This page is part of the ICVP (v0.1.0: Releases Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Questionnaire: ICVP Model Questionnaire
Branch:Generated Narrative: Questionnaire Questionnaire-ICVPModel
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | Questionnaire for ICVP Logical Model | Questionnaire | http://smart.who.int/icvp/Questionnaire/Questionnaire-ICVPModel#0.1.0 | |
  name | Full Name of the client | 1..1 | string | |
 dob | Date of Birth | 1..1 | date | |
 sex | Sex | 0..1 | choice | Value Set: hl7VS-administrativeSex |
| nationality | Nationality | 0..1 | choice | Value Set: Country |
| nid | National Identification Document | 0..1 | string | |
 guardian | Parent or Guardian Details | 0..1 | group | |
 guardianName | Name of Parent or Guardian | 0..1 | string | |
 guardianRelationship | Relationship Status | 0..1 | choice | Value Set: Relationship Status for Contact in Patient |
| vaccinDetails | Vaccine Certificate Details | 1..* | group | |
 doseNumber | Dose Number | 1..1 | choice | Value Set: Dose Number |
| disease | Name of disease of condition vaccinated or received prophylaxis against | 1..1 | choice | Value Set: ICVP Disease Targeted |
| vaccineClassification | Vaccine or Prophylaxis classification code | 1..1 | choice | Value Set: ICVP - Vaccine Codes |
| vaccineTradeItem | Vaccine Trade Item | 0..1 | string | |
| date | Date of Vaccination | 1..1 | date | |
| clinicianName | Name of supervising clinician | 0..1 | string | |
| issuer | Relevant authoring reponsible for issuing the certificate, or for overseeing the administration center | 0..1 | string | |
| manufacturerId | Manufacturer ID | 0..1 | string | |
| manufacturer | Name of Manufacturer of Vaccine | 1..1 | string | |
| batchNo | Batch Number | 1..1 | string | |
| validityPeriod | Certificate Validity Period | 0..1 | group | |
| startDate | From | 0..1 | date | |
| endDate | To | 0..1 | date | |
| Documentation for this format | ||||
Contained Resources
Generated Narrative: ValueSet #v2-0001
Language: en
Profile: Shareable ValueSet
- Include all codes defined in
http://terminology.hl7.org/CodeSystem/v2-0001
Generated Narrative: ValueSet #v3-Country
Language: en
- Include codes from
urn:iso:std:iso:3166where code matches (by regex) [A-Z]{3}
Generated Narrative: ValueSet #ICVPDiseaseTargeted
- Include these codes as defined in
http://id.who.int/icd/release/11/mmsCode Display Definition 1D47 Yellow fever Yellow fever 1C81 Poliomyelitis Poliomyelitis
Generated Narrative: ValueSet #ICVPVaccineCodes
- Include these codes as defined in
http://id.who.int/icd/release/11/mmsCode Display Definition XM0N24 Yellow fever vaccines Yellow fever vaccine XM3418 Yellow fever, live attenuated Yellow fever, live attenuated XM0N50 Poliomyelitis vaccines Poliomyelitis vaccines XM1LX9 Diphtheria, hemophilus influenzae B, pertussis, poliomyelitis, tetanus vaccines Diphtheria, hemophilus influenzae B, pertussis, poliomyelitis, tetanus vaccines XM09Q7 Diphtheria, pertussis, poliomyelitis, tetanus vaccines Diphtheria, pertussis, poliomyelitis, tetanus vaccines XM0LT9 Diphtheria, pertussis, poliomyelitis, tetanus, hepatitis B vaccines Diphtheria, pertussis, poliomyelitis, tetanus, hepatitis B vaccines XM8AW1 Diphtheria, poliomyelitis, tetanus vaccines Diphtheria, poliomyelitis, tetanus vaccines XM01H1 Hemophilus influenzae B and poliomyelitis vaccines Hemophilus influenzae B and poliomyelitis vaccines XM21E6 Diphtheria tetanus, acellular pertussis, inactivated polio virus, haemophilus Influenzae type B vaccines Diphtheria tetanus, acellular pertussis, inactivated polio virus, haemophilus Influenzae type B vaccines XM84S1 Diphtheria, hepatitis B, tetanus, acellular pertussis, inactivated polio virus, haemophilus Influenzae type B vaccines Diphtheria, hepatitis B, tetanus, acellular pertussis, inactivated polio virus, haemophilus Influenzae type B vaccines XM9JP8 Diphtheria, tetanus, acellular pertussis, inactivated polio virus vaccines Diphtheria, tetanus, acellular pertussis, inactivated polio virus vaccines XM5V19 Poliomyelitis, trivalent, inactivated, whole virus Poliomyelitis, trivalent, inactivated, whole virus XM79H3 Poliomyelitis oral, bivalent, live attenuated Poliomyelitis oral, bivalent, live attenuated XM0VX8 Poliomyelitis oral, monovalent live attenuated Poliomyelitis oral, monovalent live attenuated XM0KZ1 Poliomyelitis oral, trivalent, live attenuated Poliomyelitis oral, trivalent, live attenuated
Generated Narrative: ValueSet #doseNumber
- Include all codes defined in
http://smart.who.int/icvp/CodeSystem/doseNumber
Generated Narrative: ValueSet #DVCRelationshipStatus
- Include all codes defined in
http://smart.who.int/icvp/CodeSystem/DVCRelationshipStatus