MedMij:Vprepub-6/FHIR Vaccination-Immunization

1 Introduction

This page describes patient's use case for the retrieval of vaccination results, in a personal health environment (PHR) context. Functional specifications are described at the functional design wiki page. This use case consists of enabling a patient to view his own administered vaccinations in a PHR. The technical specification is described here. HL7 FHIR R4 is used for this purpose.

Note: This implementation guide builds on the general guidelines described in the use case overarching principles.

1.1 Vaccinations

Vaccination results are represented by the Immunization resources. It contains the relevant data elements per single vaccination about the administered vaccination such as DateTime of administration, vaccination indication and pharmaceutical product. The transaction consists of all available administered vaccinations at the XIS. The transactions:

Retrieve vaccinations

2 Actors involved

Persons		Systems		FHIR Capability Statements
Name	Description	Name	Description	Name	Description
Patient	The user of a personal healthcare environment.	PHR	Personal health record	CapabilityStatement: Client	Vaccination client requirements
(Healthcare) provider	The user of a XIS	XIS	(Healthcare) information system	CapabilityStatement: Server	Vaccination server requirements

3 Use case 1: Retrieve vaccinations

This FHIR implementation guide assumes that the PHR system is able to make a connection to the right XIS that contains the patient's information. It does not provide information on finding the right XIS nor does it provide information about security. Moreover, each transaction is performed in the context of a specific authenticated patient, for whose context (token) has been established using the authentication mechanisms described in the 'Afsprakenstelsel'. Each XIS Gateway is required to perform filtering based on the patient associated with the context for the request, so only the records associated with the authenticated patient are returned. For this reason, search parameters should not be included for patient identification.

3.1 Introduction

The retrieve vaccinations transaction is used by the PHR to retrieve vaccinations from a XIS.

3.2 Actors

Transaction group	Transaction	Actor	Role
Retrieve vaccinations(PULL)	Retrieve vaccinations request	Patient (using a PHR)	Request vaccinations from the XIS
	Retrieve vaccinations response	(Healthcare) provider (using a XIS)	Serves vaccinations to the PHR

3.3 Invocations

3.3.1 PHR: request message

The request message represents an HTTP GET parameterized query from the PHR to the XIS.

3.3.1.1 Trigger Events

When the patient(PHR) wants to obtain vaccinations, it issues a retrieve vaccinations request message.

3.3.1.2 Message Semantics

The PHR executes an HTTP GET conform to the FHIR RESTful and search specification against the XIS's Observation endpoint. This search query URL is configurable by the PHR and has the following format:

GET [base]/immunization

The PHR may use, and the XIS shall be capable of processing, the following parameters to configure the search query:

Description	Examples
Retrieve all zib Immunization resources in the search results:	GET [base]/immunization

Alternatively an operation may be defined that returns a bundle with the list of immunization resources and a patient resource.

3.3.1.2.1 Expected Actions

The XIS shall process the query to retrieve Immunization resources that match the search parameters given.

3.3.2 XIS: response message

The XIS returns an HTTP Status code appropriate to the processing as well as a FHIR Bundle including the matching observation information.

3.3.2.1 Trigger Events

The XIS completed processing of the retrieve vaccinations request message.

3.3.2.2 Message Semantics

The returned data to the PHR should conform to the HCIMs and their associated profiles listed in the table below. The resources in the response message SHALL be a valid instance of these profiles. All resources SHALL include their related profile canonical URL in the meta.profile element in order to show compliance.

Zib name NL	Zib name EN	FHIR Resources
Vaccinatie	Vaccination	Immunization	http://nictiz.nl/fhir/StructureDefinition/nl-core-Vaccination-event
Patient	Patient	Patient	http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient
Zorgverlener	HealthProfessional	Practitioner	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-Practitioner
		PractionerRole	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole
Zorgaanbieder	HealthcareProvider	Organization	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider-Organization
		Location	http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthcareProvider
FarmaceutischProduct	PharmaceuticalProduct	Medication	http://nictiz.nl/fhir/StructureDefinition/nl-core-PharmaceuticalProduct

3.3.2.3 Expected Actions

The PHR shall process the results according to application-defined rules. The PHR should contain all the resources that match the query parameters.

4 Release notes

Release notes can be found on the functional design page.