US Core Implementation Guide (Release 1)
This page is part of the US Core (v1.0.0: STU1) based on FHIR R3. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions 
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="us-core-allergyintolerance"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>url</b>: <a href="http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core AllergyIntolerance Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>url</b>: <a href="http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance">http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: US Core AllergyIntolerance Profile</p><p><b>status</b>: DRAFT</p><p><b>date</b>: 01/08/2016</p><p><b>publisher</b>: HL7 US Realm Steering Committee</p><p><b>contact</b>: </p><p><b>fhirVersion</b>: 3.0.0</p><blockquote><p><b>mapping</b></p><p><b>identity</b>: argonaut-dq-dstu2</p><p><b>uri</b>: <a href="http://unknown.org/Argonaut DQ DSTU2">http://unknown.org/Argonaut DQ DSTU2</a></p><p><b>name</b>: Argonaut DQ DSTU2</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: rim</p><p><b>uri</b>: <a href="http://hl7.org/v3">http://hl7.org/v3</a></p><p><b>name</b>: RIM Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: w5</p><p><b>uri</b>: <a href="http://hl7.org/fhir/w5">http://hl7.org/fhir/w5</a></p><p><b>name</b>: W5 Mapping</p></blockquote><blockquote><p><b>mapping</b></p><p><b>identity</b>: v2</p><p><b>uri</b>: <a href="http://hl7.org/v2">http://hl7.org/v2</a></p><p><b>name</b>: HL7 v2 Mapping</p></blockquote><p><b>kind</b>: RESOURCE</p><p><b>abstract</b>: false</p><p><b>type</b>: AllergyIntolerance</p><p><b>baseDefinition</b>: <a href="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance">http://hl7.org/fhir/StructureDefinition/AllergyIntolerance</a></p><p><b>derivation</b>: CONSTRAINT</p><h3>Snapshots</h3><table class="grid"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table><h3>Differentials</h3><table class="grid"><tr><td>-</td><td><b>Element</b></td></tr><tr><td>*</td><td>todo-bundle</td></tr></table></div> </text> <url value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance"/> <version value="1.0.0"/> <name value="US Core AllergyIntolerance Profile"/> <status value="draft"/> <date value="2016-08-01"/> <publisher value="HL7 US Realm Steering Committee"/> <contact> <telecom> <system value="url"/> <value value="http://www.healthit.gov"/> </telecom> </contact> <fhirVersion value="3.0.0"/> <mapping> <identity value="argonaut-dq-dstu2"/> <uri value="http://unknown.org/Argonaut DQ DSTU2"/> <name value="Argonaut DQ DSTU2"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/w5"/> <name value="W5 Mapping"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 v2 Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="AllergyIntolerance"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"/> <derivation value="constraint"/> <snapshot> <element id="AllergyIntolerance:uscoreallergyintolerance"> <path value="AllergyIntolerance"/> <sliceName value="USCoreAllergyIntolerance"/> <short value="US Core Allergies Profile"/> <definition value="The US Core Allergies Profile is based upon the core FHIR AllergyIntolerance Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medical allergies' requirements."/> <comment value="Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings."/> <alias value="Allergy"/> <alias value="Intolerance"/> <alias value="Adverse Reaction"/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <xpath value="not(parent::f:contained and f:contained)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-1"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/> <expression value="contained.text.empty()"/> <xpath value="not(parent::f:contained and f:text)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/> <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()"/> <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="ait-1"/> <severity value="error"/> <human value="AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error."/> <expression value="verificationStatus='entered-in-error' or clinicalStatus.exists()"/> <xpath value="f:verificationStatus/@value='entered-in-error' or exists(f:clinicalStatus)"/> <source value="AllergyIntolerance"/> </constraint> <constraint> <key value="ait-2"/> <severity value="error"/> <human value="AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error"/> <expression value="verificationStatus!='entered-in-error' or clinicalStatus.empty()"/> <xpath value="f:verificationStatus/@value!='entered-in-error' or not(exists(f:clinicalStatus))"/> <source value="AllergyIntolerance"/> </constraint> <mustSupport value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=EVN]"/> </mapping> <mapping> <identity value="w5"/> <map value="clinical.general"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.id"> <path value="AllergyIntolerance.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="id"/> </type> <isSummary value="true"/> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.meta"> <path value="AllergyIntolerance.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <isSummary value="true"/> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.implicitRules"> <path value="AllergyIntolerance.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/> <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <isModifier value="true"/> <isSummary value="true"/> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.language"> <path value="AllergyIntolerance.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueReference> <reference value="http://hl7.org/fhir/ValueSet/all-languages"/> </valueReference> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="extensible"/> <description value="A human language."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/languages"/> </valueSetReference> </binding> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.text"> <path value="AllergyIntolerance.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/> <comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-1"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.contained"> <path value="AllergyIntolerance.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/> <comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.extension"> <path value="AllergyIntolerance.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.modifierExtension"> <path value="AllergyIntolerance.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.identifier"> <path value="AllergyIntolerance.identifier"/> <short value="External ids for this item"/> <definition value="This records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)."/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="IAM-7"/> </mapping> <mapping> <identity value="rim"/> <map value="id"/> </mapping> <mapping> <identity value="w5"/> <map value="id"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.clinicalStatus"> <path value="AllergyIntolerance.clinicalStatus"/> <short value="active | inactive | resolved"/> <definition value="The clinical status of the allergy or intolerance."/> <comment value="This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.clinicalStatus"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <condition value="ait-1"/> <condition value="ait-2"/> <mustSupport value="true"/> <isModifier value="true"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-clinical-status"/> </valueSetReference> </binding> <mapping> <identity value="rim"/> <map value="Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value"/> </mapping> <mapping> <identity value="w5"/> <map value="status"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.status"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.verificationStatus"> <path value="AllergyIntolerance.verificationStatus"/> <short value="unconfirmed | confirmed | refuted | entered-in-error"/> <definition value="Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product)."/> <comment value="This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid."/> <min value="1"/> <max value="1"/> <base> <path value="AllergyIntolerance.verificationStatus"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <condition value="ait-1"/> <condition value="ait-2"/> <mustSupport value="true"/> <isModifier value="true"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-verification-status"/> </valueSetReference> </binding> <mapping> <identity value="rim"/> <map value="Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value"/> </mapping> <mapping> <identity value="w5"/> <map value="status"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.status"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.type"> <path value="AllergyIntolerance.type"/> <short value="allergy | intolerance - Underlying mechanism (if known)"/> <definition value="Identification of the underlying physiological mechanism for the reaction risk."/> <comment value="Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource."/> <alias value="Category"/> <alias value="Class"/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AllergyIntoleranceType"/> </extension> <strength value="required"/> <description value="Identification of the underlying physiological mechanism for a Reaction Risk."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-type"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="IAM-9"/> </mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> <mapping> <identity value="w5"/> <map value="class"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.category"> <path value="AllergyIntolerance.category"/> <short value="food | medication | environment | biologic"/> <definition value="Category of the identified substance."/> <comment value="This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender."/> <alias value="Category"/> <alias value="Type"/> <alias value="Reaction Type"/> <alias value="Class"/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="code"/> </type> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AllergyIntoleranceCategory"/> </extension> <strength value="required"/> <description value="Category of an identified substance."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-category"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="AL1-2"/> </mapping> <mapping> <identity value="rim"/> <map value="value < IntoleranceValue (Agent)"/> </mapping> <mapping> <identity value="w5"/> <map value="class"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.criticality"> <path value="AllergyIntolerance.criticality"/> <short value="low | high | unable-to-assess"/> <definition value="Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance."/> <comment value="The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent."/> <alias value="Severity"/> <alias value="Seriousness"/> <alias value="Contra-indication"/> <alias value="Risk"/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.criticality"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AllergyIntoleranceCriticality"/> </extension> <strength value="required"/> <description value="Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="AL1-4"/> </mapping> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]"/> </mapping> <mapping> <identity value="w5"/> <map value="grade"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.code"> <path value="AllergyIntolerance.code"/> <short value="Code that identifies the allergy or intolerance"/> <definition value="Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies")."/> <comment value="It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted."/> <alias value="Code"/> <min value="1"/> <max value="1"/> <base> <path value="AllergyIntolerance.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <mustSupport value="true"/> <isSummary value="true"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/core/ValueSet/us-core-substance"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="AL1-3 / IAM-3"/> </mapping> <mapping> <identity value="rim"/> <map value="substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value"/> </mapping> <mapping> <identity value="w5"/> <map value="what"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.substance"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.patient"> <path value="AllergyIntolerance.patient"/> <short value="Who the sensitivity is for"/> <definition value="The patient who has the allergy or intolerance."/> <alias value="Patient"/> <min value="1"/> <max value="1"/> <base> <path value="AllergyIntolerance.patient"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/> </type> <mustSupport value="true"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(PID-3)"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> </mapping> <mapping> <identity value="w5"/> <map value="who.focus"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.patient"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.onset[x]"> <path value="AllergyIntolerance.onset[x]"/> <short value="When allergy or intolerance was identified"/> <definition value="Estimated or actual date, date-time, or age when allergy or intolerance was identified."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.onset[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Age"/> </type> <type> <code value="Period"/> </type> <type> <code value="Range"/> </type> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="effectiveTime.low"/> </mapping> <mapping> <identity value="w5"/> <map value="when.init"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.assertedDate"> <path value="AllergyIntolerance.assertedDate"/> <short value="Date record was believed accurate"/> <definition value="The date on which the existance of the AllergyIntolerance was first asserted or acknowledged."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.assertedDate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mapping> <identity value="v2"/> <map value="IAM-20"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].time"/> </mapping> <mapping> <identity value="w5"/> <map value="when.recorded"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.recorder"> <path value="AllergyIntolerance.recorder"/> <short value="Who recorded the sensitivity"/> <definition value="Individual who recorded the record and takes responsibility for its content."/> <alias value="Author"/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.recorder"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role"/> </mapping> <mapping> <identity value="w5"/> <map value="who.author"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.asserter"> <path value="AllergyIntolerance.asserter"/> <short value="Source of the information about the allergy"/> <definition value="The source of the information about the allergy that is recorded."/> <comment value="The recorder takes repsonsibility for the content, but can reference the source from where they got it."/> <alias value="Source"/> <alias value="Informant"/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.asserter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="IAM-14 (if patient) / IAM-18 (if practitioner)"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=INF].role"/> </mapping> <mapping> <identity value="w5"/> <map value="who.source"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.lastOccurrence"> <path value="AllergyIntolerance.lastOccurrence"/> <short value="Date(/time) of last known occurrence of a reaction"/> <definition value="Represents the date and/or time of the last known occurrence of a reaction event."/> <comment value="This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.lastOccurrence"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mapping> <identity value="rim"/> <map value="outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.note"> <path value="AllergyIntolerance.note"/> <short value="Additional text not captured in other fields"/> <definition value="Additional narrative about the propensity for the Adverse Reaction, not captured in other fields."/> <comment value="For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes."/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <mapping> <identity value="rim"/> <map value="subjectOf.observationEvent[code="annotation"].value"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction"> <path value="AllergyIntolerance.reaction"/> <short value="Adverse Reaction Events linked to exposure to substance"/> <definition value="Details about each adverse reaction event linked to exposure to the identified substance."/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance.reaction"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="children().count() > id.count()"/> <xpath value="@value|f:*|h:div"/> <source value="Element"/> </constraint> <mapping> <identity value="rim"/> <map value="outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.id"> <path value="AllergyIntolerance.reaction.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.extension"> <path value="AllergyIntolerance.reaction.extension"/> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.modifierExtension"> <path value="AllergyIntolerance.reaction.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.substance"> <path value="AllergyIntolerance.reaction.substance"/> <short value="Specific substance or pharmaceutical product considered to be responsible for event"/> <definition value="Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'."/> <comment value="Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.reaction.substance"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="SubstanceCode"/> </extension> <strength value="example"/> <description value="Codes defining the type of the substance (including pharmaceutical products)."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/substance-code"/> </valueSetReference> </binding> <mapping> <identity value="rim"/> <map value="outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.manifestation"> <path value="AllergyIntolerance.reaction.manifestation"/> <short value="Clinical symptoms/signs associated with the Event"/> <definition value="Clinical symptoms and/or signs that are observed or associated with the adverse reaction event."/> <comment value="Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10."/> <alias value="Symptoms"/> <alias value="Signs"/> <min value="1"/> <max value="*"/> <base> <path value="AllergyIntolerance.reaction.manifestation"/> <min value="1"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Manifestation"/> </extension> <strength value="example"/> <description value="Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/clinical-findings"/> </valueSetReference> </binding> <mapping> <identity value="v2"/> <map value="AL1-5"/> </mapping> <mapping> <identity value="rim"/> <map value="code"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.description"> <path value="AllergyIntolerance.reaction.description"/> <short value="Description of the event as a whole"/> <definition value="Text description about the reaction as a whole, including details of the manifestation if required."/> <comment value="Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives."/> <alias value="Narrative"/> <alias value="Text"/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.reaction.description"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="text"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.onset"> <path value="AllergyIntolerance.reaction.onset"/> <short value="Date(/time) when manifestations showed"/> <definition value="Record of the date and/or time of the onset of the Reaction."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.reaction.onset"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <mapping> <identity value="v2"/> <map value="AL1-6"/> </mapping> <mapping> <identity value="rim"/> <map value="effectiveTime.low"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.severity"> <path value="AllergyIntolerance.reaction.severity"/> <short value="mild | moderate | severe (of event as a whole)"/> <definition value="Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations."/> <comment value="It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.reaction.severity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AllergyIntoleranceSeverity"/> </extension> <strength value="required"/> <description value="Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/reaction-event-severity"/> </valueSetReference> </binding> <mapping> <identity value="rim"/> <map value="inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.exposureRoute"> <path value="AllergyIntolerance.reaction.exposureRoute"/> <short value="How the subject was exposed to the substance"/> <definition value="Identification of the route by which the subject was exposed to the substance."/> <comment value="Coding of the route of exposure with a terminology should be used wherever possible."/> <min value="0"/> <max value="1"/> <base> <path value="AllergyIntolerance.reaction.exposureRoute"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RouteOfAdministration"/> </extension> <strength value="example"/> <description value="A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/route-codes"/> </valueSetReference> </binding> <mapping> <identity value="rim"/> <map value="outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.reaction.note"> <path value="AllergyIntolerance.reaction.note"/> <short value="Text about event not captured in other fields"/> <definition value="Additional text about the adverse reaction event not captured in other fields."/> <comment value="Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased."/> <min value="0"/> <max value="*"/> <base> <path value="AllergyIntolerance.reaction.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <mapping> <identity value="rim"/> <map value="subjectOf.observationEvent[code="annotation"].value"/> </mapping> </element> </snapshot> <differential> <element id="AllergyIntolerance:uscoreallergyintolerance"> <path value="AllergyIntolerance"/> <sliceName value="USCoreAllergyIntolerance"/> <short value="US Core Allergies Profile"/> <definition value="The US Core Allergies Profile is based upon the core FHIR AllergyIntolerance Resource and created to meet the 2015 Edition Common Clinical Data Set 'Medical allergies' requirements."/> <mustSupport value="false"/> <isModifier value="false"/> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.clinicalStatus"> <path value="AllergyIntolerance.clinicalStatus"/> <min value="0"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-clinical-status"/> </valueSetReference> </binding> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.status"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.verificationStatus"> <path value="AllergyIntolerance.verificationStatus"/> <min value="1"/> <max value="1"/> <type> <code value="code"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/allergy-verification-status"/> </valueSetReference> </binding> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.status"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.code"> <path value="AllergyIntolerance.code"/> <min value="1"/> <max value="1"/> <type> <code value="CodeableConcept"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/core/ValueSet/us-core-substance"/> </valueSetReference> </binding> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.substance"/> </mapping> </element> <element id="AllergyIntolerance:uscoreallergyintolerance.patient"> <path value="AllergyIntolerance.patient"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="AllergyIntolerance.patient"/> </mapping> </element> </differential> </StructureDefinition>
US Core © v1.0.0 (STU1) based on FHIR Release 3 (STU; 3.0.0) generated on Tue, Mar 21, 2017 11:28+1100. |
