QI-Core Implementation Guide
6.0.0 - STU6
QI-Core Implementation Guide
6.0.0 - STU6
This page is part of the Quality Improvement Core Framework (v6.0.0: STU6 (v6.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "AllergyIntolerance",
"id" : "example",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"
]
},
"text" : {
"status" : "generated",
"div" : "<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 "example" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-qicore-allergyintolerance.html\">QICore AllergyIntolerance</a></p></div><p><b>identifier</b>: <code>http://acme.com/ids/patients/risks</code>/49476534</p><p><b>clinicalStatus</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-allergyintolerance-clinical.html\">AllergyIntolerance Clinical Status Codes</a>#active)</span></p><p><b>verificationStatus</b>: Confirmed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-allergyintolerance-verification.html\">AllergyIntolerance Verification Status</a>#confirmed)</span></p><p><b>type</b>: allergy</p><p><b>category</b>: food</p><p><b>criticality</b>: high</p><p><b>code</b>: Cashew nuts <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#227493005)</span></p><p><b>patient</b>: <a href=\"Patient-example.html\">Patient/example</a> " CHALMERS"</p><p><b>onset</b>: 2004</p><p><b>recordedDate</b>: 2014-10-09 14:58:00+1100</p><p><b>recorder</b>: <a href=\"Practitioner-example.html\">Practitioner/example</a> " CAREFUL"</p><p><b>asserter</b>: <a href=\"Patient-example.html\">Patient/example</a> " CHALMERS"</p><p><b>lastOccurrence</b>: 2012-06-02 01:45:31+0000</p><p><b>note</b>: The criticality is high becasue of the observed anaphylactic reaction when challenged with cashew extract.</p><blockquote><p><b>reaction</b></p><p><b>substance</b>: cashew nut allergenic extract Injectable Product <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.4.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#1160593)</span></p><p><b>manifestation</b>: Anaphylactic reaction <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#39579001)</span></p><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><p><b>manifestation</b>: Urticaria <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64305001)</span></p><p><b>onset</b>: 2004</p><p><b>severity</b>: moderate</p><p><b>note</b>: The patient reports that the onset of urticaria was within 15 minutes of eating cashews.</p></blockquote></div>"
},
"identifier" : [
// an identifier used for this allergic propensity (adverse reaction risk)
{
"system" : "http://acme.com/ids/patients/risks",
"value" : "49476534"
}
],
"clinicalStatus" : // this individual has had several reactions
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code" : "active"
}
]
},
"verificationStatus" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code" : "confirmed"
}
]
},
"type" : "allergy",
"category" : [
"food"
],
"criticality" : "high",
"code" : // note: it's often unknown whether an allergy is mediated by an immune response, and
not as significant as once thought
// this categorisation 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
// there is no question that the allergy is real and serious
// 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.
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "227493005",
"display" : "Cashew nuts"
}
]
},
"patient" : // the patient that actually has the risk of adverse reaction
{
🔗 "reference" : "Patient/example"
},
"onsetDateTime" : "2004",
"recordedDate" : "2014-10-09T14:58:00+11:00",
"recorder" : // when the allergy was first noted (in this case the same as reaction.onset of the first
occurrence)
// the date that this entry was recorded
// who made the record / last updated it
{
🔗 "reference" : "Practitioner/example"
},
"asserter" : // the patient is the reporter in this case
{
🔗 "reference" : "Patient/example"
},
"lastOccurrence" : "2012-06-02T01:45:31+00:00",
"note" : [
// last happened June 2012. Typically, systems either track lastOccurrence,
or a list of events.
// an additional note about the allergy propensity by the recorder
{
"text" : "The criticality is high becasue of the observed anaphylactic reaction when challenged with cashew extract."
}
],
"reaction" : [
// past events. There's no claim that this is all the events, and
that should not be assumed
{
"substance" : //
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
{
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "1160593",
"display" : "cashew nut allergenic extract Injectable Product"
}
]
},
"manifestation" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "39579001",
"display" : "Anaphylactic reaction"
}
]
}
],
"description" : "Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered",
"onset" : "2012-06-12",
"severity" : "severe",
"exposureRoute" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "34206005",
"display" : "Subcutaneous route"
}
]
}
},
{
"manifestation" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "64305001",
"display" : "Urticaria"
}
]
}
],
"onset" : "2004",
"severity" : "moderate",
"note" : [
// an additional note about the reaction by the recorder
{
"text" : "The patient reports that the onset of urticaria was within 15 minutes of eating cashews."
}
]
}
]
}
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.qicore#6.0.0 based on FHIR 4.0.1. Generated 2024-03-01
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