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{{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].}}
 
{{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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__NOINDEX__
 
 
__NUMBEREDHEADINGS__
 
__NUMBEREDHEADINGS__
 
{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization {{VersieInfo|Vaccinatie-Immunisatie|release=V2}}}}
 
{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization {{VersieInfo|Vaccinatie-Immunisatie|release=V2}}}}
Regel 8: Regel 7:
  
 
=Introduction=
 
=Introduction=
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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.
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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:V2_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]].
 
'''Note''': This implementation guide builds on the general guidelines described in the [[MedMij:IG:V1/FHIR_IG#Overarching principles|use case overarching principles]].
Regel 110: Regel 109:
  
 
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]].
 
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]].
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{{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}}.
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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.
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'''Example fragment'''
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{{Collapse top|XML Example of Immunization.contained}}
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<syntaxhighlight lang="xml">
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<Immunization xmlns="http://hl7.org/fhir">
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  ...
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  <contained>
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      <Location>
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        <id value="locatie1"/>
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        <address>
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            <country value="Duitsland">
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              <extension url="http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification">
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                  <valueCodeableConcept>
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                    <coding>
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                        <system value="urn:iso:std:iso:3166"/>
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                        <code value="DE"/>
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                        <display value="Duitsland"/>
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                    </coding>
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                  </valueCodeableConcept>
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              </extension>
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            </country>
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        </address>
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      </Location>
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  </contained>
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  ...
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  <location>
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      <reference value="#locatie1"/>
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      <type value="Location"/>
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      <display value="Adres: Duitsland."/>
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  </location>
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  ...
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  </performer>
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</Immunization>
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</syntaxhighlight>
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{{Collapse bottom}}
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}}
  
 
=====Expected actions=====
 
=====Expected actions=====
Regel 123: Regel 163:
 
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]].  
 
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]].  
  
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{{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}}}}
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{{imm:V2_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"
 
{| class="wikitable"
Regel 168: Regel 208:
  
 
=Release notes=
 
=Release notes=
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Release notes can be found on the [[imm:Vprepub-2_Ontwerp_Vaccinatie-Immunisatie#Release_notes| functional design page]].
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Release notes can be found on the [[imm:V2_Ontwerp_Vaccinatie-Immunisatie#Release_notes| functional design page]].
 
{{MedMij:Sjabloon_Support}}
 
{{MedMij:Sjabloon_Support}}

Huidige versie van 19 dec 2024 om 14:34

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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 BITS.


Naar medmij.nl

Vaccinatie-Immunisatie

1 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 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 use case overarching principles.

2 Actors involved

Actors Systems FHIR CapabilityStatements
Name Description Name Description Name Description
Patient The user of a personal healthcare environment. PHR Personal health record CapabilityStatement: Retrieve Serve FHIR client/server requirements
(Healthcare) provider The user of a XIS XIS (Healthcare) information system

3 Use case 1: Retrieve vaccinations

Go to Afsprakenstelsel

This FHIR implementation guide assumes that the PHR system is able to make a connection to the right XIS that contains the patient's information. It does not provide information on finding the right XIS nor does it provide information about security. Moreover, each transaction is performed in the context of a specific authenticated patient, for whose context (token) has been established using the authentication mechanisms described in the 'Afsprakenstelsel'. Each XIS Gateway is required to perform filtering based on the patient associated with the context for the request, so only the records associated with the authenticated patient are returned. For this reason, search parameters should not be included for patient identification.

3.1 Introduction

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

3.2 Actors

Transaction group Transaction Actor Role
Retrieve vaccinations(PULL) Retrieve vaccinations request Patient (using a PHR) Request vaccinations from the XIS
Retrieve vaccinations response (Healthcare) provider (using a XIS) Serves vaccinations to the PHR

3.3 Invocations

3.3.1 PHR: request message

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

3.3.1.1 Trigger events

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

3.3.1.2 Message semantics

Search

The PHR executes an HTTP GET conform to the FHIR RESTful and search specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format. 

GET [base]/Immunization{?[includes]}

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.

Immunization
Name Description Example
patient This will specify the resource for the patient that the immunization is performed on.

Retrieve the Immunization and Patient resource: 

GET [base]/Immunization?_include:patient
location This will specify the resource for the location where the Immunization took place.

Retrieve the Immunization and Location resource: 

GET [base]/Immunization?_include:location
performer This will specify the resource for the healthcareprovider who performed the immunization on the patient.

Retrieve the Immunization and Practitioner or Organization resource: 

GET [base]/Immunization?_include:performer

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 FHIR R4 Implementation Guide.

Em.png

(*) 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 contained for information that only makes sense in the context of some parent resource. The reference simply starts with a point sign '#', signalling that the target is internal to the resource. In this case Immunization.contained.Location.

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

Example fragment

3.3.1.2.1 Expected actions

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

3.3.2 XIS: response message

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

3.3.2.1 Trigger events

The XIS completed processing of the retrieve vaccinations request message.

3.3.2.2 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 FHIR R4 Implementation Guide.

Em.png

Vaccination-Immunization uses the FHIR Packaging mechanism. This conveniently bundles all profiles, terminology, example material and other conformance resources you need into a single archive, which can be downloaded or installed using the appropriate FHIR tooling. This version of the information standard uses the following packages:

Note: packages use Semantic Versioning. Other versions can be used at will as long as they have the same major.minor number or a minor number higher than the stated version.

Building block (EN) Building block (NL) FHIR resource FHIR profile
Vaccination Vaccinatie Immunization http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event
PharmaceuticalProduct FarmaceutischProduct Medication http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct
Patient Patiënt Patient http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
HealthProfessional Zorgverlener PractitionerRole http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole
Practitioner http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner
HealthcareProvider Zorgaanbieder Location http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
Organization http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization

3.3.2.3 Expected actions

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

4 Release notes

Release notes can be found on the functional design page.

5 Support

For questions and change requests regarding the information on this page, please create a ticket in Servicedesk Portal.

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