QI-Core Implementation Guide
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QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

: AllergyIntolerance example - JSON Representation

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{
  "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><a name=\"hcexample\"> </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 &quot;example&quot; </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> &quot; CHALMERS&quot;</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> &quot; CAREFUL&quot;</p><p><b>asserter</b>: <a href=\"Patient-example.html\">Patient/example</a> &quot; CHALMERS&quot;</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."
        }
      ]
    }
  ]
}