Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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FHIR Core (FHIR)
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R4
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Public Health
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Immunization
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Craig Newman/Nathan Bunker: 28-0-0
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Clarification
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Non-substantive
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R5
Description
I realize that immunization.PrimarySource has been around for awhile and I see 4.6 definition is slightly improved over 4.0.1.
But, I think that the requirment originated from Argonaut work and was intended to represent, "a flag to indicate whether the vaccine was reported by patient rather than directly administered" this makes sense and is possible that this information is in an EHR and may actually be a discrete field.
The field seems to be mixing up provenance and the simple concept of is this something reported by a patient (or caregiver)? My mom and I both kept records in 4x6 index cards in a little box, which became "facts" when the dates were report to the querying clinician or organization. That is ALL this field should be for, and I believe was ever intended for.
I suggest you (minimally) change the definition to, "a flag to indicate whether the vaccine was reported by patient or caregiver rather than directly administered"
In US Core where this has become required and requires a DAR if missing, my understanding is that the majority of the implementer community simply hardcodes a DAR of unknown - every time.
I will place a Jira against US Core and will link it to this Jira.