imm:V2 FHIR Vaccination-Immunization alpha: verschil tussen versies

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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].}}
 
__NUMBEREDHEADINGS__
 
__NUMBEREDHEADINGS__
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{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization {{VersieInfo|Vaccinatie-Immunisatie|release=V2}}}}
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{{DISPLAYTITLE:FHIR Implementation Guide: Vaccination-Immunization 2.1.0-alpha.2}}
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[[Bestand:Icoon_Nictiz_Cirkel_Informatiestandaard_Vaccinatie.svg|link=|links |87px|Vaccinatie-Immunisatie]]
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<imagemap>
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Bestand:FO_TO_hyperlink_TO.png|311px|center|alt=Functioneel-Technisch
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circle 66 63 56 [[imm:V2_Ontwerp_Vaccinatie-Immunisatie_alpha|Functioneel ontwerp]]
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circle 305 62 51 [[imm:V2_FHIR_Vaccination-Immunization_alpha|Technisch ontwerp]]
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desc none
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</imagemap>
  
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[[Bestand:MedMij2.png |link=https://www.medmij.nl/|rechts|Naar medmij.nl]]
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==Introduction==
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[[Bestand:Icoon_Nictiz_Cirkel_Informatiestandaard_Vaccinatie.svg|link=|87px|Vaccinatie-Immunisatie]]  
+
This is the technical design (TO) for the information standard (IS) Vaccination-Immunization. This TO must be used together with the IS functional design [[imm:V2_Ontwerp_Vaccinatie-Immunisatie_alpha| functional design Vaccination-Immunization 2.1.0-alpha]]. The data exchange format used in this version is: HL7 FHIR R4.
 +
 
 +
=== Support ===
 +
For questions, feedback, or change requests, please contact our support team at [https://nictiz.atlassian.net/servicedesk/customer/portal/4 Nictiz Servicemanagement].
 +
 
 +
=== Boundaries ===
 +
This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see [[imm:V2_Ontwerp_Vaccinatie-Immunisatie_alpha| functional design Vaccination-Immunization 2.1.0-alpha]].
 +
 
 +
=== Prerequisite knowledge ===
 +
This TO assumes that the reader is familiar with the following:
 +
* The [[imm:V2_Ontwerp_Vaccinatie-Immunisatie_alpha| functional design Vaccination-Immunization 2.1.0-alpha]] accompanying this TO.
 +
* This information standard uses the data exchange formats HL7 FHIR R4, which you can find here:
 +
** [[FHIR:V1.0 FHIR IG R4|general FHIR R4 Implementation Guide]]
 +
** [[FHIR:V1.0_FHIR_IG_R4#Overarching_principles|use case overarching principles]]  
 +
** [[FHIR:V1.0_FHIR_IG_R4#FHIR_Packages|FHIR packages]].
 +
 
 +
==Components==
 +
HL7 FHIR R4 is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.
 +
 
 +
===HL7 FHIR R4===
 +
{{imm:Vprepub-2_NoteBoxPackage|p1=nictiz.fhir.nl.r4.immunization|v1=2.1.0-alpha|p2=nictiz.fhir.nl.r4.nl-core|v2={{VersieInfo|nictiz.fhir.nl.r4.nl-core|release=V2|namespace=imm}}}}
 +
 
 +
===Artifacts===
 +
The artifacts of the information standard are presented in the following table:
 +
 
 +
{| style="text-align: left;" cellpadding=5px;
 +
 
 +
|- style="color: white; background-color: #e7844b;"
 +
! zib !! FHIR resource !! FHIR profile
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| rowspan="2" | Vaccination || Immunization || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| Immunization || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event-carenetwork|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| PharmaceuticalProduct || Medication || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct|nictiz.fhir.nl.r4.immunization|pkgVersion=
 +
2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| Patient || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
|  rowspan="2" | HealthcareProvider || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| rowspan="2" | HealthProfessional || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| 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}}}}
 +
|}
 +
 
 +
===Examples of FHIR instances===
 +
You can find examples of FHIR-instances (filled-in FHIR profiles) in the [https://simplifier.net/packages/nictiz.fhir.nl.r4.immunization/2.1.0-alpha.1 Simplifier Immunization R4 package]
 +
 
 +
==Transactions==
 +
===Use case: retrieve vaccinations in a personal health environment===
 +
 
 +
====Introduction====
 +
This use case describes the 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_alpha| 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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=Introduction=
+
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to Afsprakenstelsel]]
−
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.
+
{{FHIR-IG-Afsprakenstelsel-Note}}
  
 
'''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]].
  
−
=Actors involved=
+
====Actors involved====
−
{| class="wikitable"
+
{| style="text-align: left;" cellpadding=5px;
 +
|- style="color: white; background-color: #e7844b;"
 
! colspan="2" style="text-align:left;font-weight: bold;" | Actors
 
! 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;" | Systems
 
! colspan="2" style="text-align:left;font-weight: bold;" | FHIR CapabilityStatements
 
! colspan="2" style="text-align:left;font-weight: bold;" | FHIR CapabilityStatements
−
|-
+
 
 +
|- style="color: white; background-color: #eda778;"
 
| style="text-align:left;font-weight: bold;" |Name
 
| style="text-align:left;font-weight: bold;" |Name
 
| style="text-align:left;font-weight: bold;" |Description
 
| style="text-align:left;font-weight: bold;" |Description
Regel 23: Regel 100:
 
| style="text-align:left;font-weight: bold;" |Name
 
| style="text-align:left;font-weight: bold;" |Name
 
| style="text-align:left;font-weight: bold;" |Description
 
| style="text-align:left;font-weight: bold;" |Description
−
|-
+
|- style="background-color: #fcf0e9;"
 
| Patient
 
| Patient
 
| The user of a personal healthcare environment.
 
| The user of a personal healthcare environment.
 
| PHR
 
| PHR
 
| Personal health record
 
| 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" | {{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/imm-RetrieveServe|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1|title=CapabilityStatement: Retrieve Serve}}
 
| rowspan="2" | FHIR client/server requirements  
 
| rowspan="2" | FHIR client/server requirements  
−
|-
+
|- style="background-color: #fcf0e9;"
 
| (Healthcare) provider
 
| (Healthcare) provider
 
| The user of a XIS
 
| The user of a XIS
Regel 37: Regel 114:
 
|}
 
|}
  
−
=Use case 1: Retrieve vaccinations =
+
====Transaction groups involved====
−
[[Bestand:Afsprakenstelsel-01.png|link=https://www.medmij.nl/afsprakenstelsel/|rechts |100px|Go to Afsprakenstelsel]]
+
{| style="text-align: left;" cellpadding=5px;
−
{{FHIR-IG-Afsprakenstelsel-Note}}
+
|- style="color: white; background-color: #e7844b;"
−
 
 
−
==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 group'''
 
! style="text-align:left;font-weight: bold;"| '''Transaction'''
 
! style="text-align:left;font-weight: bold;"| '''Transaction'''
 
! style="text-align:left;font-weight: bold;"| '''Actor'''
 
! style="text-align:left;font-weight: bold;"| '''Actor'''
 
! style="text-align:left;font-weight: bold;"| '''Role'''
 
! style="text-align:left;font-weight: bold;"| '''Role'''
−
|-
+
|- style="background-color: #fcf0e9;"
−
|style="background-color: white;vertical-align:top;" rowspan="2"|Retrieve vaccinations(PULL)
+
|style="vertical-align:top;" rowspan="2"|Retrieve vaccinations(PULL)
−
|style="background-color: white;vertical-align:top;"|Retrieve vaccinations request
+
|style="vertical-align:top;"|Retrieve vaccinations request
−
|style="background-color: white;vertical-align:top;"|Patient (using a PHR)
+
|style="vertical-align:top;"|Patient (using a PHR)
−
|style="background-color: white;vertical-align:top;"|Request vaccinations from the XIS
+
|style="vertical-align:top;"|Request vaccinations from the XIS
−
|-
+
|- style="background-color: #fcf0e9;"
−
|style="background-color: white;vertical-align:top;"|Retrieve vaccinations response
+
|style="vertical-align:top;"|Retrieve vaccinations response
−
|style="background-color: white;vertical-align:top;"|(Healthcare) provider (using a XIS)
+
|style="vertical-align:top;"|(Healthcare) provider (using a XIS)
−
|style="background-color: white;vertical-align:top;"|Serves vaccinations to the PHR
+
|style="vertical-align:top;"|Serves vaccinations to the PHR
 
|}
 
|}
  
−
==Invocations==
+
====Invocations====
−
===PHR: request message===
+
=====PHR: request message=====
−
The request message represents an HTTP GET parameterized query from the PHR to the XIS.
+
When the patient (PHR) wants to obtain vaccinations, it issues a retrieve vaccinations 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'''
 
'''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.
+
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 Immunization endpoint. This search query URL is configurable by the PHR and has the following format.
 
   
 
   
 
<pre>
 
<pre>
Regel 81: Regel 148:
 
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.  
 
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"  
+
{| style="text-align: left;" cellpadding=5px;
 +
|- style="color: white; background-color: #e7844b;"
 
! colspan="3" style="font-weight: bold;text-align:left;" | Immunization
 
! colspan="3" style="font-weight: bold;text-align:left;" | Immunization
−
|-
+
|- style="color: white; background-color: #eda778;"
 
| style="font-weight: bold;text-align:left;" | Name
 
| style="font-weight: bold;text-align:left;" | Name
 
| style="font-weight: bold;text-align:left;" | Description
 
| style="font-weight: bold;text-align:left;" | Description
 
| style="font-weight: bold;text-align:left;" | Example
 
| style="font-weight: bold;text-align:left;" | Example
−
|-
+
|- style="background-color: #fcf0e9;"
 
| <code>patient</code>
 
| <code>patient</code>
 
| This will specify the resource for the patient that the immunization is performed on.
 
| This will specify the resource for the patient that the immunization is performed on.
Regel 93: Regel 161:
 
|
 
|
 
Retrieve the Immunization and Patient resource:
 
Retrieve the Immunization and Patient resource:
−
<pre>GET [base]/Immunization?_include:patient</pre>
+
<pre>GET [base]/Immunization?_include=Immunization:patient</pre>
−
|-
+
|- style="background-color: #fcf0e9;"
−
| <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>
 
| <code>performer</code>
 
| This will specify the resource for the healthcareprovider who performed the immunization on the patient.
 
| This will specify the resource for the healthcareprovider who performed the immunization on the patient.
 
|
 
|
 
Retrieve the Immunization and Practitioner or Organization resource:
 
Retrieve the Immunization and Practitioner or Organization resource:
−
<pre>GET [base]/Immunization?_include:performer</pre>
+
<pre>GET [base]/Immunization?_include=Immunization:performer</pre>
 +
|}
 +
 
 +
At this point in time, there are no use cases for filter parameters on the query.
 +
 
 +
=====XIS: response message=====
 +
The expected action for the XIS is that the XIS SHALL process the query to retrieve patient's Immunization resources and the referenced resources. The trigger event is the XIS completed processing of the retrieve vaccinations request message.
 +
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.
 +
 
 +
'''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]].
 +
'''Note:''' the transactions defined in ART-DECOR are normative. For example, while the Patient.identifier element in the nl-core profile has a cardinality of 0..*, the ART-DECOR serve transaction specifies a cardinality of 1..*.
 +
 
 +
{| style="text-align: left;" cellpadding=5px;
 +
 
 +
|- style="color: white; background-color: #e7844b;"
 +
! zib !! FHIR resource !! FHIR profile
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| Vaccination || Immunization || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| PharmaceuticalProduct || Medication || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct|nictiz.fhir.nl.r4.immunization|pkgVersion=
 +
2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| Patient || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
|  rowspan="2" | HealthcareProvider || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| rowspan="2" | HealthProfessional || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| 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}}}}
 
|}
 
|}
  
−
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]].
+
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}}.  
 
{{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}}.  
Regel 151: Regel 257:
 
}}
 
}}
  
−
=====Expected actions=====
+
===Use case: retrieve vaccinations in XIS===
−
The XIS SHALL process the query to retrieve patient's Immunization resources and the referenced resources.
+
This retrieve vaccinations transaction group is used by a XIS (careprovider A) to retrieve vaccinations from another XIS (careprovider B).
 +
====Involved actors====
 +
{| style="text-align: left;" cellpadding=5px;
 +
 
 +
|- style="color: white; background-color: #e7844b;"
 +
! Transaction group || Transaction || Actor || System role code || FHIR CapabilityStatement
 +
 
 +
|- style="background-color: #fcf0e9;"
 +
| rowspan="2" | Retrieve vaccinations(PULL)
 +
| Retrieve vaccinations request || XIS careprovider A (Client) || IMM-VAR-FHIR || rowspan="2" |{{Simplifier|http://nictiz.nl/fhir/CapabilityStatement/imm-RetrieveServe|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1|title=CapabilityStatement: Retrieve Serve}}
 +
 
 +
|- style="background-color: #fcf0e9;"
 +
| Retrieve vaccinations response || XIS careprovider B (Server) || IMM-VAB-FHIR
 +
 
 +
|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''Abbreviations: IMM-VAR = Immunisatie-vaccinatie raadplegend (systeem), IMM-VAB = Immunisatie-vaccinatie beschikbaarstellend (systeem).''
 +
|}
  
−
===XIS: response message===
+
====Search parameters====
−
The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.
+
The XIS of careprovider A (Client) shall be able to provide, and the XIS careprovider B (Server) shall be capable of processing, all includes and search parameters listed below. These includes and parameters are a selection of the defined includes and search parameters. The includes can also be combined to retrieve multiple resources. The following table describes the search parameter(s) and include(s) of transaction 'Retrieve completed vaccinations request'.
 +
{| style="text-align: left;" cellpadding=5px;
 +
|- style="color: white; background-color: #e7844b;"
 +
! FHIR Search Parameter !! Description !! FHIR Resource !! Example
  
−
====Trigger events====
+
|- style="color: white; background-color: #eda778;"
−
The XIS completed processing of the retrieve vaccinations request message.
+
! colspan="4"  | Immunization
  
−
====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: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}}}}
+
|- style="background-color: #fcf0e9;"
 +
| patient.identifier|| The client may search on patient identification number. || Immunization || Retrieves all Immunizations resources of a patient with a fake BSN of 111222333. <pre>GET [base]/Immunization?patient.identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333</pre>
  
−
{| class="wikitable"
+
|- style="background-color: #fcf0e9;"
−
! style="font-weight: bold;text-align:left;" | Building block (EN)
+
| _include=Immunization:patient || The client may request that the server returns resources related to the search results, in order to reduce the overall network delay of repeated retrievals of related resources. This will specify the resource for the patient that the immunization is performed on. || Immunization || Retrieves all Immunization resources and includes the Patient resource in the search results. <pre>GET [base]/Immunization?_include=Immunization:patient</pre>
−
! style="font-weight: bold;text-align:left;" | Building block (NL)
+
|- style="background-color: #fcf0e9;"
−
! style="font-weight: bold;text-align:left;" | FHIR resource
+
| _include=Immunization:performer|| The client may request that the server returns resources related to the search results, in order to reduce the overall network delay of repeated retrievals of related resources. This will specify the resource for the performer (organization) by whom the immunization was carried out. || Immunization || Retrieves all Immunization resources and includes the Organization resource in the search results. <pre>GET [base]/Immunization?_include=Immunization:performer</pre>
−
! style="font-weight: bold;text-align:left;" | FHIR profile
+
|+ style="align: bottom; caption-side: bottom; text-align: left;" | ''XIS executes a HTTP GET/POST conform to the FHIR [http://hl7.org/fhir/http.html RESTful] and [http://hl7.org/fhir/search.html search] specification''
−
|-
 
−
| 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====
+
====Response Resources====
−
The PHR processes the results according to application-defined rules.
+
The returned data to the client XIS (careprovider A) 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]].
 +
 
 +
{| style="text-align: left;" cellpadding=5px;
 +
 
 +
|- style="color: white; background-color: #e7844b;"
 +
! zib !! FHIR resource !! FHIR profile
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
|Vaccination || Immunization || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event-carenetwork|nictiz.fhir.nl.r4.immunization|pkgVersion=2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| PharmaceuticalProduct || Medication || {{Simplifier|http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct|nictiz.fhir.nl.r4.immunization|pkgVersion=
 +
2.1.0-alpha.1}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| Patient || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
|  rowspan="2" | HealthcareProvider || 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}}}}
 +
 
 +
|-  style="background-color: #fcf0e9;"
 +
| 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}}}}
  
−
=Release notes=
+
|}
−
Release notes can be found on the [[imm:V2_Ontwerp_Vaccinatie-Immunisatie#Release_notes| functional design page]].
 
−
{{MedMij:Sjabloon_Support}}
 

Huidige versie van 1 apr 2026 om 10:48

Icoon Nictiz Cirkel Informatie Oranje.svg

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.


Vaccinatie-Immunisatie
Functioneel ontwerpTechnisch ontwerpFunctioneel-Technisch

1 Introduction

This is the technical design (TO) for the information standard (IS) Vaccination-Immunization. This TO must be used together with the IS functional design functional design Vaccination-Immunization 2.1.0-alpha. The data exchange format used in this version is: HL7 FHIR R4.

1.1 Support

For questions, feedback, or change requests, please contact our support team at Nictiz Servicemanagement.

1.2 Boundaries

This information standard may overlap with other standards related to identification, roles, and geographic classifications, requiring careful alignment to ensure consistency and avoid duplication. For more information, see functional design Vaccination-Immunization 2.1.0-alpha.

1.3 Prerequisite knowledge

This TO assumes that the reader is familiar with the following:

2 Components

HL7 FHIR R4 is used to accommodate the Dutch Clinical Information Models (zibs) used in the IS.

2.1 HL7 FHIR R4

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.

2.2 Artifacts

The artifacts of the information standard are presented in the following table:

zib FHIR resource FHIR profile
Vaccination Immunization http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event
Immunization http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event-carenetwork
PharmaceuticalProduct Medication http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct
Patient Patient http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
HealthcareProvider Organization http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization
Location http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
HealthProfessional PractitionerRole http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole
Practitioner http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner

2.3 Examples of FHIR instances

You can find examples of FHIR-instances (filled-in FHIR profiles) in the Simplifier Immunization R4 package

3 Transactions

3.1 Use case: retrieve vaccinations in a personal health environment

3.1.1 Introduction

This use case describes the 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.

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.

Note: This implementation guide builds on the general guidelines described in the use case overarching principles.

3.1.2 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

3.1.3 Transaction groups involved

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

3.1.4 Invocations

3.1.4.1 PHR: request message

When the patient (PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message. The request message represents an HTTP GET parameterized query from the PHR to the XIS.

Search

The PHR executes an HTTP GET conform to the FHIR RESTful and search specification against the XIS's Immunization 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=Immunization:patient
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=Immunization:performer

At this point in time, there are no use cases for filter parameters on the query.

3.1.4.2 XIS: response message

The expected action for the XIS is that the XIS SHALL process the query to retrieve patient's Immunization resources and the referenced resources. The trigger event is the XIS completed processing of the retrieve vaccinations request message. The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching information.

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. Note: the transactions defined in ART-DECOR are normative. For example, while the Patient.identifier element in the nl-core profile has a cardinality of 0..*, the ART-DECOR serve transaction specifies a cardinality of 1..*.

zib FHIR resource FHIR profile
Vaccination Immunization http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event
PharmaceuticalProduct Medication http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct
Patient Patient http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
HealthcareProvider Organization http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization
Location http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
HealthProfessional PractitionerRole http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole
Practitioner http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner

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

3.2 Use case: retrieve vaccinations in XIS

This retrieve vaccinations transaction group is used by a XIS (careprovider A) to retrieve vaccinations from another XIS (careprovider B).

3.2.1 Involved actors

Transaction group Transaction Actor System role code FHIR CapabilityStatement
Retrieve vaccinations(PULL) Retrieve vaccinations request XIS careprovider A (Client) IMM-VAR-FHIR CapabilityStatement: Retrieve Serve
Retrieve vaccinations response XIS careprovider B (Server) IMM-VAB-FHIR
Abbreviations: IMM-VAR = Immunisatie-vaccinatie raadplegend (systeem), IMM-VAB = Immunisatie-vaccinatie beschikbaarstellend (systeem).

3.2.2 Search parameters

The XIS of careprovider A (Client) shall be able to provide, and the XIS careprovider B (Server) shall be capable of processing, all includes and search parameters listed below. These includes and parameters are a selection of the defined includes and search parameters. The includes can also be combined to retrieve multiple resources. The following table describes the search parameter(s) and include(s) of transaction 'Retrieve completed vaccinations request'.

FHIR Search Parameter Description FHIR Resource Example
Immunization


patient.identifier The client may search on patient identification number. Immunization Retrieves all Immunizations resources of a patient with a fake BSN of 111222333. 
GET [base]/Immunization?patient.identifier=http://fhir.nl/fhir/NamingSystem/bsn|111222333
_include=Immunization:patient The client may request that the server returns resources related to the search results, in order to reduce the overall network delay of repeated retrievals of related resources. This will specify the resource for the patient that the immunization is performed on. Immunization Retrieves all Immunization resources and includes the Patient resource in the search results. 
GET [base]/Immunization?_include=Immunization:patient
_include=Immunization:performer The client may request that the server returns resources related to the search results, in order to reduce the overall network delay of repeated retrievals of related resources. This will specify the resource for the performer (organization) by whom the immunization was carried out. Immunization Retrieves all Immunization resources and includes the Organization resource in the search results. 
GET [base]/Immunization?_include=Immunization:performer
XIS executes a HTTP GET/POST conform to the FHIR RESTful and search specification

3.2.3 Response Resources

The returned data to the client XIS (careprovider A) 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.

zib FHIR resource FHIR profile
Vaccination Immunization http://nictiz.nl/fhir/StructureDefinition/imm-Vaccination-event-carenetwork
PharmaceuticalProduct Medication http://nictiz.nl/fhir/StructureDefinition/imm-PharmaceuticalProduct
Patient Patient http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
HealthcareProvider Organization http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization
Location http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
Overgenomen van "https://informatiestandaarden.nictiz.nl/index.php?title=imm:V2_FHIR_Vaccination-Immunization_alpha&oldid=305621"