Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Immunization-example-protocol.xml

Example Immunization/protocol (XML)

Public Health and Emergency Response Work Group Maturity Level : N/A Standards Status : Informative Compartments : Patient , Practitioner

Raw XML ( canonical form + also see XML Format Specification )

Jump past Narrative

Example where the provider indicates the protocol being followed (id = "protocol") 

<?xml version="1.0" encoding="UTF-8"?>


  
  (Details : {http://terminology.hl7.org/CodeSystem/v3-ActSite code 'LA' = 'left arm', given
           as 'left arm'})(Details : {http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration code 'IM' =
           'Injection, intramuscular', given as 'Injection, intramuscular'})(Details : {http://terminology.hl7.org/CodeSystem/immunization-program-eligibility code
           'ineligible' = 'Not Eligible)(Details : {http://terminology.hl7.org/CodeSystem/immunization-funding-source code 'private'
           = 'Private)
    
    
  
  
  
    
      
      
    
    
  
  
    
  
  
    
  
  
  
  
    
  
  
    
  
  
  
  
    
      
      
      
    
  
  
    
      
      
      
    
  
  
    
    
    
  
  
    
      
        
        
      
    
      
         
      
  
  
    
      
        
        
      
    
      
         
      
  
  
  
    
      
      
    
  
  
    
      
      
    
  
  
    
    
      
        
        
      
    
    
  
  
    
    
      
        
        
      
    
    
  

<Immunization xmlns="http://hl7.org/fhir">
  <id value="protocol"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: Immunization</b> <a name="protocol"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Immunization &quot;protocol&quot; </p> </div> <p> <b> identifier</b> : id: urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234</p> <p> <b> status</b> : completed</p> <p> <b> vaccineCode</b> : Twinrix (HepA/HepB) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-CVX.html">Vaccine Administered Code Set (CVX)</a> #104)</span> </p> <h3> Manufacturers</h3> <table class="grid"><tr> <td> -</td> <td> <b> Reference</b> </td> </tr> <tr> <td> *</td> <td> <a href="organization-example.html">Organization/hl7</a>  &quot;Health Level Seven International&quot;</td> </tr> </table> <p> <b> lotNumber</b> : PT123F</p> <p> <b> expirationDate</b> : 2018-12-15</p> <p> <b> patient</b> : <a href="patient-example.html">Patient/example</a>  &quot;Peter CHALMERS&quot;</p> <p> <b> encounter</b> : <a href="encounter-example.html">Encounter/example</a> </p> <p> <b> occurrence</b> : 2018-06-18</p> <p> <b> primarySource</b> : true</p> <p> <b> location</b> : <a href="location-example.html">Location/1</a>  &quot;South Wing, second floor&quot;</p> <p> <b> site</b> : left arm <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v3-ActSite.html">ActSite</a> #LA)</span> </p> <p> <b> route</b> : Injection, intramuscular <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v3-RouteOfAdministration.html">RouteOfAdministration</a> #IM)</span> </p> <p> <b> doseQuantity</b> : 5 mg<span style="background: LightGoldenRodYellow"> (Details: UCUM code mg = 'mg')</span> </p> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : Ordering Provider <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v2-0443.html">providerRole</a> #OP)</span> </p> <p> <b> actor</b> : <a href="practitioner-example.html">Practitioner/example</a>  &quot;Adam CAREFUL&quot;</p> </blockquote> <blockquote> <p> <b> performer</b> </p> <p> <b> function</b> : Administering Provider <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-v2-0443.html">providerRole</a> #AP)</span> </p> <p> <b> actor</b> : <a href="practitioner-example.html">Practitioner/example</a>  &quot;Adam CAREFUL&quot;</p> </blockquote> <p> <b> isSubpotent</b> : false</p> <h3> ProgramEligibilities</h3> <table class="grid"><tr> <td> -</td> <td> <b> Program</b> </td> <td> <b> ProgramStatus</b> </td> </tr> <tr> <td> *</td> <td> VFC <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </td> <td> Not Eligible <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-immunization-program-eligibility.html">Immunization Program Eligibility</a> #ineligible)</span> </td> </tr> </table> <p> <b> fundingSource</b> : Private <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-immunization-funding-source.html">Immunization Funding Source</a> #private)</span> </p> <blockquote> <p> <b> protocolApplied</b> </p> <p> <b> series</b> : 2-dose</p> <p> <b> targetDisease</b> : Viral hepatitis, type A <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #40468003)</span> </p> <p> <b> doseNumber</b> : 1</p> </blockquote> <blockquote> <p> <b> protocolApplied</b> </p> <p> <b> series</b> : 3-dose</p> <p> <b> targetDisease</b> : Type B viral hepatitis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #66071002)</span> </p> <p> <b> doseNumber</b> : 2</p> <p> <b> seriesDoses</b> : 3</p> </blockquote> </div> </text> <identifier> 
    <system value="urn:ietf:rfc:3986"/>     <value value="urn:oid:1.3.6.1.4.1.21367.2005.3.7.1234"/>   </identifier>   <status value="completed"/>   <vaccineCode>     <coding>       <system value="http://hl7.org/fhir/sid/cvx"/>       <code value="104"/>     </coding>     <text value="Twinrix (HepA/HepB)"/>   </vaccineCode>   <manufacturer>     <reference>       <reference value="Organization/hl7"/>     </reference>   </manufacturer>   <lotNumber value="PT123F"/>   <expirationDate value="2018-12-15"/>   <patient>     <reference value="Patient/example"/>   </patient>   <encounter>     <reference value="Encounter/example"/>   </encounter>   <occurrenceDateTime value="2018-06-18"/>   <primarySource value="true"/>   <location>     <reference value="Location/1"/>   </location>   <site>     <coding>       <system value="http://terminology.hl7.org/CodeSystem/v3-ActSite"/>       <code value="LA"/>       <display value="left arm"/>     </coding>   </site>   <route>     <coding>       <system value="http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"/>       <code value="IM"/>       <display value="Injection, intramuscular"/>     </coding>   </route>   <doseQuantity>     <value value="5"/>     <system value="http://unitsofmeasure.org"/>     <code value="mg"/>   </doseQuantity>   <performer>     <function>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/>         <code value="OP"/>       </coding>     </function>       <actor>          <reference value="Practitioner/example"/>       </actor>   </performer>   <performer>     <function>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/v2-0443"/>         <code value="AP"/>       </coding>     </function>       <actor>          <reference value="Practitioner/example"/>       </actor>   </performer>   <isSubpotent value="false"/>   <programEligibility>     <program>       <text value="VFC"/>     </program>     <programStatus>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/>         <code value="ineligible"/>       </coding>     </programStatus>   </programEligibility>   <fundingSource>     <coding>       <system value="http://terminology.hl7.org/CodeSystem/immunization-funding-source"/>       <code value="private"/>     </coding>   </fundingSource>   <protocolApplied>     <series value="2-dose"/>     <targetDisease>       <coding>         <system value="http://snomed.info/sct"/>         <code value="40468003"/>       </coding>     </targetDisease>     <doseNumber value="1"/>   </protocolApplied>   <protocolApplied>     <series value="3-dose"/>     <targetDisease>       <coding>         <system value="http://snomed.info/sct"/>         <code value="66071002"/>       </coding>     </targetDisease>     <doseNumber value="2"/>     <seriesDoses value="3"/>   </protocolApplied> 


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Immunization

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Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.