Dose Override Feature

As of ICE Version 1.22.1, a new feature is available that allows client applications to override how ICE would normally evaluate a specified shot.

The Dose Override feature enables client applications to indicate that an administered shot must be treated as INVALID or VALID, as specified in the request sent to the ICE service. By doing so, the client is essentially forcing ICE to bypass any logic it would normally use to evaluate the shot. ICE will mark the shot as specified in the request, regardless of what would normally be done. Typically, this feature would be used when there is a vaccine efficacy concern (e.g. - an incorrect administration, vaccine expiration, etc.), or to indicate that a shot should be marked Valid when ICE would normally evaluate it as Invalid.

We suggest that this feature, if used at all, be used with caution and only under certain circumstances such as those described above and in accordance to how it operates, specified below. Users should carefully consider the use cases and experiment with the feature so that are no unexpected results.

By default, this feature is disabled in the downloadable distribution. To enable it, add the following line to the ice.properties file:

enable_dose_override_feature=Y

When passing the request up to ICE, specify the shot validity using with <isValid /> element of the SubstanceAdministrationEvent, as follows:

<isValid value="true"/>

or

<isValid value=”false”/>

The example below is a combination shot. The value for the isValid element is false, indicating that all components of the vaccine (DTP, Hep B, and IPV) will all be evaluated as invalid. (It is currently not possible to specify the validity for each component of the vaccine.)

 

1 2 3 4 5 6 7 8 9 10 11 <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="aaaaff20d0328zzzz16d39b552f1c74c6b43d5e0"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="1111d60c93d6-988a-4c37-b9f0-3af4a6e6e9d4"/> <substanceCode code="110" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval high="20151222" low="20151222"/> <isValid value="false"/> </substanceAdministrationEvent>

 

In the response, ICE will include either the DOSE_OVERRIDE_VALID or DOSE_OVERRIDE_INVALID for that shot. The response for the above request is:

 

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 <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="aaaaff20d0328zzzz16d39b552f1c74c6b43d5e0"/> <substanceAdministrationGeneralPurpose code="384810002" codeSystem="2.16.840.1.113883.6.5"/> <substance> <id root="1111d60c93d6-988a-4c37-b9f0-3af4a6e6e9d4"/> <substanceCode code="110" codeSystem="2.16.840.1.113883.12.292"/> </substance> <administrationTimeInterval low="20151222000000.000-0500" high="20151222000000.000-0500"/> <isValid value="true"/> <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="309a6a00-79d7-4e6b-b272-0dd8e3eaa306"/> <dataSourceType code="ICE_1.22.1" 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="b427c20e-e224-47dc-a1d7-da9e255ee05a"/> <substanceCode code="20" codeSystem="2.16.840.1.113883.12.292" displayName="DTaP"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20151222000000.000-0500" high="20151222000000.000-0500"/> <isValid value="false"/> <relatedClinicalStatement> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="fa7d4df0-00d2-439d-a4db-7cd35323126d"/> <observationFocus code="200" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="DTP Vaccine Group"/> <observationEventTime low="20190319000000.000-0400" high="20190319000000.000-0400"/> <observationValue> <concept code="INVALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> <interpretation code="DOSE_OVERRIDE_INVALID" codeSystem="2.16.840.1.113883.3.795.12.100.3" codeSystemName="ICE Evaluation Reason" displayName="Dose Override, Invalid"/> </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="aae7a87d-4e2b-41c1-a6ae-8e6241753a33"/> <dataSourceType code="ICE_1.22.1" 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="64146d5f-f17b-43c9-92ce-0c54cc5b87d4"/> <substanceCode code="08" codeSystem="2.16.840.1.113883.12.292" displayName="Hep B peds, less than 20yrs"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20151222000000.000-0500" high="20151222000000.000-0500"/> <isValid value="true"/> <relatedClinicalStatement> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="cf3cdf0a-6241-438e-b833-04f3dbb7915d"/> <observationFocus code="100" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Hep B Vaccine Group"/> <observationEventTime low="20190319000000.000-0400" high="20190319000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> <interpretation code="DOSE_OVERRIDE_INVALID" codeSystem="2.16.840.1.113883.3.795.12.100.3" codeSystemName="ICE Evaluation Reason" displayName="Dose Override, Invalid"/> </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="dc7b4dc8-5496-4c3e-9d71-7468a3c99240"/> <dataSourceType code="ICE_1.22.1" 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="4a2f2fc7-75b1-43a9-8a34-9d330667e0d4"/> <substanceCode code="10" codeSystem="2.16.840.1.113883.12.292" displayName="IPV"/> </substance> <doseNumber value="1"/> <administrationTimeInterval low="20151222000000.000-0500" high="20151222000000.000-0500"/> <isValid value="true"/> <relatedClinicalStatement> <observationResult> <templateId root="2.16.840.1.113883.3.795.11.6.1.1"/> <id root="350c7439-66d1-4b49-8c14-8e7600494672"/> <observationFocus code="400" codeSystem="2.16.840.1.113883.3.795.12.100.1" codeSystemName="Vaccine Groups" displayName="Polio Vaccine Group"/> <observationEventTime low="20190319000000.000-0400" high="20190319000000.000-0400"/> <observationValue> <concept code="VALID" codeSystem="2.16.840.1.113883.3.795.12.100.2" codeSystemName="ICE Evaluation Status" displayName="Valid Dose"/> </observationValue> <interpretation code="DOSE_OVERRIDE_INVALID" codeSystem="2.16.840.1.113883.3.795.12.100.3" codeSystemName="ICE Evaluation Reason" displayName="Dose Override, Invalid"/> </observationResult> </relatedClinicalStatement> </substanceAdministrationEvent> </relatedClinicalStatement> </substanceAdministrationEvent>