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
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:AllergyIntolerance ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "example"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://acme.com/ids/patients/risks"^^xsd:anyURI ] ;
fhir:value [ fhir:v "49476534" ]
] ) ; # an identifier used for this allergic propensity (adverse reaction risk)
fhir:clinicalStatus [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"^^xsd:anyURI ] ;
fhir:code [ fhir:v "active" ] ] )
] ; # this individual has had several reactions
fhir:verificationStatus [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"^^xsd:anyURI ] ;
fhir:code [ fhir:v "confirmed" ] ] )
] ; #
fhir:type [ fhir:v "allergy"] ; # note: it's often unknown whether an allergy is mediated by an immune response, and
# not as significant as once thought
fhir:category ( [ fhir:v "food"] ) ; # 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
fhir:criticality [ fhir:v "high"] ; # there is no question that the allergy is real and serious
fhir:code [
( fhir:coding [
a sct:227493005 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "227493005" ] ;
fhir:display [ fhir:v "Cashew nuts" ] ] )
] ; # 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.
fhir:patient [
fhir:reference [ fhir:v "Patient/example" ]
] ; # the patient that actually has the risk of adverse reaction
fhir:onset [ fhir:v "2004"^^xsd:gYear] ; # when the allergy was first noted (in this case the same as reaction.onset of the first
# occurrence)
fhir:recordedDate [ fhir:v "2014-10-09T14:58:00+11:00"^^xsd:dateTime] ; # the date that this entry was recorded
fhir:recorder [
fhir:reference [ fhir:v "Practitioner/example" ]
] ; # who made the record / last updated it
fhir:asserter [
fhir:reference [ fhir:v "Patient/example" ]
] ; # the patient is the reporter in this case
fhir:lastOccurrence [ fhir:v "2012-06-02T01:45:31+00:00"^^xsd:dateTime] ; # last happened June 2012. Typically, systems either track lastOccurrence,
# or a list of events.
fhir:note ( [
fhir:text [ fhir:v "The criticality is high becasue of the observed anaphylactic reaction when challenged with cashew extract." ]
] ) ; # an additional note about the allergy propensity by the recorder
fhir:reaction ( [
fhir:substance [
( fhir:coding [
fhir:system [ fhir:v "http://www.nlm.nih.gov/research/umls/rxnorm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "1160593" ] ;
fhir:display [ fhir:v "cashew nut allergenic extract Injectable Product" ] ] ) ] ; # \n It's possible to list specific things to which the patient responded,\n e.g. chocolate (that happened to contain cashew nuts). This event has\n such a specific substance. Note that systems should ensure that what\n goes in here does not conflict with the substance above, and systems\n processing the data can be sure that what is here does not contravene\n the substance above\n
( fhir:manifestation [
( fhir:coding [
a sct:39579001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "39579001" ] ;
fhir:display [ fhir:v "Anaphylactic reaction" ] ] ) ] ) ;
fhir:description [ fhir:v "Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered" ] ;
fhir:onset [ fhir:v "2012-06-12"^^xsd:date ] ;
fhir:severity [ fhir:v "severe" ] ;
fhir:exposureRoute [
( fhir:coding [
a sct:34206005 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "34206005" ] ;
fhir:display [ fhir:v "Subcutaneous route" ] ] ) ]
] [
( fhir:manifestation [
( fhir:coding [
a sct:64305001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64305001" ] ;
fhir:display [ fhir:v "Urticaria" ] ] ) ] ) ;
fhir:onset [ fhir:v "2004"^^xsd:gYear ] ;
fhir:severity [ fhir:v "moderate" ] ;
( fhir:note [
fhir:text [ fhir:v "The patient reports that the onset of urticaria was within 15 minutes of eating cashews." ] ] ) # an additional note about the reaction by the recorder
] ) . # past events. There's no claim that this is all the events, and
# that should not be assumed
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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