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This page is part of the US Core (v0.0.0: STU1 Ballot 1) based on FHIR v1.8.0. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

D.4.1 StructureDefinition-us-core-allergyintolerance

This profile sets minimum expectations for the AllergyIntolerance resource to record, search and fetch allergies/adverse reactions associated with a patient. It identifies the mandatory core elements, extensions, vocabularies and value sets which SHALL be present in the AllergyIntolerance resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US-Core AllergyIntolerance profile:

  • Query for Allergies belonging to a Patient
  • Record a Patient Allergy
Mandatory Data Elements and Terminology

The following data-elements are mandatory (i.e data MUST be present). These are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each AllergyIntolerance must have:

  1. a status of the allergy
  2. a verification status
  3. a code which tells you what the patient is allergic to
  4. a patient

Profile specific implementation guidance:

  • Representing No Known Allergies: No Known Allergies will be represented using the US Core-AllergyIntolerance profile with appropriate negation code in AllergyIntolerence.code.

Examples

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance

This profile builds on AllergyIntolerance.

This profile was published on Mon Aug 01 00:00:00 AEST 2016 as a draft by Health Level Seven International (FHIR - Infrastructure).

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

Summary of the Mandatory Requirements

  1. Conditionally One clinical status in AllergyIntolerance.clinicalStatus
  2. One code in AllergyIntolerance.verificationStatus which has an required binding to:
  3. One Identification of a substance, or a class of substances, that is considered to be responsible for the adverse reaction risk in AllergyIntolerance.code which has an extensible binding to:
  4. One patient reference in AllergyIntolerance.patient
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*US Core Allergies Profile
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier ∑0..*IdentifierExternal ids for this item
... clinicalStatus ?!S0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required)
... verificationStatus ?!S1..1codeunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatus (required)
... type ∑0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required)
... category ∑0..*codefood | medication | biologic | environment
Binding: AllergyIntoleranceCategory (required)
... criticality ∑0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required)
... code S1..1CodeableConceptAllergy or intolerance code
Binding: US Core Substance-Reactant for Intolerance and Negation Codes (extensible)
... patient S1..1Reference(US Core Patient Profile)Who the sensitivity is for
... onset[x] 0..1dateTime, Age, Period, Range, stringWhen allergy or intolerance was identified
... assertedDate 0..1dateTimeDate record was believed accurate
... recorder 0..1Reference(Practitioner), Reference(Patient)Who recorded the sensitivity
... asserter ∑0..1Reference(Patient), Reference(RelatedPerson), Reference(Practitioner)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
... reaction I0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (example)
.... certainty 0..1codeunlikely | likely | confirmed | unknown
Binding: AllergyIntoleranceCertainty (required)
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SNOMED CT Clinical Findings (example)
.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: SNOMED CT Route Codes (example)
.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format

Summary of the Mandatory Requirements

  1. Conditionally One clinical status in AllergyIntolerance.clinicalStatus
  2. One code in AllergyIntolerance.verificationStatus which has an required binding to:
  3. One Identification of a substance, or a class of substances, that is considered to be responsible for the adverse reaction risk in AllergyIntolerance.code which has an extensible binding to:
  4. One patient reference in AllergyIntolerance.patient

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*US Core Allergies Profile
... id ∑0..1idLogical id of this artifact
... meta ∑0..1MetaMetadata about the resource
... implicitRules ?!∑0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier ∑0..*IdentifierExternal ids for this item
... clinicalStatus ?!S0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required)
... verificationStatus ?!S1..1codeunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatus (required)
... type ∑0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required)
... category ∑0..*codefood | medication | biologic | environment
Binding: AllergyIntoleranceCategory (required)
... criticality ∑0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required)
... code S1..1CodeableConceptAllergy or intolerance code
Binding: US Core Substance-Reactant for Intolerance and Negation Codes (extensible)
... patient S1..1Reference(US Core Patient Profile)Who the sensitivity is for
... onset[x] 0..1dateTime, Age, Period, Range, stringWhen allergy or intolerance was identified
... assertedDate 0..1dateTimeDate record was believed accurate
... recorder 0..1Reference(Practitioner), Reference(Patient)Who recorded the sensitivity
... asserter ∑0..1Reference(Patient), Reference(RelatedPerson), Reference(Practitioner)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
... reaction I0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!∑0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (example)
.... certainty 0..1codeunlikely | likely | confirmed | unknown
Binding: AllergyIntoleranceCertainty (required)
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SNOMED CT Clinical Findings (example)
.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: SNOMED CT Route Codes (example)
.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, CSV), Schema: XML Schematron

 

D.4.1.2 Quick Start

Below is an overview of the required search and read operations.

Summary of Argonaut Search Criteria for StructureDefinition-us-core-allergyintolerance

Clients

  • A client has connected to a server and fetched a patient’s profile using [GET /Profile?patient=[id]].

Servers

  • A server is capable of returning a patient’s profile list using [GET /AllergyIntolerance?patient=[id]].
  • A server has ensured that every API request includes a valid Authorization token, supplied via:Authorization: Bearer {server-specific-token-here}
  • A server has rejected any unauthorized requests by returning an HTTP 401 Unauthorized response code.

GET /AllergyIntolerance?patient=\[id\]

Support: Mandatory to support search by patient.

Implementation Notes: Search for all allergies for a patient. Fetches a bundle of all AllergyIntolerance resources for the specified patient (how to search by reference).

Response Class:

  • (Status 200): successful operation
  • (Status 400): invalid parameter
  • (Status 401/4xx): unauthorized request
  • (Status 403): insufficient scope

Example:

GET https://fhir-open-api-dstu2.smarthealthit.org/AllergyIntolerance?patient=1137192