FHIR Implementation Guide: Vaccinations 0.1.0

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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 resources 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

Persons Systems FHIR Capability Statements
Name Description Name Description Name Description
Patient The user of a personal healthcare environment. PHR Personal health record Verwijzing.png CapabilityStatement: Client Vaccination client requirements
(Healthcare) provider The user of a XIS XIS (Healthcare) information system Verwijzing.png CapabilityStatement: Server Vaccination server requirements

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. Trigger events

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

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{?_include=Immunization:patient&_include:iterate=Immunization: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 and the Health Professional/Organization. If those references are not in the Bundle, a client SHALL be able to resolve them at the source. The client may wish to have these references resolved in the Bundle by specifying the _include parameter on the query. The server SHALL support this _include parameter. It MAY include referenced resources even if the client doesn't ask for them if it doesn't support read operations for these resources. Expected actions

The XIS SHALL process the query to retrieve patient's Immunization resources and the included 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. 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 be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the .meta.profile element in order to show compliance.

Canonical URL FHIR Resources Based on Zib (NL) Based on Zib (EN)
http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-event Immunization Vaccinatie Vaccination
http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient Patient Patient Patient
http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner Practitioner Zorgverlener HealthProfessional
http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole PractionerRole
http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization Organization Zorgaanbieder HealthcareProvider
http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider Location
http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct Medication FarmaceutischProduct PharmaceuticalProduct Expected actions

The PHR SHALL process the results. The PHR SHOULD contain all the resources that match the query and all the reference resources that are included in the Bundle.

4 Release notes

Release notes can be found on the functional design page.