QI-Core Implementation Guide
7.0.0-ballot - STU7 United States of America flag

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 7.0.0-ballot 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

Resource Profile: QICore AllergyIntolerance

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance Version: 7.0.0-ballot
Active as of 2018-08-22 Computable Name: QICoreAllergyIntolerance

Profile of AllergyIntolerance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Must Have:
  • code: (QI) Code that identifies the allergy or intolerance
  • patient: (QI) Who the sensitivity is for
  • reaction.manifestation: Clinical symptoms/signs associated with the Event
QI Elements:
  • clinicalStatus: (QI) active | inactive | resolved
  • type: (QI) allergy | intolerance - Underlying mechanism (if known)
  • category: (QI) food | medication | environment | biologic
  • criticality: (QI) low | high | unable-to-assess
  • onset[x]: (QI) When allergy or intolerance was identified
  • recordedDate: (QI) Date first version of the resource instance was recorded
  • lastOccurrence: (QI) Date(/time) of last known occurrence of a reaction
  • reaction: (QI) Adverse Reaction Events linked to exposure to substance
  • reaction.severity: (QI) mild | moderate | severe (of event as a whole)
Primary code path: code
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

See the patterns page for implementation and usage patterns. 

define "Statin Allergy Intolerance":
  ["AllergyIntolerance": "Statin Allergen"] StatinAllergyIntolerance
    where (StatinAllergyIntolerance.clinicalStatus is null or StatinAllergyIntolerance.clinicalStatus ~ Global."allergy-active")


This example represents a situation where the subject is currently experiencing, or is at risk of, a reaction to the identified substance.

Examples

Typical Food Allergy
Refuted Food Allergy

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreAllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... Slices for extension Content/Rules for all slices
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... clinicalStatus 0..1 CodeableConcept (QI) active | inactive | resolved
... type 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
... criticality 0..1 code (QI) low | high | unable-to-assess
... code 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
... patient 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... reaction 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ 0..* code (QI) food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ 0..1 code (QI) low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... reaction S 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... manifestation S 1..* CodeableConcept Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleCommonSubstancesForAllergyAndIntoleranceDocumentationIncludingRefutations .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1186.8
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus ?!SΣC 0..1 CodeableConcept (QI) active | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ 0..* code (QI) food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ 0..1 code (QI) low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... recorder 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Who recorded the sensitivity
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Source of the information about the allergy
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... note 0..* Annotation Additional text not captured in other fields
... reaction S 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... substance 0..1 CodeableConcept Specific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation S 1..* CodeableConcept Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... description 0..1 string Description of the event as a whole
.... onset 0..1 dateTime Date(/time) when manifestations showed
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..* Annotation Text about event not captured in other fields

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleCommonSubstancesForAllergyAndIntoleranceDocumentationIncludingRefutations .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1186.8
AllergyIntolerance.reaction.substanceexampleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreAllergyIntolerance

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreAllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... Slices for extension Content/Rules for all slices
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... clinicalStatus 0..1 CodeableConcept (QI) active | inactive | resolved
... type 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
... criticality 0..1 code (QI) low | high | unable-to-assess
... code 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
... patient 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... reaction 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ 0..* code (QI) food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ 0..1 code (QI) low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... reaction S 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... manifestation S 1..* CodeableConcept Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleCommonSubstancesForAllergyAndIntoleranceDocumentationIncludingRefutations .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1186.8
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus ?!SΣC 0..1 CodeableConcept (QI) active | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code (QI) allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ 0..* code (QI) food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ 0..1 code (QI) low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ 1..1 CodeableConcept (QI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(QICore Patient) (QI) Who the sensitivity is for
... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
... onset[x] 0..1 (QI) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (QI) Date first version of the resource instance was recorded
... recorder 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Who recorded the sensitivity
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Source of the information about the allergy
... lastOccurrence 0..1 dateTime (QI) Date(/time) of last known occurrence of a reaction
... note 0..* Annotation Additional text not captured in other fields
... reaction S 0..* BackboneElement (QI) Adverse Reaction Events linked to exposure to substance
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... substance 0..1 CodeableConcept Specific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation S 1..* CodeableConcept Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... description 0..1 string Description of the event as a whole
.... onset 0..1 dateTime Date(/time) when manifestations showed
.... severity 0..1 code (QI) mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..* Annotation Text about event not captured in other fields

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleCommonSubstancesForAllergyAndIntoleranceDocumentationIncludingRefutations .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1186.8
AllergyIntolerance.reaction.substanceexampleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCoreAllergyIntolerance

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron