O‘zbekiston Raqamli sog‘liqni saqlash platformasi
0.5.0 - ci-build Uzbekistan bayroqcha

Uzbekistan Digital Health Platform - Local Development build (v0.5.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Immunization

Ushbu sahifa qo‘llanma yozilgan asl manba tilidan tarjimalarni o‘z ichigaoladi. Ushbu tarjimalar haqidagi ma’lumot va ularga fikr bildirish bo‘yichako‘rsatmalarni bu yerda topishingiz mumkin.

Mashina tarjimasi, inson tomonidan tekshirilishi zarur. Ushbu sahifa ingliz tilidan sun'iy intellekt yordamida avtomatik tarjima qilingan va hali muharrir tomonidan tekshirilmagan. Har qanday nomuvofiqlikda asl inglizcha versiya ustuvor hisoblanadi.

Ushbu ish jarayoni milliy emlash jadvali qanday qilib shaxsiylashtirilgan tavsiyani shakllantirishini, bemorni qabulga yozish, konsultatsiya va emlash tashriflarida qanday kuzatishini va vaksina dozasi qanday qayd etilishini ko'rsatadi. Bu yerda ishlatilgan barcha resurslar UZ Core'da profillangan.

Ishtirokchilar: Emlash dasturi menejeri / Ma'lumotlar boshqaruvchisi (jadvalni yuritadi); tibbiy registrator (bemorni yozadi); bemor yoki ota-ona/vasiy (tavsiyalarni ko'radi); shifokor va hamshira (yaroqlilikni baholaydi va emlaydi). Klinik tashriflar FHIR Encounter resurslari sifatida olib boriladi — bitta konsultatsiya tashrifi va alohida emlash tashrifi.

Zanjir:

National schedule to recorded doseProgrammanagerProgrammanagerRegistrarRegistrarDoctorDoctorNurseNurseDHP(recommendation engine)DHP(recommendation engine)1publishPlanDefinition(national schedule)one active scheduleper jurisdiction2POSTEncounter1 - consult(status = planned; subject = patient;participant = nurse; serviceProvider = clinic)3PUT Encounter 1 (status = in-progress)primary intake, sets reason4GETImmunizationRecommendation?patient=[id]engine reads PlanDefinition+ Immunization history+ patient demographics5ImmunizationRecommendation(due / overdue, dose number)6PUT Encounter 1 (status = completed)assess eligibility; reason -> ImmunizationRecommendation7POST Encounter 2 - vaccination(status = in-progress)8POSTImmunization(encounter -> Encounter 2; basedOn -> ImmunizationRecommendation;status = completed | not-done)opt[reaction occurs]9POSTAdverseEvent(suspectEntity -> Immunization) +Observation


1. Jadval kod sifatida

Milliy jadval bir marta PlanDefinition sifatida e'lon qilinadi. Har bir tavsiya etilgan doza PlanDefinition.action hisoblanadi; vaksina va dozalash tafsilotlari definitionCanonical orqali ActivityDefinitionga yoki milliy kengaytmalar (doseSequence, maximumInterval, gracePeriod) orqali harakat ustida olib boriladi. Dozalar orasidagi minimal intervallar action.relatedAction.offsetDurationdan foydalanadi; yaroqlilik action.conditiondan foydalanadi.

GET [base]/PlanDefinition?status=active&context-type-value=focus$http://snomed.info/sct|33879002

Berilgan ko'lam/yurisdiksiya uchun bir vaqtning o'zida faqat bitta jadval versiyasi faol bo'lishi mumkin va jadval validatsiya qoidalarini qondirishi shart (doza ketma-ketligida uzilishlar yo'q, imkonsiz vaqt oynalari yo'q, ikkita bir-biriga ustma-ust tushadigan faol versiya yo'q). PlanDefinition sahifasiga qarang.

2. Tavsiyani shakllantirish

Tavsiya mexanizmi faol PlanDefinition'ni, bemorning mavjud Immunization tarixini va bemorning demografik ma'lumotlarini o'qiydi hamda ImmunizationRecommendation hosil qiladi. Har bir yozuv vaccineCode va/yoki targetDisease, doseNumber, forecastStatus (muddati keldi, muddati o'tdi, …) va dateCriterion (eng erta/tavsiya etilgan/eng kech sanalar) ni olib boradi.

# read what a patient is due for
GET [base]/ImmunizationRecommendation?patient=Patient/[id]&_sort=-date

# read the doses already given
GET [base]/Immunization?patient=Patient/[id]&status=completed

Tavsiya odatda jadval va bemor tarixi asosida mexanizm tomonidan hisoblab chiqiladi - mijozlar uni ko'rsatadi. Konsultatsiya davomida klinisist uni ko'rib chiqishi yoki mexanizm uni shakllantirmagan hollarda yaratishi ham mumkin.

3. Konsultatsiya tashrifi

Tibbiy yordam Encounter doirasida ko'rsatiladi. Yozuv va konsultatsiya bitta uzoq muddatli konsultatsiya tashrifidan foydalanadi, uning statusi tashrif davom etishi bilan o'zgarib boradi — har bir medxodim uchun yangi Encounter yaratilmaydi:

  • Tibbiy registrator bemorni yozadi va status = planned bilan Encounter yaratadi. subject — bemor, serviceProvider — klinika, participant esa registrator va tayinlangan hamshirani o'z ichiga oladi. Endi bemor o'sha hamshiraning ish ro'yxatida paydo bo'ladi.
  • Hamshira birlamchi qabul uchun tashrifni ochadi va o'sha Encounter'ni status = in-progress ga yangilaydi, tashrif reasonini va actualPeriodni qayd etadi.
  • Oilaviy shifokor bemorni o'sha Encounter doirasida ko'rikdan o'tkazadi, ImmunizationRecommendationni ko'rib chiqadi yoki yaratadi va Encounter.reasonni o'sha tavsiyaga ishora qilib qo'yish orqali uni bog'laydi. Konsultatsiya tugagach, Encounter status = completed ga o'tadi.
# registrar books the patient (consultation encounter)
POST [base]/Encounter
{
  "resourceType": "Encounter",
  "meta": { "profile": ["https://dhp.uz/fhir/core/StructureDefinition/uz-core-encounter"] },
  "status": "planned",
  "subject": { "reference": "Patient/[id]" },
  "serviceProvider": { "reference": "Organization/[clinic]" },
  "participant": [{ "actor": { "reference": "Practitioner/[nurse]" } }]
}

# nurse opens the visit
PUT [base]/Encounter/[id]    # status -> in-progress, set reason, actualPeriod

# doctor links the recommendation and closes the consult
PUT [base]/Encounter/[id]    # reason -> ImmunizationRecommendation, status -> completed

4. Dozani kiritish

Vaksinatsiya odatda konsultatsiyaga qaraganda boshqa muassasada, boshqa kunda o'tkaziladi - shu sababli u konsultatsiya tashrifi emas, balki alohida Encounter'ga qayd etiladi. Hamshira kiritish uchun o'sha emlash tashrifini (status = in-progress) ochadi, so'ngra unga Immunization.encounter orqali va tavsiyaga Immunization.basedOn orqali ishora qiluvchi Immunizationni qayd etadi. status natijani olib boradi:

Natija Immunization.status Shuningdek o'rnatiladi
Vaksina berildi completed occurrence, vaccineCode, administeredProduct, lotNumber, doseQuantity, performer
Tibbiy istisno not-done statusReason = MEDPREC (tibbiy ehtiyot chorasi) yoki IMMUNE (immunitet)
Rad etish not-done statusReason = PATOBJ (bemorning e'tirozi)
Mahsulot mavjud emas not-done statusReason = OSTOCK (mahsulot zaxirada yo'q)
Xato bilan qayd etilgan entered-in-error -

statusReason Immunization status reason value setga (required) bog'langan; yuqoridagi to'rtta kod, HL7 v3 ActReason'dan, yagona yaroqli qiymatlardir.

POST [base]/Immunization
{
  "resourceType": "Immunization",
  "meta": { "profile": ["https://dhp.uz/fhir/core/StructureDefinition/uz-core-immunization"] },
  "status": "completed",
  "vaccineCode": { "coding": [{ "system": "http://hl7.org/fhir/sid/cvx", "code": "03" }] },
  "patient": { "reference": "Patient/[id]" },
  "encounter": { "reference": "Encounter/[vaccination-encounter-id]" },
  "basedOn": [{ "reference": "ImmunizationRecommendation/[id]" }],
  "occurrenceDateTime": "2026-05-30",
  "lotNumber": "AB-2231",
  "performer": [{ "actor": { "reference": "PractitionerRole/[id]" } }],
  "protocolApplied": [{ "doseNumberPositiveInt": 1 }]
}

Doza bemor + vaccineCode + occurrence + lotNumber bo'yicha yagona tarzda aniqlanadi - bir xil kombinatsiyani ikki marta yubormang.

5. Reaksiyani qayd etish (agar bo'lsa)

Agar bemorda emlashdan keyingi reaksiya bo'lsa, suspectEntitysi Immunization'ga ishora qiluvchi AdverseEventni qayd eting, ixtiyoriy ravishda reaksiyani tavsiflovchi Observation bilan.

Bog'liq