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
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