Immunization (QDM)
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QDM defines Immunization as vaccines administered to patients in healthcare settings but does not include non-vaccine agents. QDM defines two contexts for immunization: Immunization, Administered; Immunization, Order.
The HL7 CQI Workgroup reviewed and updated this content on April 24, 2018 based on QDM version 5.3. The content was updated on June 7, 2018 consistent with QDM version 5.4. The only change between QDM versions 5.3 and 5.4 is that version 5.4 removes the "supply" attribute from "Immunization, Administered" and retains the "supply" attribute for "Immunization, Order"
FHIR Immunization Recommendation resource is specifically designed to provide an immunization forecast from a forecasting engine to a provider, basically to carry clinical decision support recommendations specific to immunizations and, therefore, is not consistent with the intent of the QDM datatype "Immunization, Order". The most closely associated resource is MedicationRequest. There is no comparable FHIR resource to specify ImmunizationRequest.
Immunization, Administered
| QDM Attribute | QI Core Metadata Element | Comment |
| Immunization, Administered | Immunization (the .status metadata allows conformance to the specific QDM datatype context) | QDM matched to QI Core / FHIR |
| Dosage | Immunization.doseQuantity | QDM matched to QI Core / FHIR |
| Negation Rationale | Immunization.explanation.reasonNotGiven | QDM matched to QI Core / FHIR |
| Reason | Immunization.explanation.reason | QDM matched to QI Core / FHIR |
| Route | Immunization.route | QDM matched to QI Core / FHIR |
| Author dateTime | Immunization.date | QDM matched to QI Core / FHIR NOTE: See QDM Known Issues for update – Immunization, Administered should include only the dateTime of the immunization administration. Until QDM 5.5 version, implementers should map Immunization, Administered author dateTime to administrationTime. [1] |
| Code | Immunization.vaccineCode | QDM matched to QI Core / FHIR |
| id | Immunization.id | QDM matched to QI Core / FHIR |
| Source | Immunization.primarySource | Source addressed by primarySource or reportOrigin |
Immunization, Order
| QDM Attribute | QI Core Metadata Element | Comment |
| Immunization, Order | MedicationRequest.intent | Medication Request intent uses the concepts proposal, plan, order, original-order, reflex-order, filler-order, instance-order, option. Constrain to "order" from the intent value set for QDM datatypes with the order context. |
| Active dateTime | MedicationRequest.dispenseRequest.validityPeriod | This indicates the validity period of a prescription (stale dating the Prescription). |
| Dosage | MedicationRequest.dosageInstruction | Indicates how the medication is to be used by the patient. |
| Negation Rationale | MedicationStatement.reasonNotTaken | Medication Request in QI Core does not reference negation rationale. See FHIR Tracker Item 15941 addressing notDoneReason requirement. |
| Reason | MedicationRequest.reasonCode | QDM matched to QI Core / FHIR |
| Route | MedicationRequest.dosageInstruction.route | QDM matched to QI Core / FHIR. |
| Author dateTime | MedicationRequest.authoredOn | QDM matched to QI Core / FHIR Note: FHIR Provenance generally addresses the author of the message; the identifier/source of the original resource element is defined by the resource. Individual resource element provenance is summarized in the FHIR W5 Report (http://hl7.org/fhir/w5.html). |
| Supply | MedicationRequest.dispenseRequest.quantity | QDM matched to QI Core / FHIR. |
| Code | MedicationRequest.medication | QDM matched to QI Core / FHIR |
| id | MedicationRequest.id | QDM matched to QI Core / FHIR |
| Source | MedicationRequest.requester | QDM matched to FHIR |
