Generated Narrative: StructureDefinition Inmunizacion-cl-ips Name Flags Card. Type Description & Constraints Immunization ImmunizationCL #xD; vaccineCode 1..1 CodeableConceptIPS(2.0.0) Código de la Vacuna que fue administrada o será administrada Binding: VaccinesUvIps (2.0.0) (preferred): El tipo de vacuna para la enfermedad o enfermedades concretas contra las que se ha inmunizado al paciente, o un código para inmunización ausente/desconocida. Additional Bindings Purpose Documentation VaccinesWhoAtcUvIps (2.0.0) candidate Para cuando se prefiera el sistema de códigos ATC de la OMS Set de Valores del Programa Nacional de Inmunizaciones (PNI) candidate Conjunto de códigos para vacunas según la descripción nacional #xD; patient 1..1 Reference(Paciente) Paciente inmunizado #xD; reference S 1..1 string Literal reference, Relative, internal or absolute URL #xD; occurrence[x] 1..1 dateTime, string Momento de administración de la vacuna #xD; Slices for extension Content/Rules for all slices #xD; extension:data-absent-reason S 0..1 code occurrence[x] razón de la ausencia URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason Binding: DataAbsentReason (required) #xD; site 0..1 CodeableConceptIPS(2.0.0) Body site vaccine was administered Binding: SNOMEDCTBodyStructures (preferred) #xD; route 0..1 CodeableConceptIPS(2.0.0) How vaccine entered body Binding: MedicineRouteOfAdministrationUvIps (2.0.0) (preferred) #xD; protocolApplied #xD; targetDisease 0..* CodeableConcept Vaccine preventatable disease being targetted Binding: VaccineTargetDiseasesUvIps (2.0.0) (preferred): La enfermedad o enfermedades concretas contra las que se ha inmunizado al paciente. #xD; Documentation for this format
Este perfil representa las restricciones aplicadas al recurso Inmunización por la Guía de Implementación FHIR del Resumen Internacional del Paciente (IPS). Un registro de una vacunación se representa en el resumen del paciente como una instancia de un recurso Inmunización restringido por este perfil. Describe el evento de un paciente al que se le ha administrado una vacuna o un registro de una vacuna notificado por un paciente, un clínico u otra parte.
Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can 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.
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 information is added later.
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.
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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
Corresponde a un Id creado por el equipo de gestión de datos del Deis
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Fecha de la próxima fecha de vacunación si corresponde
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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identificador(es) por los que se conoce este registro de Inmunización. En el caso del sistema público correspondería al ID del Registro de Inmunización
Es el número de identificación del evento donde a un paciente se le administra una vacuna o registro de inmunización
Indica el estado actual del evento de inmunización
Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
This element is labeled as a modifier because it is a status element that contains statuses entered-in-error and not-done which means that the resource should not be treated as valid
Indica la razón por la que no se realizó el evento de inmunización
This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here.
.inboundRelationship[typeCode=SUBJ].source[classCode=CACT, moodCode=EVN].reasonCOde
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Descripción de la razón por la cual no se produjo la inmunización
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Código de la Vacuna que fue administrada o será administrada
Vacuna que se administró o se iba a administrar. Se proporciona valores que utilizan en el RNI (Registro Nacional de Inmunizaciones)
Conformidad adicional vinculante con un conjunto de valores de vacunas del sistema de códigos ATC de la OMS para su uso en contextos jurisdiccionales específicos u otros contextos en los que se prefiera el uso de la terminología ATC.
Para cuando se prefiera el sistema de códigos ATC de la OMS
Códigos de ejemplo según la referencia nacional para vacunas
Conjunto de códigos para vacunas según la descripción nacional
El tipo de vacuna para la enfermedad o enfermedades concretas contra las que se ha inmunizado al paciente, o un código para inmunización ausente/desconocida.
Nombre normalizado a nivel nacional de la vacuna
El paciente que recibió o no recibió la inmunización
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
The visit or admission or other contact between patient and health care provider the immunization was performed as part of.
Momento en la que se realiza la inmunización o se administra la vacuna
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. An exact date is always preferable, but the use of the String data type is acceptable when an exact date is not known. A small number of vaccines (e.g. live oral typhoid vaccine) are given as a series of patient self-administered dose over a span of time. In cases like this, often, only the first dose (typically a provider supervised dose) is recorded with the occurrence indicating the date/time of the first dose.
Date vaccine administered or was to be administered.
Cuando realizó el registro de la inmunización
La fecha en que se registró por primera vez la ocurrencia de la inmunización, potencialmente significativamente después de la ocurrencia del evento
Indicates context the data was recorded in
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.
Reflects the “reliability” of the content.
immunization.uncertaintycode (if primary source=false, uncertainty=U)
También pude ser considerado como registro secundario
Should not be populated if primarySource = True, not required even if primarySource = False.
The source of the data for a record which is not from a primary source.
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported) .participation[typeCode=INF].role[classCode=LIC] (this syntax for health care professional) .participation[typeCode=INF].role[classCode=PRS] (this syntax for family member)
El lugar donde se produjo la administración de la vacuna
RXA-27 (or RXA-11, deprecated as of v2.7)
Número de lote del producto de la vacuna
Fecha de vencimiento del lote de la vacuna
Body site where vaccine was administered.
The path by which the vaccine product is taken into the body.
The quantity of vaccine product that was administered.
Indica quién realizó el evento de inmunización
Extensions that cannot be ignored even if unrecognized
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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Describes the type of performance (e.g. ordering provider, administering provider, etc.).
The role a practitioner or organization plays in the immunization event.
Prestador personal u organizacional que realizó la acción
When the individual practitioner who performed the action is known, it is best to send.
Extra information about the immunization that is not conveyed by the other attributes.
Reasons why the vaccine was administered.
The reason why a vaccine was administered.
Condition, Observation or DiagnosticReport that supports why the immunization was administered.
Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent.
Typically, the recognition of the dose being sub-potent is retrospective, after the administration (ex. notification of a manufacturer recall after administration). However, in the case of a partial administration (the patient moves unexpectedly and only some of the dose is actually administered), subpotency may be recognized immediately, but it is still important to record the event.
By default, a dose should be considered to be potent.
This element is labeled as a modifier because an immunization event with a subpotent vaccine doesn't protect the patient the same way as a potent dose.
Reason why a dose is considered to be subpotent.
The reason why a dose is considered to be subpotent.
Educational material presented to patient
Educational material presented to the patient (or guardian) at the time of vaccine administration.
One of documentType or reference SHALL be present
documentType.exists() or reference.exists()
exists(f:documentType) or exists(f:reference)
Educational material document identifier
Identifier of the material presented to the patient.
Reference pointer to the educational material given to the patient if the information was on line.
Date the educational material was published.
Date the educational material was given to the patient.
Corresponde al Id del criterio de elegibilidad de la vacuna administrada
Indica la elegibilidad de un paciente para un programa de financiamiento
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Descripción del programa asociado al identificador del criterio
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered).
The source of funding used to purchase the vaccine administered.
Detalles de una reacción que proviene de la inmunización
Categorical data indicating that an adverse event is associated in time to an immunization.
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.
OBX-14 (ideally this would be reported in an IAM segment, but IAM is not part of the HL7 v2 VXU message - most likely would appear in OBX segments if at all)
Indica si se reportó reacción adversa a la vacuna
(HL7 v2 doesn't seem to provide for this)
.participation[typeCode=INF].role[classCode=PAT] (this syntax for self-reported=true)
El protocolo (conjunto de recomendaciones) que sigue el proveedor que administró la dosis
One possible path to achieve presumed immunity against a disease - within the context of an authority.
Who is responsible for publishing the recommendations
Indicates the authority who published the protocol (e.g. ACIP) that is being followed.
Vaccine preventatable disease being targetted
The vaccine preventable disease the dose is being administered against.
La enfermedad o enfermedades concretas contra las que se ha inmunizado al paciente.
The use of an integer is preferred if known. A string should only be used in cases where an integer is not available (such as when documenting a recurring booster dose).
Recommended number of doses for immunity
The recommended number of doses to achieve immunity.