Brontekst bekijken van imm:V2 FHIR Vaccination-Immunization

{{Vdraft/InformationBox|This FHIR IG is currently under development and can not be considered stable and ready for use. For questions and change requests regarding this IG, please create a ticket in [{{VersieInfo|BITS|release=V2|namespace=imm}} BITS].}}
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{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization {{VersieInfo|Vaccinatie-Immunisatie|release=V2}}}}

[[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]]
[[Bestand:Icoon_Nictiz_Cirkel_Informatiestandaard_Vaccinatie.svg|link=|87px|Vaccinatie-Immunisatie]] 

=Introduction=
This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the [[imm:Vprepub-2_Ontwerp_Vaccinatie-Immunisatie| functional design wiki page]]. This use case consists of enabling a patient to view his own administered vaccinations in a PHR. The technical specification is described here. HL7 FHIR R4 is used for this purpose. Vaccinations are represented by the Immunization resource in FHIR. A transaction will retrieve all administered vaccinations from the XIS.

'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:IG:V1/FHIR_IG#Overarching principles|use case overarching principles]].

=Actors involved=
{| class="wikitable"
! colspan="2" style="text-align:left;font-weight: bold;" | Actors
! colspan="2" style="text-align:left;font-weight: bold;" | Systems
! colspan="2" style="text-align:left;font-weight: bold;" | FHIR CapabilityStatements
|-
| style="text-align:left;font-weight: bold;" |Name
| style="text-align:left;font-weight: bold;" |Description
| style="text-align:left;font-weight: bold;" |Name
| style="text-align:left;font-weight: bold;" |Description
| style="text-align:left;font-weight: bold;" |Name
| style="text-align:left;font-weight: bold;" |Description
|-
| Patient
| The user of a personal healthcare environment.
| PHR
| Personal health record
| rowspan="2" | {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/imm-RetrieveServe|nictiz.fhir.nl.r4.immunization|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.immunization|release=V2|namespace=imm}}|title=CapabilityStatement: Retrieve Serve}}
| rowspan="2" | FHIR client/server requirements 
|-
| (Healthcare) provider
| The user of a XIS
| XIS
| (Healthcare) information system
|}

=Use case 1: Retrieve vaccinations =
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to Afsprakenstelsel]]
{{FHIR-IG-Afsprakenstelsel-Note}}

==Introduction==
The retrieve vaccinations transaction is used by the PHR to retrieve vaccinations from a XIS.

==Actors==
{| class="wikitable" "cellpadding="10"
! style="text-align:left;font-weight: bold;"| '''Transaction group'''
! style="text-align:left;font-weight: bold;"| '''Transaction'''
! style="text-align:left;font-weight: bold;"| '''Actor'''
! style="text-align:left;font-weight: bold;"| '''Role'''
|-
|style="background-color: white;vertical-align:top;" rowspan="2"|Retrieve vaccinations(PULL)
|style="background-color: white;vertical-align:top;"|Retrieve vaccinations request
|style="background-color: white;vertical-align:top;"|Patient (using a PHR)
|style="background-color: white;vertical-align:top;"|Request vaccinations from the XIS
|-
|style="background-color: white;vertical-align:top;"|Retrieve vaccinations response
|style="background-color: white;vertical-align:top;"|(Healthcare) provider (using a XIS)
|style="background-color: white;vertical-align:top;"|Serves vaccinations to the PHR
|}

==Invocations==
===PHR: request message===
The request message represents an HTTP GET parameterized query from the PHR to the XIS.

====Trigger events====
When the patient (PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.

====Message semantics====
'''Search'''

The PHR executes an HTTP GET conform to the FHIR [http://hl7.org/fhir/http.html RESTful] and [http://hl7.org/fhir/search.html search] specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format.
 
<pre>
GET [base]/Immunization{?[includes]}
</pre>

'''Search Parameters'''

The PHR may supply, and the XIS shall be capable of processing, all inlcudes listed below. These includes are a selection of the defined includes. The includes can also be combined to retrieve multiple resources. 

{| class="wikitable" 
! colspan="3" style="font-weight: bold;text-align:left;" | Immunization
|-
| style="font-weight: bold;text-align:left;" | Name
| style="font-weight: bold;text-align:left;" | Description
| style="font-weight: bold;text-align:left;" | Example
|-
| <code>patient</code>
| This will specify the resource for the patient that the immunization is performed on.

|
Retrieve the Immunization and Patient resource:
<pre>GET [base]/Immunization?_include:patient</pre>
|-
| <code>location</code>
| This will specify the resource for the location where the Immunization took place.
|
Retrieve the Immunization and Location resource:
<pre>GET [base]/Immunization?_include:location</pre>
|-
| <code>performer</code>
| This will specify the resource for the healthcareprovider who performed the immunization on the patient.
|
Retrieve the Immunization and Practitioner or Organization resource:
<pre>GET [base]/Immunization?_include:performer</pre>
|}

At this point in time, there are no use cases for filter parameters on the query. The stated query will return a Bundle with all known administered immunizations. Each immunization is conveyed in an Immunization resource. The Immunization resource will contain references to actors such as the patient (Patient resource), the health professional (PractitionerRole and Practitioner resources) and the organization (Organization resource). The client SHALL be able to resolve there referenced resources, as described in the [[MedMij:IG:V1/FHIR_IG#Profile_use_and_declaration|MedMij FHIR R4 Implementation Guide]].

{{NoteBox|(*) The vaccination location, may or may not be a fully specified address and may or may not be a location of a healthcare provider. It is conceivable that it is as vague as "Germany" when a parent informs the registry of a having received a vaccination "in Germany" without any further info. In these cases it might be unreasonable to assume a full Location resource which is separately accessible. FHIR has a mechanism {{fhir|contained}} for information that only makes sense in the context of some parent resource. The {{fhir|reference}} simply starts with a point sign '#', signalling that the target is internal to the resource. In this case {{fhir|Immunization.contained.Location}}. 

It is the prerogative of the source system whether or not {{fhir|Location}} is an independent object. The expectation is that healthcare provider locations are independent {{fhir|Location}} resources. Receiving systems should expect normal FHIR rules for resolving references, which include resolving contained references.

'''Example fragment'''

{{Collapse top|XML Example of Immunization.contained}}
<syntaxhighlight lang="xml">
<Immunization xmlns="http://hl7.org/fhir">
   ...
   <contained>
      <Location>
         <id value="locatie1"/>
         <address>
            <country value="Duitsland">
               <extension url="http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification">
                  <valueCodeableConcept>
                     <coding>
                        <system value="urn:iso:std:iso:3166"/>
                        <code value="DE"/>
                        <display value="Duitsland"/>
                     </coding>
                  </valueCodeableConcept>
               </extension>
            </country>
         </address>
      </Location>
   </contained>
   ...
   <location>
      <reference value="#locatie1"/>
      <type value="Location"/>
      <display value="Adres: Duitsland."/>
   </location>
   ...
   </performer>
</Immunization>
</syntaxhighlight>
{{Collapse bottom}}
}}

=====Expected actions=====
The XIS SHALL process the query to retrieve patient's Immunization resources and the referenced resources.

===XIS: response message===
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.

====Trigger events====
The XIS completed processing of the retrieve vaccinations request message.

====Message semantics====
The returned data to the PHR should conform to the profiles listed in the table below. The resources in the response message SHALL conform to the requirements as described in the [[MedMij:IG:V1/FHIR_IG#Profile_use_and_declaration|MedMij FHIR R4 Implementation Guide]]. 

{{imm:Vprepub-2_NoteBoxPackage|p1=nictiz.fhir.nl.r4.immunization|v1={{VersieInfo|nictiz.fhir.nl.r4.immunization|release=V2|namespace=imm}}|p2=nictiz.fhir.nl.r4.nl-core|v2={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}

{| class="wikitable"
! style="font-weight: bold;text-align:left;" | Building block (EN)
! style="font-weight: bold;text-align:left;" | Building block (NL)
! style="font-weight: bold;text-align:left;" | FHIR resource
! style="font-weight: bold;text-align:left;" | FHIR profile
|-
| Vaccination
| Vaccinatie
| Immunization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event|nictiz.fhir.nl.r4.immunization|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.immunization|release=V2|namespace=imm}}}}
|-
| PharmaceuticalProduct
| FarmaceutischProduct
| Medication
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct|nictiz.fhir.nl.r4.immunization|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.immunization|release=V2|namespace=imm}}}}
|-
| Patient
| Patiënt
| Patient
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient|nictiz.fhir.nl.r4.nl-core|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
|-
| rowspan="2" | HealthProfessional
| rowspan="2" | Zorgverlener
| PractitionerRole
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole|nictiz.fhir.nl.r4.nl-core|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
|-
| Practitioner
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner|nictiz.fhir.nl.r4.nl-core|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
|-
| rowspan="2" | HealthcareProvider
| rowspan="2" | Zorgaanbieder
| Location
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider|nictiz.fhir.nl.r4.nl-core|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
|-
| Organization
| {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization|nictiz.fhir.nl.r4.nl-core|pkgVersion={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
|-
|}

====Expected actions====
The PHR processes the results according to application-defined rules.

=Release notes=
Release notes can be found on the [[imm:Vprepub-2_Ontwerp_Vaccinatie-Immunisatie#Release_notes| functional design page]].
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