Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Example AllergyIntolerance/example (XML)

Patient Care Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner, RelatedPerson

Raw XML (canonical form + also see XML Format Specification)

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A typical Food Allergy (id = "example")

<?xml version="1.0" encoding="UTF-8"?>

<AllergyIntolerance xmlns="http://hl7.org/fhir">
  <id value="example"/> 

  <!--    an identifier used for this allergic propensity (adverse reaction risk)    -->
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: AllergyIntolerance</b> <a name="example"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource AllergyIntolerance &quot;example&quot; </p> </div> <p> <b> identifier</b> : <span title="  an identifier used for this allergic propensity (adverse reaction risk)  ">id: 49476534</span> </p> <p> <b> clinicalStatus</b> : <span title="  this individual has had several reactions  ">Active <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-allergyintolerance-clinical.html">AllergyIntolerance Clinical Status Codes</a> #active)</span> </span> </p> <p> <b> verificationStatus</b> : Confirmed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-allergyintolerance-verification.html">AllergyIntolerance Verification Status</a> #confirmed)</span> </p> <p> <b> type</b> : <span title="  note: it's often unknown whether an allergy is mediated by an immune response,
         and not as significant as once thought  ">allergy</span> </p> <p> <b> category</b> : <span title="  this categorization is implied by &quot;cashew nut&quot; and therefore basically
         
    redundant, but many systems collect this field anyway, since it's either 
    useful when the substance is not coded, or it's quicker to sort/filter on
    than using terminology based reasoning  ">food</span> </p> <p> <b> criticality</b> : <span title="  there is no question that the allergy is real and serious  ">high</span> </p> <p> <b> code</b> : <span title="  Allergy or intolerance code (substance, product, condition or negated/excluded
         statement) or text. A few times, 
    there's a full description of a complex substance/product - in these caes,
         use the
    extension [url] to refer to a Substance resource.  ">Cashew nuts <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #227493005)</span> </span> </p> <p> <b> patient</b> : <span title="  the patient that actually has the risk of adverse reaction  "><a href="patient-example.html">Patient/example</a>  &quot;Peter CHALMERS&quot;</span> </p> <p> <b> onset</b> : <span title="  when the allergy was first noted (in this case the same as reaction.onset of
         the first occurrence)  ">2004</span> </p> <p> <b> recordedDate</b> : <span title="  the date that this entry was recorded  ">2014-10-09T14:58:00+11:00</span> </p> <blockquote> <p> <b> participant</b> </p> <p> <b> function</b> : Author <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-provenance-participant-type.html">Provenance participant type</a> #author)</span> </p> <p> <b> actor</b> : <a href="practitioner-example.html">Practitioner/example</a>  &quot;Adam CAREFUL&quot;</p> </blockquote> <blockquote> <p> <b> participant</b> </p> <p> <b> function</b> : Informant <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-provenance-participant-type.html">Provenance participant type</a> #informant)</span> </p> <p> <b> actor</b> : <a href="patient-example.html">Patient/example</a>  &quot;Peter CHALMERS&quot;</p> </blockquote> <p> <b> lastOccurrence</b> : <span title="  last happened June 2012. Typically, systems either track lastOccurrence,
     or a list of events.  ">2012-06</span> </p> <p> <b> note</b> : <span title="  an additional note about the allergy propensity by the recorder  ">The criticality is high becasue of the observed anaphylactic reaction when challenged
           with cashew extract.</span> </p> <blockquote> <p> <b> reaction</b> </p> <p> <b> substance</b> : <span title="  
      It's possible to list specific things to which the patient responded,
      e.g. chocolate (that happened to contain cashew nuts). This event has
      such a specific substance. Note that systems should ensure that what
      goes in here does not conflict with the substance above, and systems
      processing the data can be sure that what is here does not contravene
      the substance above
     ">cashew nut allergenic extract Injectable Product <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-rxNorm.html">RxNorm</a> #1160593)</span> </span> </p> <h3> Manifestations</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Anaphylactic reaction <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #39579001)</span> </td> </tr> </table> <p> <b> description</b> : Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine
           administered</p> <p> <b> onset</b> : 2012-06-12</p> <p> <b> severity</b> : severe</p> <p> <b> exposureRoute</b> : Subcutaneous route <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #34206005)</span> </p> </blockquote> <blockquote> <p> <b> reaction</b> </p> <h3> Manifestations</h3> <table class="grid"><tr> <td> -</td> <td> <b> Concept</b> </td> </tr> <tr> <td> *</td> <td> Urticaria <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #64305001)</span> </td> </tr> </table> <p> <b> onset</b> : 2004</p> <p> <b> severity</b> : moderate</p> <p> <b> note</b> : <span title="  an additional note about the reaction by the recorder  ">The patient reports that the onset of urticaria was within 15 minutes of eating
             cashews.</span> </p> </blockquote> </div> </text> <identifier> 
    <system value="http://acme.com/ids/patients/risks"/> 
    <value value="49476534"/> 
  </identifier> 

  <!--    this individual has had several reactions    -->   
  <clinicalStatus> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"/> 
      <code value="active"/> 
      <display value="Active"/> 
    </coding> 
  </clinicalStatus> 

  <verificationStatus> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"/> 
      <code value="confirmed"/> 
      <display value="Confirmed"/> 
    </coding> 
  </verificationStatus> 
  
  <!--    note: it's often unknown whether an allergy is mediated by an immune response,
   and not as significant as once thought    -->
  <type value="allergy"/> 
  
  <!--    this categorization is implied by "cashew nut" and therefore basically 
    redundant, but many systems collect this field anyway, since it's either 
    useful when the substance is not coded, or it's quicker to sort/filter on
    than using terminology based reasoning    -->

  
  <category value="food"/> 
     
  <!--    there is no question that the allergy is real and serious    --> 
  <criticality value="high"/> 
  
  <!--    Allergy or intolerance code (substance, product, condition or negated/excluded
   statement) or text. A few times, 
    there's a full description of a complex substance/product - in these caes,
   use the
    extension [url] to refer to a Substance resource.    -->
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="227493005"/> 
      <display value="Cashew nuts"/> 
    </coding> 
  </code> 
 
  <!--    the patient that actually has the risk of adverse reaction    -->
  <patient> 
    <reference value="Patient/example"/> 
  </patient> 

  <!--    when the allergy was first noted (in this case the same as reaction.onset of
   the first occurrence)    --> 
  <onsetDateTime value="2004"/> 

  <!--    the date that this entry was recorded    -->  
  <recordedDate value="2014-10-09T14:58:00+11:00"/> 
  
  <participant>  
    <function>  
      <coding>  
        <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>  
        <code value="author"/>  
        <display value="Author"/>  
      </coding>  
    </function>  
    <actor>  
      <reference value="Practitioner/example"/>  
    </actor>  
  </participant>  

  <!--    the patient is the reporter in this case    -->
  <participant>  
    <function>  
      <coding>  
        <system value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>  
        <code value="informant"/>  
        <display value="Informant"/>  
      </coding>  
    </function>  
    <actor>  
      <reference value="Patient/example"/>  
    </actor>  
  </participant> 

  <!--    last happened June 2012. Typically, systems either track lastOccurrence,
     or a list of events.    -->
  <lastOccurrence value="2012-06"/> 
  
  <!--    an additional note about the allergy propensity by the recorder    -->
  <note> 
    <text value="The criticality is high becasue of the observed anaphylactic reaction when challenged
     with cashew extract."/> 
  </note>   
  
  <!--    past events. There's no claim that this is all the events, and 
     that should not be assumed    -->
  <reaction>  
    <!--    
      It's possible to list specific things to which the patient responded,
      e.g. chocolate (that happened to contain cashew nuts). This event has
      such a specific substance. Note that systems should ensure that what
      goes in here does not conflict with the substance above, and systems
      processing the data can be sure that what is here does not contravene
      the substance above
       -->
    <substance> 
      <coding> 
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
        <code value="1160593"/> 
        <display value="cashew nut allergenic extract Injectable Product"/> 
      </coding>   
    </substance> 
    <manifestation> 
    <concept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="39579001"/> 
      <display value="Anaphylactic reaction"/> 
      </coding> 
    </concept> 
    </manifestation> 
    <description value="Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine
     administered"/> 
    <onset value="2012-06-12"/> 
    <severity value="severe"/> 
    <exposureRoute> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="34206005"/> 
        <display value="Subcutaneous route"/> 
      </coding> 
    </exposureRoute> 
  </reaction> 

  <!--    this was the first occurrence    -->
  <reaction>  
    <manifestation> 
    <concept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64305001"/> 
      <display value="Urticaria"/> 
      </coding> 
    </concept> 
    </manifestation> 
    <onset value="2004"/> 
    <severity value="moderate"/> 
    <!--    an additional note about the reaction by the recorder    -->
    <note> 
      <text value="The patient reports that the onset of urticaria was within 15 minutes of eating
       cashews."/> 
    </note>   
  </reaction> 
  
</AllergyIntolerance> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.