FHIR enabling an Immunization registry – part 3

So we’ve made a few proposals in the last couple of posts:

The next thing to think about is how to generate the ImmunizationRecommendation (IR) from the PlanDefinition.

This could be really complicated, depending on the circumstances around the generation. For example, if we just wanted the recommendation for a new born then it’s quite easy. If we wanted more ‘smarts’ – e.g. the recommendation for someone of a given age considering their immunization and clinical history, then it becomes rather more complicated. In this post we’ll keep it simple and not look at the patient’s history, focusing on the ‘mechanics’ of the generation.

As a background to the discussion, let’s think about how a client might use the registry API.

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FHIR enabling an immunization registry – part 2

In the previous post we discussed how an immunization registry might receive Immunization resources documenting the administration of vaccines to an individual (complicated), and how to expose those resources to a client (easy).

But vaccine administrations don’t exist in a vacuum – they’re generally related to some particular plan consisting of multiple administrations of different vaccines over a period of time with the intent of providing the recipient with protection against specific diseases. (And, as COVID has emphasized, protection of the planetary population as a whole).

So we need a way to represent that general plan, customize it for an individual – and then a way to link individual vaccine administrations back to that plan so we can be sure that an individual is receiving the vaccinations they should be. And we want to be able to report on this administration at a population level as well as the individual.

That’s a bit more complicated than it might appear.

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FHIR enabling an immunization registry

In New Zealand (and other places as well I expect) we’ve had a national registry for immunizations for a number of years – the National Immunization Register or NIR

It’s currently fed by HL7 version 2 messages and there’s a User Interface for authorized users, but there was always a plan to introduce a FHIR interface to some point – something that has been accelerated by the current COVID pandemic of course.

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