This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 4.0.1. For a full list of available versions, see the Directory of published versions
Public Health and Emergency Response Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Patient, Practitioner |
Generated Questionnaire for Immunization
<?xml version="1.0" encoding="UTF-8"?> <Questionnaire xmlns="http://hl7.org/fhir"> <id value="qs1"/> <identifier> <system value="urn:ietf:rfc:3986"/> </identifier> <status value="draft"/> <date value="2018-04-03T12:05:46+10:00"/> <publisher value="Health Level Seven International (Public Health and Emergency Response)"/> <item> <linkId value="Immunization"/> <text value="Immunization event information"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Describes the event of a patient being administered a vaccine or a record of an immunization as reported by a patient, a clinician or another party."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="Immunization.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <type value="display"/> </item> <item> <linkId value="Immunization.id.value"/> <text value="Logical id of this artifact"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <linkId value="Immunization.meta"/> <text value="Metadata about the resource"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="uri"/> </extension> <linkId value="Immunization.implicitRules"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/> <type value="display"/> </item> <item> <linkId value="Immunization.implicitRules.value"/> <text value="A set of rules under which this content was created"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="code"/> </extension> <linkId value="Immunization.language"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <type value="display"/> </item> <item> <linkId value="Immunization.language.value"/> <text value="language"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <linkId value="Immunization.text"/> <text value="Text summary of the resource, for human interpretation"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later."/> <type value="display"/> </item> </item> <item> <linkId value="Immunization.contained"/> <text value="Contained, inline Resources"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/> <type value="display"/> </item> </item> <item> <linkId value="Immunization.extension"/> <text value="Additional Content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="Immunization.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Identifier"/> </extension> <linkId value="Immunization.identifier"/> <text value="Business identifier"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="A unique identifier assigned to this immunization record."/> <type value="display"/> </item> <item> <linkId value="Immunization.identifier.label"/> <text value="label:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.identifier.system"/> <text value="system:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.identifier.value"/> <text value="value:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="code"/> </extension> <linkId value="Immunization.status"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indicates the current status of the immunization event. Will generally be set to show that the immunization has been completed or not done. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/> <type value="display"/> </item> <item> <linkId value="Immunization.status.value"/> <text value="status"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.statusReason"/> <text value="Reason not done"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indicates the reason the immunization event was not performed. This is generally only used for the status of "not-done". The reason for performing the immunization event is captured in reasonCode, not here."/> <type value="display"/> </item> <item> <linkId value="Immunization.statusReason.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.statusReason.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.vaccineCode"/> <text value="Vaccine product administered"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Vaccine that was administered or was to be administered."/> <type value="display"/> </item> <item> <linkId value="Immunization.vaccineCode.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.vaccineCode.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.patient"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The patient who either received or did not receive the immunization."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Patient"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.patient.value"/> <text value="Who was immunized"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.encounter"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The visit or admission or other contact between patient and health care provider the immunization was performed as part of."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Encounter"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.encounter.value"/> <text value="Encounter immunization was part of"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="datetime"/> </extension> <linkId value="Immunization.date"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Date vaccine administered or was to be administered. When immunizations are given a specific date and time should always be known. When immunizations are patient reported, a specific date might not be known.  Although partial dates are allowed, an adult patient might not be able to recall the year a childhood immunization was given."/> <type value="display"/> </item> <item> <linkId value="Immunization.date.value"/> <text value="Vaccine administration date"/> <type value="dateTime"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="boolean"/> </extension> <linkId value="Immunization.primarySource"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="An indication that the content of the record is based on information from the person who administered the vaccine. This reflects the context under which the data was originally recorded. Reflects the “reliability” of the content."/> <type value="display"/> </item> <item> <linkId value="Immunization.primarySource.value"/> <text value="Indicates context the data was recorded in"/> <type value="boolean"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.reportOrigin"/> <text value="Indicates the source of a secondarily reported record"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The source of the data when the report of the immunization event is not based on information from the person who administered the vaccine. Should not be populated if primarySource = True, not required even if primarySource = False."/> <type value="display"/> </item> <item> <linkId value="Immunization.reportOrigin.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.reportOrigin.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.location"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The service delivery location where the vaccine administration occurred."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Location"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.location.value"/> <text value="Where immunization occurred"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.manufacturer"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Name of vaccine manufacturer."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Organization"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.manufacturer.value"/> <text value="Vaccine manufacturer"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="Immunization.lotNumber"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Lot number of the vaccine product."/> <type value="display"/> </item> <item> <linkId value="Immunization.lotNumber.value"/> <text value="Vaccine lot number"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="datetime"/> </extension> <linkId value="Immunization.expirationDate"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Date vaccine batch expires."/> <type value="display"/> </item> <item> <linkId value="Immunization.expirationDate.value"/> <text value="Vaccine expiration date"/> <type value="dateTime"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.site"/> <text value="Body site vaccine was administered"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Body site where vaccine was administered."/> <type value="display"/> </item> <item> <linkId value="Immunization.site.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.site.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.route"/> <text value="How vaccine entered body"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The path by which the vaccine product is taken into the body."/> <type value="display"/> </item> <item> <linkId value="Immunization.route.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.route.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Quantity"/> </extension> <linkId value="Immunization.doseQuantity"/> <text value="Amount of vaccine administered"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The quantity of vaccine product that was administered."/> <type value="display"/> </item> <item> <linkId value="Immunization.doseQuantity.comparator"/> <text value="comp:"/> <type value="choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.doseQuantity.value"/> <text value="value:"/> <type value="decimal"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.doseQuantity.units"/> <text value="units:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.doseQuantity.code"/> <text value="coded units:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.doseQuantity.system"/> <text value="units system:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="Immunization.performer"/> <text value="Who performed event"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indicates who performed the immunization event."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="Immunization.performer.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <type value="display"/> </item> <item> <linkId value="Immunization.performer.id.value"/> <text value="xml:id (or equivalent in JSON)"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="Immunization.performer.extension"/> <text value="Additional content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="Immunization.performer.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.performer.function"/> <text value="What type of performance was done"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Describes the type of performance (e.g. ordering provider, administering provider, etc.)."/> <type value="display"/> </item> <item> <linkId value="Immunization.performer.function.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.performer.function.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.performer.actor"/> <type value="group"/> <required value="true"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="The practitioner or organization who performed the action. When the individual practitioner who performed the action is known, it is best to send."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Practitioner, Organization"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.performer.actor.value"/> <text value="Individual or organization who was performing"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Annotation"/> </extension> <linkId value="Immunization.note"/> <text value="Additional immunization notes"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Extra information about the immunization that is not conveyed by the other attributes."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.reasonCode"/> <text value="Why immunization occurred"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Reasons why the vaccine was administered."/> <type value="display"/> </item> <item> <linkId value="Immunization.reasonCode.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.reasonCode.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="Reference"/> </extension> <linkId value="Immunization.reasonReference"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Condition, Observation or DiagnosticReport that supports why the immunization was administered."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-allowedResource"> <valueCode value="Condition, Observation, DiagnosticReport"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter"> <valueString value="subject=$subj&patient=$subj&encounter=$encounter"/> </extension> <linkId value="Immunization.reasonReference.value"/> <text value="Why immunization occurred"/> <type value="reference"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="boolean"/> </extension> <linkId value="Immunization.isPotent"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indication if a dose is considered to be subpotent. By default, a dose should be considered to be potent."/> <type value="display"/> </item> <item> <linkId value="Immunization.isPotent.value"/> <text value="Dose potency"/> <type value="boolean"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.subpotentReason"/> <text value="Reason for being subpotent"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Reason why a dose is considered to be subpotent."/> <type value="display"/> </item> <item> <linkId value="Immunization.subpotentReason.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.subpotentReason.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="Immunization.education"/> <text value="Educational material presented to patient"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Educational material presented to the patient (or guardian) at the time of vaccine administration."/> <type value="display"/> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="Immunization.education.id"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <type value="display"/> </item> <item> <linkId value="Immunization.education.id.value"/> <text value="xml:id (or equivalent in JSON)"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <linkId value="Immunization.education.extension"/> <text value="Additional content defined by implementations"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <linkId value="Immunization.education.modifierExtension"/> <text value="Extensions that cannot be ignored"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <type value="display"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="string"/> </extension> <linkId value="Immunization.education.documentType"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Identifier of the material presented to the patient."/> <type value="display"/> </item> <item> <linkId value="Immunization.education.documentType.value"/> <text value="Educational material document identifier"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="uri"/> </extension> <linkId value="Immunization.education.reference"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Reference pointer to the educational material given to the patient if the information was on line."/> <type value="display"/> </item> <item> <linkId value="Immunization.education.reference.value"/> <text value="Educational material reference pointer"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="datetime"/> </extension> <linkId value="Immunization.education.publicationDate"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Date the educational material was published."/> <type value="display"/> </item> <item> <linkId value="Immunization.education.publicationDate.value"/> <text value="Educational material publication date"/> <type value="dateTime"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="datetime"/> </extension> <linkId value="Immunization.education.presentationDate"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Date the educational material was given to the patient."/> <type value="display"/> </item> <item> <linkId value="Immunization.education.presentationDate.value"/> <text value="Educational material presentation date"/> <type value="dateTime"/> <required value="false"/> <repeats value="false"/> </item> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.programEligibility"/> <text value="Patient eligibility for a vaccination program"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indicates a patient's eligibility for a funding program."/> <type value="display"/> </item> <item> <linkId value="Immunization.programEligibility.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.programEligibility.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs"> <valueInteger value="1"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType"> <valueString value="CodeableConcept"/> </extension> <linkId value="Immunization.fundingSource"/> <text value="Funding source for the vaccine"/> <type value="group"/> <required value="false"/> <repeats value="true"/> <item> <extension url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/questionnaire-item-control"/> <code value="flyover"/> <display value="Fly-over"/> </coding> </valueCodeableConcept> </extension> <text value="Indicates the source of the vaccine actually administered. This may be different than the patient eligibility (e.g. the patient may be eligible for a publically purchased vaccine but due to inventory issues, vaccine purchased with private funds was actually administered)."/> <type value="display"/> </item> <item> <linkId value="Immunization.fundingSource.coding"/> <text value="code:"/> <type value="open-choice"/> <required value="false"/> <repeats value="false"/> </item> <item> <linkId value="Immunization.fundingSource.text"/> <text value="text:"/> <type value="string"/> <required value="false"/> <repeats value="false"/> </item> </item> </item> </Questionnaire>
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.