Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) 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

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"?>
<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 with Details</b></p><p ><b >id</b>: protocol</p><p ><b >identifier</b>: urn:oid:1.3.6.1.4.1.21367.2005年3月7日.1234</p><p ><b >status</b>: completed</p><p ><b >vaccineCode</b>: Twinrix (HepA/HepB) <span >(Details : {http://hl7.org/fhir/sid/cvx code '104' = 'Hep A-Hep B)</span></p><p ><b >patient</b>: <a >Patient/example</a></p><p ><b >encounter</b>: <a >Encounter/example</a></p><p ><b >occurrence</b>: 18/06/2018</p><p ><b >primarySource</b>: true</p><p ><b >location</b>: <a >Location/1</a></p><p ><b >manufacturer</b>: <a >Organization/hl7</a></p><p ><b >lotNumber</b>: PT123F</p><p ><b >expirationDate</b>: 15/12/2018</p><p ><b >site</b>: left arm <span >(Details : {http://terminology.hl7.org/CodeSystem/v3-ActSite code 'LA' = 'left arm', given
 as 'left arm'})</span></p><p ><b >route</b>: Injection, intramuscular <span >(Details : {http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration code 'IM' =
 'Injection, intramuscular', given as 'Injection, intramuscular'})</span></p><p ><b >doseQuantity</b>: 5 mg<span > (Details: UCUM code mg = 'mg')</span></p><blockquote ><p ><b >performer</b></p><p ><b >function</b>: Ordering Provider <span >(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'OP' = 'Ordering Provider)</span></p><p ><b >actor</b>: <a >Practitioner/example</a></p></blockquote><blockquote ><p ><b >performer</b></p><p ><b >function</b>: Administering Provider <span >(Details : {http://terminology.hl7.org/CodeSystem/v2-0443 code 'AP' = 'Administering Provider)</span></p><p ><b >actor</b>: <a >Practitioner/example</a></p></blockquote><p ><b >isSubpotent</b>: false</p><p ><b >programEligibility</b>: Not Eligible <span >(Details : {http://terminology.hl7.org/CodeSystem/immunization-program-eligibility code
 'ineligible' = 'Not Eligible)</span></p><p ><b >fundingSource</b>: Private <span >(Details : {http://terminology.hl7.org/CodeSystem/immunization-funding-source code 'private'
 = '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 >(Details : {SNOMED CT code '40468003' = 'Viral hepatitis, type A)</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 >(Details : {SNOMED CT code '66071002' = 'Type B viral hepatitis)</span></p><p ><b >doseNumber</b>: 2</p></blockquote></div></text><identifier ><system value="urn:ietf:rfc:3986"/><value value="urn:oid:1.3.6.1.4.1.21367.2005年3月7日.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><patient ><referencevalue="Patient/example "/></patient><encounter ><referencevalue="Encounter/example "/></encounter><occurrenceDateTime value="2018年06月18日"/><primarySource value="true"/><location ><referencevalue="Location/1 "/></location><manufacturer ><referencevalue="Organization/hl7 "/></manufacturer><lotNumber value="PT123F"/><expirationDate value="2018年12月15日"/><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 ><valuevalue="5"/><systemvalue="http://unitsofmeasure.org"/><codevalue="mg"/></doseQuantity><performer ><function ><coding ><system value="http://terminology.hl7.org/CodeSystem/v2-0443"/><code value="OP"/></coding></function><actor ><referencevalue="Practitioner/example "/></actor></performer><performer ><function ><coding ><system value="http://terminology.hl7.org/CodeSystem/v2-0443"/><code value="AP"/></coding></function><actor ><referencevalue="Practitioner/example "/></actor></performer><isSubpotent value="false"/><programEligibility ><coding ><system value="http://terminology.hl7.org/CodeSystem/immunization-program-eligibility"/><code value="ineligible"/></coding></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><doseNumberPositiveInt value="1"/></protocolApplied><protocolApplied ><series value="3-dose"/><targetDisease ><coding ><system value="http://snomed.info/sct"/><code value="66071002"/></coding></targetDisease><doseNumberPositiveInt value="2"/></protocolApplied></Immunization>

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.