. Page versions: R5 R4B R4 R3 R2This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
Indicates the patient has a susceptibility to an adverse reaction upon exposure to a specified substance.
Allergy/Intolerance resources are used to provide information about adverse sensitivities to substances that lead to physiologic changes that are clinically observable. An adverse sensitivity is defined as:
A condition expected to result in undesirable physiologic reaction to an amount of a substance that would not produce a reaction in most individuals. The substance is the trigger of an immunologic response that produces the observed physiologic changes, or in some instances nonimmunologic mechanisms that produce clinically identical physiologic changes. The immunologic response might be considered the actual cause of the reaction, but it is exposure to the trigger substance that is clinically observable.
This definition excludes clinically identical episodes that may be caused by physical agents, such as heat, cold, sunlight, or vibration, by exercise activity, or by infectious agents. Those conditions caused by physical agents or infectious would be captured on the problem list (List/Condition Resources). The allergy/intolerance list is a list of conditions that represent a propensity unique to this individual for a reaction upon future exposure to a specified substance.
Note that this specification draws a distinction between the patients condition/problem list and an allergy/intolerance list, even though allergies and intolerances are also conditions. This is because the distinction is a long established clinical workflow, even to patients. Asking an individual "if they have any problems" is not going to invoke an account of their past reactions to medications or foods. Instead, they are asked if they "have any allergies". An allergy/intolerance is also different in that a potential harm from exposure to an external substance that may be ordered by a provider in the course of their care but is not inherent to exposure to that substance for the general population.
Most of the details of the sensitivity can be found in the set of reactions that are associated with the resource, though these may not be present when the patient has not provided enough information. Adverse Reactions do not have to be always associated with an AllergyIntolerance which may appropriate when an single reaction has not provided enough evidence for a meaningful Allergy/Intolerance, or in specific views of events rather than in a general clinical record.
This resource is referenced by ImmunizationRecommendation and Procedure
<AllergyIntolerance xmlns="http://hl7.org/fhir"><!-- from Resource: extension, modifierExtension, language, text, and contained --> <identifier><!-- 0..* Identifier External Ids for this item --></identifier> <criticality value="[code]"/><!-- 0..1 fatal | high | medium | low --> <sensitivityType value="[code]"/><!-- 1..1 allergy | intolerance | unknown --> <recordedDate value="[dateTime]"/><!-- 0..1 When recorded --> <status value="[code]"/><!-- 1..1 suspected | confirmed | refuted | resolved --> <subject><!-- 1..1 Resource(Patient) Who the sensitivity is for --></subject> <recorder><!-- 0..1 Resource(Practitioner|Patient) Who recorded the sensitivity --></recorder> <substance><!-- 1..1 Resource(Substance) The substance that causes the sensitivity --></substance> <reaction><!-- 0..* Resource(AdverseReaction) Reactions associated with the sensitivity --></reaction> <sensitivityTest><!-- 0..* Resource(Observation) Observations that confirm or refute --></sensitivityTest> </AllergyIntolerance>
Alternate definitions: Schema/Schematron, Resource Profile
| Path | Definition | Type | Reference |
|---|---|---|---|
| AllergyIntolerance.criticality | The criticality of an adverse sensitivity | Fixed | http://hl7.org/fhir/criticality |
| AllergyIntolerance.sensitivityType | The type of an adverse sensitivity | Fixed | http://hl7.org/fhir/sensitivitytype |
| AllergyIntolerance.status | The status of the adverse sensitivity | Fixed | http://hl7.org/fhir/sensitivitystatus |
Criticality is defined as "The potential seriousness of a future reaction." This represents a clinical judgment about the worst case scenario for a future reaction. It would be based on the severity of past reactions, the dose and route of exposure that produced past reactions, and the life-threatening or organ system threatening potential of the reaction type. Criticality is an attribute of the allergic condition, not the reaction(s).
High criticality does not equate to a future severe reaction, but rather the potential for a severe and life-threatening reaction. Most reaction types are dose dependent, including anaphylaxis. Therefore, although they have a sensitivity of high criticality, exposure to a small dose of the substance to which they are sensitive might result in only a mild reaction. Severity of the reaction is also dependent on the route of exposure, but criticality since it applies to the condition, is not.
Search parameters for this resource. The standard parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Paths |
| _id | token | The logical resource id associated with the resource (must be supported by all servers) | |
| _language | token | The language of the resource | |
| date | date | Recorded date/time. | AllergyIntolerance.recordedDate |
| recorder | reference | Who recorded the sensitivity | AllergyIntolerance.recorder (Patient, Practitioner) |
| status | token | The status of the sensitivity | AllergyIntolerance.status |
| subject | reference | The subject that the sensitivity is about | AllergyIntolerance.subject (Patient) |
| substance | reference | The name or code of the substance that produces the sensitivity | AllergyIntolerance.substance (Substance) |
| type | token | The type of sensitivity | AllergyIntolerance.sensitivityType |
© HL7.org 2011+. FHIR DSTU (v0.0.82.2943) generated on Tue, Sep 30, 2014 18:09+1000.
Links:
What's a DSTU? |
Version History |
|
Propose a change