How is the administration of vaccines captured in FHIR?
A recent tragic story in the Irish media brought home to me that I was too old to have been vaccinated for measles.
The MMR jab came to Ireland in 1985 — ten years too late for me. Cases of measles have been in the single digits in recent years, so it never crossed my mind that this might be a problem.
Let’s say I decide to reduce my future risk from measles by getting vaccinated.
I start by booking an appointment with my GP. Maybe I was vaccinated as a teenager and don’t remember, or maybe there’s a reason I shouldn’t be vaccinated.
How might all this look in FHIR?
I start by booking an appointment.
Patient
My patient record in the clinic’s system.
Organization
The clinic the doctor practices from.
Practitioner
Details of the doctor.
PractitionerRole [n]
The doctor’s position and any other roles he might play.
Appointment
The appointment date, time and location.
I turn up on the day for my consultation. All of the above FHIR resources are accessed again when I arrive at reception, and some more are created.
Encounter
My meeting with the doctor.
Observation [n]
The doctor takes notes during our discussion — my current worries about measles, my fitness to receive a vaccine, my recollections of past vaccines.
ImmunizationEvaluation [n]
The doctor pulls up a list of all vaccines I’ve had in the past and compares them against the recommended vaccines for someone my age.
ImmunizationRecommendation
A vaccine is recommended for measles and the resource’s targetDisease element updated to reflect that.
3 days later I arrive at the same clinic for an appointment with the vaccine nurse. Many of the previously created resources are looked up by reception and by the nurse, and a few more are created.
Practitioner
The nurse who administers the vaccine.
PractitionerRole [n]
Her various roles: practice nurse, immunization nurse.
Encounter
Another Encounter is created for my meeting with the nurse.
Immunization
The vaccine as it was administered, complete with vaccine code, lot number and manufacturer.
ImmunizationEvaluation
Created during daily admin when all administered vaccines are reconciled for the day.
Observation [n]
Any side effects I report on the day or after the fact.
Like so many of us I’ve had a lot of vaccines over the past few years. It’s always surprising to map out what appears to be a simple, everyday medical occurrence to its representation in FHIR.
Here are the three core FHIR resources associated with vaccine administration.
Immunization
ImmunizationRecommendation
ImmunizationEvaluation
Have I left out any resources?
---