  • once created will or might have an id, versionId, lastUpdated, text, and identifier
  • DSTU2 uses slightly different element names (e.g., substance and onset)

This is the Intro for the VA.MHV.immunization Profile

The My Immunizations will have a User Interface similar to

Simple UI that is similar to current MyHealtheVet

Simple Immunization UI

The mapping between the FHIR Immunization resource and the above User Interface can be found on the Mappings for MyHealtheVet mapping to FHIR/PGHD (MHV-UI)

Policy and Design Considerations

Where MyHealtheVet can determine that the new immunization being entered already exists, in either PGHD, Vista, and Cerner, the user should be warned that they are creating duplicate information. Some logic should be determined on if there should be a hard rule forbidding this duplicate entry, or if there should be a linkage to the medical record so that other applications can detect that this is a duplicate. This link is possible in FHIR, but has not been included here.

Profile

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreImmunizationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization 0..*USCoreImmunizationProfileImmunization event information
... meta
.... tag 1..1CodingTags applied to this resource
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: https://wiki.mobilehealth.va.gov/x/Onc1C
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
... status 1..1codecompleted | entered-in-error | not-done
Required Pattern: completed
... statusReason 0..0
... vaccineCode 1..1CodeableConceptVaccine Product Type (bind to CVX)
... patient 1..1Reference(US Core Patient Profile)Who was immunized
... encounter 0..0
... occurrence[x] 1..1dateTimeVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource 1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
... location 0..0
... manufacturer 0..0
... lotNumber 0..0
... expirationDate 0..0
... site 0..0
... route 1..1CodeableConceptHow vaccine entered body
... doseQuantity 0..0
... performer 0..0
... note 0..1AnnotationAdditional immunization notes
... reasonCode 0..0
... reasonReference 0..0
... isSubpotent 0..0
... education 0..0
... programEligibility 0..0
... fundingSource 0..0
... reaction
.... detail 0..1Reference(Observation) {c}Additional information on reaction
... protocolApplied 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codecompleted | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Required Pattern: completed
... vaccineCode SΣC1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
... patient SΣ1..1Reference(US Core Patient Profile)Who was immunized
... occurrence[x] SΣ1..1dateTimeVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource SΣ1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.


Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
... route 1..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... note Σ0..1AnnotationAdditional immunization notes

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Immunization.statusrequiredPattern: completed
Immunization.vaccineCodeextensibleCVX Vaccines Administered Vaccine Set
Immunization.reportOriginexamplePattern: recall
Immunization.routeexampleImmunizationRouteCodes
NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ1..1CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: https://wiki.mobilehealth.va.gov/x/Onc1C
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!SΣ1..1codecompleted | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Required Pattern: completed
... vaccineCode SΣC1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
... patient SΣ1..1Reference(US Core Patient Profile)Who was immunized
... occurrence[x] SΣ1..1dateTime SVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource SΣ1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.


Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... route 1..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... note Σ0..1AnnotationAdditional immunization notes
... subpotentReason 0..*CodeableConceptReason for being subpotent
Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.


... reaction 0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation) {c}Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Immunization.meta.securityextensibleAll Security Labels
Immunization.meta.tagexamplePattern: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
Immunization.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Immunization.statusrequiredPattern: completed
Immunization.vaccineCodeextensibleCVX Vaccines Administered Vaccine Set
Immunization.reportOriginexamplePattern: recall
Immunization.routeexampleImmunizationRouteCodes
Immunization.performer.functionextensibleImmunizationFunctionCodes
Immunization.subpotentReasonexampleImmunizationSubpotentReason
Immunization.protocolApplied.targetDiseaseexampleImmunizationTargetDiseaseCodes

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements (1 nested mandatory element)
Prohibited: 16 elements

Differential View

This structure is derived from USCoreImmunizationProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization 0..*USCoreImmunizationProfileImmunization event information
... meta
.... tag 1..1CodingTags applied to this resource
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: https://wiki.mobilehealth.va.gov/x/Onc1C
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
... status 1..1codecompleted | entered-in-error | not-done
Required Pattern: completed
... statusReason 0..0
... vaccineCode 1..1CodeableConceptVaccine Product Type (bind to CVX)
... patient 1..1Reference(US Core Patient Profile)Who was immunized
... encounter 0..0
... occurrence[x] 1..1dateTimeVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource 1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
... location 0..0
... manufacturer 0..0
... lotNumber 0..0
... expirationDate 0..0
... site 0..0
... route 1..1CodeableConceptHow vaccine entered body
... doseQuantity 0..0
... performer 0..0
... note 0..1AnnotationAdditional immunization notes
... reasonCode 0..0
... reasonReference 0..0
... isSubpotent 0..0
... education 0..0
... programEligibility 0..0
... fundingSource 0..0
... reaction
.... detail 0..1Reference(Observation) {c}Additional information on reaction
... protocolApplied 0..0

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codecompleted | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Required Pattern: completed
... vaccineCode SΣC1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
... patient SΣ1..1Reference(US Core Patient Profile)Who was immunized
... occurrence[x] SΣ1..1dateTimeVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource SΣ1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.


Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
... route 1..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... note Σ0..1AnnotationAdditional immunization notes

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Immunization.statusrequiredPattern: completed
Immunization.vaccineCodeextensibleCVX Vaccines Administered Vaccine Set
Immunization.reportOriginexamplePattern: recall
Immunization.routeexampleImmunizationRouteCodes

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Immunization C0..*USCoreImmunizationProfileImmunization event information
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ1..1CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".



Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: https://wiki.mobilehealth.va.gov/x/Onc1C
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierBusiness identifier
... status ?!SΣ1..1codecompleted | entered-in-error | not-done
Binding: ImmunizationStatusCodes (required)
Required Pattern: completed
... vaccineCode SΣC1..1CodeableConceptVaccine Product Type (bind to CVX)
Binding: CVX Vaccines Administered Vaccine Set (extensible)
... patient SΣ1..1Reference(US Core Patient Profile)Who was immunized
... occurrence[x] SΣ1..1dateTime SVaccine administration date
... recorded 1..1dateTimeWhen the immunization was first captured in the subject's record
... primarySource SΣ1..1booleanIndicates context the data was recorded in
Required Pattern: false
... reportOrigin 0..1CodeableConceptIndicates the source of a secondarily reported record
Binding: ImmunizationOriginCodes (example): The source of the data for a record which is not from a primary source.


Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/immunization-origin
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: recall
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... route 1..1CodeableConceptHow vaccine entered body
Binding: ImmunizationRouteCodes (example): The route by which the vaccine was administered.

... note Σ0..1AnnotationAdditional immunization notes
... subpotentReason 0..*CodeableConceptReason for being subpotent
Binding: ImmunizationSubpotentReason (example): The reason why a dose is considered to be subpotent.


... reaction 0..*BackboneElementDetails of a reaction that follows immunization
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 0..1dateTimeWhen reaction started
.... detail 0..1Reference(Observation) {c}Additional information on reaction
.... reported 0..1booleanIndicates self-reported reaction

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Immunization.meta.securityextensibleAll Security Labels
Immunization.meta.tagexamplePattern: 2ce6d9aa-c068-4809-8dda-662bcb16d09a
Immunization.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Immunization.statusrequiredPattern: completed
Immunization.vaccineCodeextensibleCVX Vaccines Administered Vaccine Set
Immunization.reportOriginexamplePattern: recall
Immunization.routeexampleImmunizationRouteCodes
Immunization.performer.functionextensibleImmunizationFunctionCodes
Immunization.subpotentReasonexampleImmunizationSubpotentReason
Immunization.protocolApplied.targetDiseaseexampleImmunizationTargetDiseaseCodes

This structure is derived from USCoreImmunizationProfile

Summary

Mandatory: 2 elements (1 nested mandatory element)
Prohibited: 16 elements

 

Other representations of profile: CSV, Excel, Schematron