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Series/Season Display Selection and Number of Doses Remaining

Series/Season Display Selection and Number of Doses Remaining

Contents

The Series/Season Selection and Number of Doses Remaining features are optional features that may be enabled by the ICE service provider.

When the output-series-information property is set to true, ICE will return the selected series/seasons for substance administration events and forecasts. When the output-number-of-doses-remaining property is set to true, ICE will return the selected series/seasons for forecasts and include the number of doses remaining in the series. When both properties are enabled, the selected series/seasons are returned for both substance administration events and forecasts, and the number of doses remaining are included in the forecasts. Both options are disabled by default.

Note: This feature is under testing and is not yet available for general use. This feature introduces new related clinical statements within substance administration events and administration proposals. Tools that parse ICE responses may require modification to properly handle the presence of these new elements when these features are enabled.

Series/Seasons Display Selection

The series/season selection is included in the response as an observation result with an observation focus code of SERIES_DISPLAY_OPTIONS within a related clinical statement (see Output Format Specifics and Sample Outputs below). A nested related clinical statement contains an observation result with an observation focus indicating the selection type and an observation value specifying the selected series.

For each vaccine group, the list of series and the rules used to determine which series ICE selects are specified in the ICE wiki page.

The coded values for series, selection types, seasons, and optional observation focus outputs can be found on the ICE Implementation Guide Codes Google Sheet.

There are 3 different possible series selection display type designations:

Selection Types

  1. SERIES_DISPLAY_UNAMBIGUOUS

    • When this display type is specified, it indicates that there is no other series that could possibly be selected for the patient to complete a series for the vaccine group.

    • ICE is forecasting the next dose based on this series. Therefore, the series specified by this display type can confidently be displayed/returned to the end user.

  2. SERIES_DISPLAY_BEST_GUESS

    • When this display type is specified, it indicates that while there is more than Series that could be used for the patient to complete a series in the vaccine group, the series specified is the “best guess” and the one that ICE is accurately using for the forecast.

    • ICE is accurately forecasting the next dose based on this series. The series specified by this display type can confidently be displayed/returned to the end user, with the recognition that other series could potentially be followed or the series displayed by ICE may change future doses or vaccines added to the patient’s immunization record.

  3. SERIES_DISPLAY_ALTERNATIVE (not currently used)

    • Note: This is a placeholder feature and not currently used. Additional rules specific to each vaccine group need to be developed to accurately display alternatives. Please let us know if there is an interest in this feature.

    • This display type may be returned by ICE when there are alternative series that could be followed to complete a series in the vaccine group. The utility of this display type has not yet been determined, so currently it is not returned in the ICE output.

    • May or may not be returned in conjunction with a SERIES_DISPLAY_BEST_GUESS selection.

    • An example utility for this display type would be when there are no shots on record for a particular vaccine group. For example, if a patient has not received any COVID-19 shots, ICE could return multiple different product-specific series.

    • Unlike a series specified by SERIES_DISPLAY_UNAMBIGUOUS and SERIES_DISPLAY_BEST_GUESS, any series selection specified by this display type is not used by ICE when determining the forecast.

To summarize, the logic to determine which series is selected for display is as follows:

  • If there is only one series defined in a vaccine group, the series selection type is SERIES_DISPLAY_UNAMBIGUOUS.

  • If there is more than one series defined in a vaccine group, the series selection type is SERIES_DISPLAY_BEST_GUESS.

  • For purposes of the ICE service provider, a selection categorized as either SERIES_DISPLAY_UNAMBIGUOUS or SERIES_DISPLAY_BEST_GUESS may be returned to the end user.

Seasons

For seasonal vaccine groups (COVID-19, Influenza, Infant RSV, and H1N1), the associated season is returned in a related clinical statement embedded within the series for both substance administration events and forecasts. The nested related clinical statement contains an observation result with an observation focus code of SEASON and an observation value specifying the selected series containing the season code and a display name describing the season, including its start and end dates.

Not all seasons have a defined code; for seasons prior to any defined season, a code for a default season is used. For seasons subsequent to the season with the most recently defined code, the most recent code is returned. In both of these cases, the display name will indicate the actual start and end dates of the season associated with the series.

Number of Doses Remaining

When the number of doses remaining option is enabled, the number of doses remaining is returned in a related clinical statement embedded within the series display for forecasts. The logic is as follows:

  • If the series is not complete and a dose is recommended (Due Now or Due in Future), the number of doses remaining is returned simply by subtracting the number of doses administered from the total number of doses needed to complete the selected series (i.e. - either SERIES_DISPLAY_UNAMBIGUOUS or SERIES_DISPLAY_BEST_GUESS)

  • If the series is complete, there are no recurring doses defined by the series, and no doses are recommended, the number of doses remaining is 0.

  • If the series is complete, there are no recurring series defined by the series, but a dose is nevertheless recommended by ICE (not a typical circumstance), the number of doses remaining is 0 doses remaining in series; one or more additional doses may still be recommended

  • If the series is complete, there are recurring doses defined by the series, and a dose is recommended, the number of doses remaining is Recurring.

Output Format Specifics

Series Selected for Display

Substance Administration Events

  • Series Display Type: substanceAdministrationEvents/substanceAdministrationEvent[x]/relatedClinicalStatement/substanceAdministrationEvent/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationFocus[@codeSystem = '2.16.840.1.113883.3.795.12.100.501']

  • Series Code Value: substanceAdministrationEvents/substanceAdministrationEvent[x]/relatedClinicalStatement/substanceAdministrationEvent/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationValue[@codeSystem = '2.16.840.1.113883.3.795.12.100.10']

  • Season Focus: substanceAdministrationEvents/substanceAdministrationEvent[x]/relatedClinicalStatement/substanceAdministrationEvent/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationFocus[@codeSystem = '2.16.840.1.113883.3.795.12.100.11']

  • Season Value: substanceAdministrationEvents/substanceAdministrationEvent[x]/relatedClinicalStatement/substanceAdministrationEvent/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationValue[@codeSystem = '2.16.840.1.113883.3.795.12.100.11']

Substance Administration Proposals

  • Series Display Type: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationFocus[@codeSystem = '2.16.840.1.113883.3.795.12.100.501']

  • Series Code Value: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationValue[@codeSystem = '2.16.840.1.113883.3.795.12.100.10']

  • Season Focus: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationFocus[@codeSystem = '2.16.840.1.113883.3.795.12.100.11']

  • Season Value: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/observationValue[@codeSystem = '2.16.840.1.113883.3.795.12.100.11']

Number of Doses Remaining

When enabled, the number of doses remaining is embedded under the selected series for display for substance administration proposals.

  • Number of Doses Remaining Code System: substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/relatedClinicalStatement/observationResult/observationFocus[@code = 'NUMBER_OF_DOSES_REMAINING' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']

  • Number of Doses Remaining Value (as text): substanceAdministrationProposals/substanceAdministrationProposal[x]/relatedClinicalStatement/observationResult/observationFocus[@code = 'SERIES_DISPLAY_OPTIONS' and @codeSystem = '2.16.840.1.113883.3.795.12.100.500']/relatedClinicalStatement/observationResult/relatedClinicalStatement/observationResult/observationValue

Sample Outputs

Example 1 - DTP - 1 dose remaining to be administered in the 3-dose series

<clinicalStatements> <observationResults/> <substanceAdministrationEvents> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="83c0161d530f96397a628d39454584ec"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="514abe31-356e-4881-aa0b-1ba4eaa7075d"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20070701000000.000-0400" high="20070701000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="7987622b-03ed-4f9f-8b1c-8ee449f2fa37"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="a2385a7a-47f2-4ffa-a0f3-f25ac9c49ca9"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20070701000000.000-0400" high="20070701000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="72ac0a35-d0a5-43e8-96a6-776250a5af98"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationEventTime low="20080701000000.000-0400" high="20080701000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="08adcbda-9802-4549-8ace-90098cf8abbc"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="8299da14-06eb-4abf-adbd-92777302742d"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="d3096efb6a5e1f3b2b2ba51efd9e44b7"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="84faa4ed-069e-4430-958b-0425e1cc49f8"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20070725000000.000-0400" high="20070725000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="ac89e17e-e98f-4599-a21c-8a82de647ff7"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="7e746a55-e065-4b43-8b68-98e81d422827"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="2"/> <administrationTimeInterval low="20070725000000.000-0400" high="20070725000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="92900838-14bf-4e1f-925a-5c692da6ad25"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationEventTime low="20080701000000.000-0400" high="20080701000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="5026af49-35fb-4b3a-844b-d8964ff8652c"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="e9713bc3-c987-4fac-bbb3-17a5f8688b7f"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> </substanceAdministrationEvents> <substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="c6ce9174-49ce-428c-9229-54b0e467aa2f"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20080125000000.000-0500" high="20080125000000.000-0500"/> <validAdministrationTimeInterval low="20080125000000.000-0500"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="8bf1836a-57d7-4d9f-88d3-3d55b5d14c58"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="2efa5d68-c70b-4702-ae58-968d4492b7f0"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-e89494bf-6328-4f5e-9f99-3789bc4032a1"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="1"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="741e56a7-1764-47a6-817c-124334ce6f67"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationValue> <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Recommended"/> </observationValue> <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due now."/> <interpretation code="ADMINISTER_TDAP_OR_TD" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Administer Tdap or Td vaccine"/> <interpretation code="SUPPLEMENTAL_TEXT" codeSystem="2.16.840.1.113883.3.795.12.100.6" displayName="Supplemental text is available for this recommendation." originalText="Administer either Tdap or Td."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> </substanceAdministrationProposals> </clinicalStatements

Example 2 - DTP - 3-dose series is complete; number of doses remaining is “Recurring”

<clinicalStatements> <observationResults/> <substanceAdministrationEvents> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="f1ca43d1cf0a04a185cbd691b79dc3be"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="b52fbdfb-19f7-471a-9db6-9d376907c9f8"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20070701000000.000-0400" high="20070701000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="bbea9385-e26c-47f8-856e-81f3a1a524d4"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="5c4d59a4-ce8a-4a2c-bc1a-655507b854bb"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20070701000000.000-0400" high="20070701000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="e835fb40-9b09-4076-b888-ac7f4150e5cb"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationEventTime low="20080701000000.000-0400" high="20080701000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="64b37b72-24b5-4718-8a1d-158a00d1cd7a"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="cf25386c-f46f-43d3-8436-09df7ec105ea"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="1393d2c6b9d954b0840febb81cbf6ecd"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="e6fae1b5-5669-4200-af20-f7d065ecf01a"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20070725000000.000-0400" high="20070725000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="5b4a7ad1-8ca7-4575-a408-e5e83f2e2d72"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="13d92082-cde5-4d61-864d-dc6b11274eee"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="2"/> <administrationTimeInterval low="20070725000000.000-0400" high="20070725000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="041f2b74-36e9-465f-8a00-1fb24ad389df"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="6e4e40cb-0f83-4cb0-a1b7-229b6d8b25d3"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="656b9517-d9b4-4df3-9a06-d65082d731ff"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationEventTime low="20080701000000.000-0400" high="20080701000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="c241f772a03f10ca2b47e3ce4c1ccee5"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="6ca89482-7dd4-4f46-ba22-65cef7c35980"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20080121000000.000-0500" high="20080121000000.000-0500"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="c9a0ca90-9891-4509-a445-a94ee09cddf3"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="21c95564-4027-44b5-bd67-cdb4858df9ce"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="3"/> <administrationTimeInterval low="20080121000000.000-0500" high="20080121000000.000-0500"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="7e27398f-1980-45ed-8870-13b2bc14ebd6"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationEventTime low="20080701000000.000-0400" high="20080701000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="30dff352-0712-435e-9674-a17f8d378de9"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="f99541dc-eb02-4759-a353-05a6747735bf"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> </substanceAdministrationEvents> <substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="c5bd9723-ad26-4a95-b181-7306564dad3d"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="115" codeSystem="2.16.840.1.113883.12.292" codeSystemName="Vaccines (CVX)" displayName="Tdap"/> </substance> <proposedAdministrationTimeInterval low="20110701000000.000-0400" high="20130728000000.000-0400"/> <validAdministrationTimeInterval low="20110701000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="a9a3c802-0d6d-429a-a3a2-bb6cc5e3c912"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="46013d9f-12d3-419d-a8bb-ee3048e5238b"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="DTP3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="DTP 3-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-c2451c9c-8918-47d3-82e4-621e4fc94423"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="Recurring"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="f530f486-4c7d-4b08-8011-0c50a4e6deea"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="DTP Vaccine Group"/> <observationValue> <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Future Recommendation"/> </observationValue> <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due in the future."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> </substanceAdministrationProposals> </clinicalStatements>

Example 3 - Rotavirus - No Doses are Recommended

<clinicalStatements> <observationResults/> <substanceAdministrationEvents> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="8ef3b447bccf5bddf707332ab0ac416f"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="06b2f513-b34b-4f85-a891-7027066347af"/> <substanceCode code="119" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20120301000000.000-0500" high="20120301000000.000-0500"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="08d62ecb-f979-4df0-beab-f036170eb3af"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="59597ec2-18a4-42fe-b03a-fa155acdaa70"/> <substanceCode code="119" codeSystem="2.16.840.1.113883.12.292" displayName="Rotavirus RV1 (Rotarix, 2 dose)"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20120301000000.000-0500" high="20120301000000.000-0500"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="b134cfe0-eeef-4ab9-9a36-fac3aa6c6fd9"/> <observationFocus code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> <observationEventTime low="20120802000000.000-0400" high="20120802000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="bd3e6e8f-9ccd-43b8-9b4f-7c0f44ae9586"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="1ec17604-0dd5-43bb-9f76-c78b4516e457"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="Rotavirus2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Rotavirus 2-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="d53636a13a01de6fc860d28161090702"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="da1ab1cc-6dd0-444e-9b3a-129d26249db2"/> <substanceCode code="119" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20120325000000.000-0400" high="20120325000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="4190cbb3-51de-4420-a718-c49e244cb3ac"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="aee991ea-a442-4c57-bbfe-56b0be8c8de7"/> <substanceCode code="119" codeSystem="2.16.840.1.113883.12.292" displayName="Rotavirus RV1 (Rotarix, 2 dose)"/> </substance> <doseNumber value="2"/> <administrationTimeInterval low="20120325000000.000-0400" high="20120325000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="d7896a06-5fc5-4f05-81e4-505424644f91"/> <observationFocus code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> <observationEventTime low="20120802000000.000-0400" high="20120802000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="c78483a0-d92d-446b-af8f-d0c5d95ce20f"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="b4b53c2e-bb70-4c36-bd37-3734dbb3c6f6"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="Rotavirus2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Rotavirus 2-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> </substanceAdministrationEvents> <substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="4704e83d-1fd8-454d-8a46-db41a02082ef"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> </substance> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="1b9ff21f-709e-4c14-af58-e4d8bb13983c"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="67dbeec6-357c-4637-a5d0-6f207855ea79"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="Rotavirus2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Rotavirus 2-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-ef37884d-76de-411f-b222-4ea2cccfee69"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="0"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="1e9cf382-71f1-496d-a2c6-7ce23e96fc9e"/> <observationFocus code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> <observationValue> <concept code="NOT_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Not Recommended"/> </observationValue> <interpretation code="COMPLETE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Completed vaccine series."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> </substanceAdministrationProposals> </clinicalStatements>

Example 4 - COVID-19 - 1 dose prior season, one dose recommended in current season

<clinicalStatements> <observationResults/> <substanceAdministrationEvents> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="19e6e3c2fe2e35f2f4bae2b17ff9f542"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="20abb968-f7a2-4677-9224-1aa924d7ad3f"/> <substanceCode code="308" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20250810000000.000-0400" high="20250810000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="d94e6be5-0b34-4972-820f-3d4c569e793a"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="f20e7961-b076-486b-841a-197e3fc148c6"/> <substanceCode code="308" codeSystem="2.16.840.1.113883.12.292" displayName="COVID-19, mRNA, LNP-S, PF, tris-sucrose, 3 mcg/0.3"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20250810000000.000-0400" high="20250810000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="13637031-a2ac-48ad-8c17-857648beb918"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="f488b8ff-58e4-44d8-94af-996358d0a185"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="COVID19Sep2023PfizerLT5ySeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="COVID-19 Seasonal Pfizer LT 5y Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Season-1bccb5ab-fc08-453c-bf7a-10815c2a7bd9"/> <observationFocus code="SEASON" codeSystem="2.16.840.1.113883.3.795.12.100.11" codeSystemName="ICE Vaccine Season" displayName="Season" originalText="Season associated with the series"/> <observationValue> <concept code="COVID19Aug2024Season" codeSystem="2.16.840.1.113883.3.795.12.100.11" codeSystemName="ICE Vaccine Season" displayName="2024-2025 COVID-19 Season (08/22/2024 - 08/26/2025)"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="2a380bfe-c760-4e03-8672-c40623be900f"/> <observationFocus code="850" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="COVID-19 Vaccine Group"/> <observationEventTime low="20251201000000.000-0500" high="20251201000000.000-0500"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> </substanceAdministrationEvents> <substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="50d618c5-a164-42b3-8016-9829bf5d19dd"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="311" codeSystem="2.16.840.1.113883.12.292" codeSystemName="Vaccines (CVX)" displayName="COVID-19, mRNA, LNP-S, PF, 25mcg/0.25 mL, Moderna"/> </substance> <proposedAdministrationTimeInterval low="20250831000000.000-0400" high="20251004000000.000-0400"/> <validAdministrationTimeInterval low="20250831000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="d8e5aa94-253f-4e54-9671-e7a6be24ed24"/> <observationFocus code="850" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="COVID-19 Vaccine Group"/> <observationValue> <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Recommended"/> </observationValue> <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due now."/> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="3ba22c3d-bbb7-4013-a16b-e7b8cbc4b7b2"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="67d1840e-95ed-4d6a-bdca-2984d3f7f5bd"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="COVID19Aug2025lt2Series" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="COVID-19 Seasonal LT2 Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-f953056e-2e2b-4096-a05a-fecd790cc58d"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="2"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Season-255628e4-d9c9-4b31-b5dc-6730966d1749"/> <observationFocus code="SEASON" codeSystem="2.16.840.1.113883.3.795.12.100.11" codeSystemName="ICE Vaccine Season" displayName="Season" originalText="Season associated with the series"/> <observationValue> <concept code="COVID19Aug2025Season" codeSystem="2.16.840.1.113883.3.795.12.100.11" codeSystemName="ICE Vaccine Season" displayName="2025-2026 COVID-19 Season (08/27/2025 - 01/01/2100)"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> </substanceAdministrationProposals> </clinicalStatements>

Example 5 - Hep A and Hep B Twinrix Vaccine

The Twinrix vaccine (CVX 104) is a combination Hep A and Hep B vaccine. In the example below, ICE selects the Hep B Child/Adolescent Series for both administered doses and for the Hep B recommendation. For the Hep A series, ICE selects the Hep A 2-Dose Child/Adult Series for the first administered dose and then switches to the Hep A Adult 3-Dose Series for the second administered dose and the Hep A recommendation.

<clinicalStatements> <observationResults/> <substanceAdministrationEvents> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="dbb8eeb7f0a3ce2c195c4a6038b96c16"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="e95e6ca0-2b59-4275-acb4-013f995f70ab"/> <substanceCode code="104" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20070526000000.000-0400" high="20070526000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="67e70677-0c21-4497-a397-cc5e128e66e8"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="4bf96b60-bcbc-480a-9bb9-a762c7d75326"/> <substanceCode code="43" codeSystem="2.16.840.1.113883.12.292" displayName="Hep B adult &gt;=20 yrs"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20070526000000.000-0400" high="20070526000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="da597734-ad03-4441-b6e9-4737bcd11389"/> <observationFocus code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> <observationEventTime low="20250526000000.000-0400" high="20250526000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="d4f4dc14-1a78-42ca-a436-6581e54b8f48"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="61ed7e99-43ca-4e1b-9ac6-edf3d568f634"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepBChildAdolescentSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepB Child/Adolescent Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="76f138b7-42de-4a27-a97c-39d289680384"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="d74f3ea0-b36a-41dc-9254-9f0526c2d634"/> <substanceCode code="83" codeSystem="2.16.840.1.113883.12.292" displayName="Hep A ped/adol 2 dose"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20070526000000.000-0400" high="20070526000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="c27c72d2-9238-432e-bacb-c86312ec7be3"/> <observationFocus code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep A Vaccine Group"/> <observationEventTime low="20250526000000.000-0400" high="20250526000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="008c03d4-d20c-4a8a-ac6a-75b114e19582"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="f7cbb232-d302-4da3-a838-bbac5dffc438"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepA2DoseChildAdultSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepA 2-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="2.16.840.1.113883.3.795.12.100.10" extension="c9d2a04eca64230613d10713c405558e"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="00cd836e-5096-452f-ad07-547809351141"/> <substanceCode code="104" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20250526000000.000-0400" high="20250526000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="50632326-c5ca-4637-89cf-b5dfc3a37079"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="8abccc78-7f7b-4dc0-a8d0-6d679d7a815a"/> <substanceCode code="43" codeSystem="2.16.840.1.113883.12.292" displayName="Hep B adult &gt;=20 yrs"/> </substance> <doseNumber value="2"/> <administrationTimeInterval low="20250526000000.000-0400" high="20250526000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="37e0d77b-f405-468c-9158-9247bd18ada4"/> <observationFocus code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> <observationEventTime low="20250526000000.000-0400" high="20250526000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="b4e888b5-b0dd-4fb5-9db6-3ccb6291dccd"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="ac99be96-4e48-478c-b8f3-83de619d87c0"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepBChildAdolescentSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepB Child/Adolescent Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <substanceAdministrationEvent> <templateId root="2.16.840.1.113883.3.795.11.9.1.1"/> <id root="d253d454-c49e-45bb-b549-20ffa3f4c7fa"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <id root="6287c664-f6b1-42be-9241-f0e511459ab7"/> <substanceCode code="83" codeSystem="2.16.840.1.113883.12.292" displayName="Hep A ped/adol 2 dose"/> </substance> <doseNumber value="2"/> <administrationTimeInterval low="20250526000000.000-0400" high="20250526000000.000-0400"/> <isValid value="true"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="a609288d-24a0-4643-b947-41512f394cd2"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="3bdcaa44-a01b-4769-b563-655f3b1a1fd1"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepAAdult3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepA 3-Dose Series"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="PERT" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertinent information"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="cd7ff3d5-36cc-4dd7-b594-1c33aa921655"/> <observationFocus code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep A Vaccine Group"/> <observationEventTime low="20250526000000.000-0400" high="20250526000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent> </substanceAdministrationEvents> <substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="b6340343-62a0-4b4c-af65-59036861bc0c"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep A Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20251026000000.000-0400"/> <validAdministrationTimeInterval low="20251026000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="e58a32d8-4466-4c72-a0f6-66c68def00ca"/> <observationFocus code="810" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep A Vaccine Group"/> <observationValue> <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Future Recommendation"/> </observationValue> <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due in the future."/> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="157af5a5-1030-4b10-b7bf-dc98a60f72d4"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="80cc1cff-4a32-4f0d-ae37-d73eb553d58c"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepAAdult3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepA 3-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-23a1b3ba-5744-4dc9-aadd-50dac97f1fe8"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="1"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="30a94461-87ad-4047-9bdc-e9605af448c4"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20250721000000.000-0400" high="20250721000000.000-0400"/> <validAdministrationTimeInterval low="20250721000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="baa8e207-f72d-49d7-b8d0-6adf4f639bfc"/> <observationFocus code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> <observationValue> <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Future Recommendation"/> </observationValue> <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due in the future."/> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="b1fbb864-d41a-40fd-9c93-420e37e310bd"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="71517a0b-4cf5-480a-b77d-b250b1b7c85d"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepBChildAdolescentSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepB Child/Adolescent Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-a7f8c4e1-0497-4650-b96d-16b4379a3cb4"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="1"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> </substanceAdministrationProposals> </clinicalStatements>

Example 6 - All Recommendations

The output below displays the forecast for every vaccine group and each of their series displays and doses remaining for a 18 month-old female patient with no vaccinations on record.

<substanceAdministrationProposals> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="6086df8c-c0cc-446e-8e74-dab7ae37c6da"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="830" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Meningococcal ACWY Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20350801000000.000-0400" high="20370828000000.000-0400"/> <validAdministrationTimeInterval low="20350801000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="c8eb0c75-a398-4f9b-a081-020afca9cc06"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="bab33e9f-8edc-4e41-a5ea-79fda30a57ab"/> <observationFocus code="SERIES_DISPLAY_UNAMBIGUOUS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="MCV42DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="MCV4 2-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-3f1ed37f-652f-4a25-b9d5-44538aff15e3"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="2"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="649549e9-3395-421b-89f3-aaa2adca8bfa"/> <observationFocus code="830" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Meningococcal ACWY Vaccine Group"/> <observationValue> <concept code="FUTURE_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Future Recommendation"/> </observationValue> <interpretation code="DUE_IN_FUTURE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due in the future."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="2970f71d-3b15-4ce0-ae5f-dc332671665e"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="600" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Varicella Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20250801000000.000-0400" high="20251228000000.000-0500"/> <validAdministrationTimeInterval low="20250801000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="626ba24c-08ab-476c-b66b-d9e076d74853"/> <observationFocus code="600" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Varicella Vaccine Group"/> <observationValue> <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Recommended"/> </observationValue> <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due now."/> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="f4c2dc17-2938-4ce2-902b-7e9ce8216775"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="d0a23dfb-b926-489f-8ae5-9ca460f1f3a8"/> <observationFocus code="SERIES_DISPLAY_UNAMBIGUOUS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="Varicella2DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Varicella 2-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-f632e99f-8abf-42a6-b971-13f6cda3b16e"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="2"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="78b70ee1-e904-4fea-b100-6f8b06897c54"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> </substance> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="550442e0-11ce-4992-96af-550fa790097e"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="e1e6afcd-29a6-427a-86dd-55ba0fe26e85"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="Rotavirus3DoseSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Rotavirus 3-Dose Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-68b0a539-d3cc-449b-84a5-002e89c27087"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="0"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="4cd5a906-544e-4203-90f4-2bf2f82dd5ae"/> <observationFocus code="820" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Rotavirus Vaccine Group"/> <observationValue> <concept code="NOT_RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Not Recommended"/> </observationValue> <interpretation code="TOO_OLD_TO_INITIATE" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Vaccine not recommended at this age; too old to initiate."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="b2827ad5-21a7-4fa4-8f9b-1fa921cc3248"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="750" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Pneumococcal Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20250801000000.000-0400" high="20250801000000.000-0400"/> <validAdministrationTimeInterval low="20241107000000.000-0500"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="bb66b7b3-f18d-4f57-a2b5-8b6ad5ab3590"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="504af857-b20a-4cb3-83fc-abfc3e3ad22e"/> <observationFocus code="SERIES_DISPLAY_UNAMBIGUOUS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="PneumococcalSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="Pneumococcal Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-aae44558-f61c-4132-b2d0-98f642ab035d"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="6"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="031e44a1-1c25-4706-b5a0-8bb6bd6dcdaf"/> <observationFocus code="750" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Pneumococcal Vaccine Group"/> <observationValue> <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Recommended"/> </observationValue> <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due now."/> <interpretation code="SUPPLEMENTAL_TEXT" codeSystem="2.16.840.1.113883.3.795.12.100.6" displayName="Supplemental text is available for this recommendation." originalText="Administer either PCV15 or PCV20; if PCV15 or PCV20 is not available, PCV13 should be used."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="eabefdbb-72df-42bb-b5e6-3230f9a8ff2e"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5" codeSystemName="SNOMED CT" displayName="Immunization/vaccination management (procedure)"/> <substance> <substanceCode code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> </substance> <proposedAdministrationTimeInterval low="20241001000000.000-0400" high="20241128000000.000-0500"/> <validAdministrationTimeInterval low="20240829000000.000-0400"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="1b51ef4f-a226-4e33-8677-f8df26e49956"/> <observationFocus code="SERIES_DISPLAY_OPTIONS" codeSystem="2.16.840.1.113883.3.795.12.100.500" displayName="Series Options for Display"/> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="b9554bfb-051d-46b1-8824-cbbbec20bd6f"/> <observationFocus code="SERIES_DISPLAY_BEST_GUESS" codeSystem="2.16.840.1.113883.3.795.12.100.501"/> <observationValue> <concept code="HepBChildAdolescentSeries" codeSystem="2.16.840.1.113883.3.795.12.100.10" codeSystemName="ICE Series" displayName="HepB Child/Adolescent Series"/> </observationValue> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <id root="Doses-remaining-f3034e92-ef3e-4baa-b494-d9ff222d6025"/> <observationFocus code="NUMBER_OF_DOSES_REMAINING" codeSystem="2.16.840.1.113883.3.795.12.100.10" displayName="Doses Remaining" originalText="Number of doses remaining in the series, as of the evaluation date"/> <observationValue> <text value="3"/> </observationValue> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> </observationResult> </relatedClinicalStatement> <relatedClinicalStatement> <targetRelationshipToSource code="RSON" codeSystem="2.16.840.1.113883.5.1002" displayName="has pertaining reason"/> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="ea8195ad-e448-470a-bb93-feada09b777d"/> <observationFocus code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" displayName="Hep B Vaccine Group"/> <observationValue> <concept code="RECOMMENDED" codeSystem="2.16.840.1.113883.3.795.12.100.5" codeSystemName="ICE Evaluation Status" displayName="Recommended"/> </observationValue> <interpretation code="DUE_NOW" codeSystem="2.16.840.1.113883.3.795.12.100.6" codeSystemName="ICE Recommendation Reasons: All" displayName="Due now."/> </observationResult> </relatedClinicalStatement> </substanceAdministrationProposal> <substanceAdministrationProposal> <templateId root="2.16.840.1.113883.3.795.11.6.3.1"/> <id root="275a5b2e-d160-49c6-88f6-0f84a86bdb42"/> <dataSourceType code="ICE_2.55.1" codeSystem="2.16.840.1.113883.3.795.5.4.12.1.2" codeSystemName="org.cdsframework source"/> 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