This page is part of the US Core (v3.1.0: STU3) based on FHIR R4. 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-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 or update a Patient Allergy
Mandatory and Must Support Data Elements
The following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They 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:
- a status of the allergy*
- a code which tells you what the patient is allergic to
- a patient
*The status element has the following constraints: SHALL be present if verification status is not entered-in-error and SHALL NOT be present if verification Status is entered-in-error.
Each AllergyIntolerance must support:
- a verification status
Profile specific implementation guidance:
-
No Known Allergies may be represented using the US Core-AllergyIntolerance profile with appropriate negation code in
AllergyIntolerence.code
and the appropriate verification status inAllergyIntolerance.verificationStatus
.If a patient has not been asked about their allergies, this would be represented as:
-
AllergyIntolerance.code
= “716186003” (No known allergy (situation)) -
AllergyIntolerance.verificationStatus
= “unconfirmed”
If a patient has been asked, but has indicated they have no known allergies, this would be represented as:
-
AllergyIntolerance.code
= “716186003” (No known allergy (situation)) -
AllergyIntolerance.verificationStatus
= “verified”
-
Examples
Formal Views of Profile Content
Description of Profiles, Differentials, and Snapshots.
The official URL for this profile is:
http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance
Published on Tue May 21 00:00:00 AEST 2019 as active by the HL7 US Realm Steering Committee.
This profile builds on AllergyIntolerance
AllergyIntolerance
Summary of the Mandatory Requirements
- A CodeableConcept in
AllergyIntolerance.code
with an extensible binding to US Core Common substances for allergy and intolerance documentation including refutations - A Patient Reference in
AllergyIntolerance.patient
Summary of the Must Support Requirements
- A CodeableConcept in
AllergyIntolerance.clinicalStatus
with a required binding to AllergyIntolerance Clinical Status Codes - A CodeableConcept in
AllergyIntolerance.verificationStatus
with a required binding to AllergyIntolerance Verification Status Codes
Summary of Constraints
- AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
- AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
AllergyIntolerance | I | 0..* | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | External ids for this item |
clinicalStatus | ?!SΣI | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
verificationStatus | ?!SΣI | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
type | ΣI | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required) |
category | ΣI | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required) |
criticality | ΣI | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required) |
code | SΣI | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: US Core Common substances for allergy and intolerance documentation including refutations (extensible) |
patient | SΣI | 1..1 | Reference(US Core Patient Profile) | Who the sensitivity is for |
encounter | I | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted |
onset[x] | I | 0..1 | When allergy or intolerance was identified | |
onsetDateTime | dateTime | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
recordedDate | I | 0..1 | dateTime | Date first version of the resource instance was recorded |
recorder | I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity |
asserter | ΣI | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy |
lastOccurrence | I | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction |
note | I | 0..* | Annotation | Additional text not captured in other fields |
reaction | I | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
substance | I | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example) |
manifestation | I | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example) |
description | I | 0..1 | string | Description of the event as a whole |
onset | I | 0..1 | dateTime | Date(/time) when manifestations showed |
severity | I | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required) |
exposureRoute | I | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example) |
note | I | 0..* | Annotation | Text about event not captured in other fields |
Documentation for this format |
AllergyIntolerance
Summary of the Mandatory Requirements
- A CodeableConcept in
AllergyIntolerance.code
with an extensible binding to US Core Common substances for allergy and intolerance documentation including refutations - A Patient Reference in
AllergyIntolerance.patient
Summary of the Must Support Requirements
- A CodeableConcept in
AllergyIntolerance.clinicalStatus
with a required binding to AllergyIntolerance Clinical Status Codes - A CodeableConcept in
AllergyIntolerance.verificationStatus
with a required binding to AllergyIntolerance Verification Status Codes
Summary of Constraints
- AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
- AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
Differential View
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
AllergyIntolerance | I | 0..* | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) | |
id | Σ | 0..1 | string | Logical id of this artifact |
meta | ΣI | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
contained | 0..* | Resource | Contained, inline Resources | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
identifier | ΣI | 0..* | Identifier | External ids for this item |
clinicalStatus | ?!SΣI | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
verificationStatus | ?!SΣI | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
type | ΣI | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required) |
category | ΣI | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required) |
criticality | ΣI | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required) |
code | SΣI | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: US Core Common substances for allergy and intolerance documentation including refutations (extensible) |
patient | SΣI | 1..1 | Reference(US Core Patient Profile) | Who the sensitivity is for |
encounter | I | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted |
onset[x] | I | 0..1 | When allergy or intolerance was identified | |
onsetDateTime | dateTime | |||
onsetAge | Age | |||
onsetPeriod | Period | |||
onsetRange | Range | |||
onsetString | string | |||
recordedDate | I | 0..1 | dateTime | Date first version of the resource instance was recorded |
recorder | I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity |
asserter | ΣI | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy |
lastOccurrence | I | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction |
note | I | 0..* | Annotation | Additional text not captured in other fields |
reaction | I | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | I | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
substance | I | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example) |
manifestation | I | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example) |
description | I | 0..1 | string | Description of the event as a whole |
onset | I | 0..1 | dateTime | Date(/time) when manifestations showed |
severity | I | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required) |
exposureRoute | I | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example) |
note | I | 0..* | Annotation | Text about event not captured in other fields |
Documentation for this format |
Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron
Quick Start
Below is an overview of the required set of RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.
- See the General Guidance section for additional rules and expectations when a server requires status parameters.
- See the General Guidance section for additional guidance on searching for multiple patients.
Mandatory Search Parameters:
The following search parameters and search parameter combinations SHALL be supported.:
-
SHALL support searching for all allergies for a patient using the
patient
search parameter:GET [base]/AllergyIntolerance?patient=[reference]
Example:
- GET [base]/AllergyIntolerance?patient=1137192
Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient (how to search by reference)
Optional Search Parameters:
The following search parameter combinations SHOULD be supported.:
-
SHOULD support searching using the combination of the
patient
andclinical-status
search parameters:GET [base]/AllergyIntolerance?patient=[reference]&clinical-status={[system]}|[code]
Example:
- GET [base]/AllergyIntolerance?patient=[id]&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical|active
Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient and status code. This will not return any "entered in error" resources because of the conditional presence of the clinicalStatus element. (how to search by reference and how to search by token)