QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

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 8.0.0-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

## : AllergyIntolerance example

Page standards status: Informative

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @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:l <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance>     ] )
      ] ; #
      fhir:language [ fhir:v "en"] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: AllergyIntolerance example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><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\">Language: en</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>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active}\">Active</span></p><p><b>verificationStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-verification confirmed}\">Confirmed</span></p><p><b>type</b>: Allergy</p><p><b>category</b>: Food</p><p><b>criticality</b>: High Risk</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 227493005}\">Cashew nuts</span></p><p><b>patient</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></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 Adam Careful </a></p><p><b>asserter</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>lastOccurrence</b>: 2012-06-02 01:45:31+0000</p><p><b>note</b>: </p><blockquote><div><p>The criticality is high becasue of the observed anaphylactic reaction when challenged     with cashew extract.</p>\n</div></blockquote><blockquote><p><b>reaction</b></p><p><b>substance</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 1160593}\">cashew nut allergenic extract Injectable Product</span></p><p><b>manifestation</b>: <span title=\"Codes:{http://snomed.info/sct 39579001}\">Anaphylactic reaction</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>: <span title=\"Codes:{http://snomed.info/sct 34206005}\">Subcutaneous route</span></p></blockquote><blockquote><p><b>reaction</b></p><p><b>manifestation</b>: <span title=\"Codes:{http://snomed.info/sct 64305001}\">Urticaria</span></p><p><b>onset</b>: 2004</p><p><b>severity</b>: Moderate</p><p><b>note</b>: </p><blockquote><div><p>The patient reports that the onset of urticaria was within 15 minutes of eating cashews.</p>\n</div></blockquote></blockquote></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:system [
    fhir:v "http://acme.com/ids/patients/risks"^^xsd:anyURI ;
    fhir:l <http://acme.com/ids/patients/risks>     ] ;
    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:l <http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical>       ] ;
    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:l <http://terminology.hl7.org/CodeSystem/allergyintolerance-verification>       ] ;
    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:l <http://snomed.info/sct>       ] ;
    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:l fhir:Patient/example ;
    fhir:reference [ fhir:v "Patient/example" ]
      ] ; #     the patient that actually has the risk of adverse reaction
      fhir:onset [
    a fhir:DateTime ;
    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:l fhir:Practitioner/example ;
    fhir:reference [ fhir:v "Practitioner/example" ]
      ] ; #     who made the record / last updated it
      fhir:asserter [
    fhir:l fhir:Patient/example ;
    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:l <http://www.nlm.nih.gov/research/umls/rxnorm>         ] ;
    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:l <http://snomed.info/sct>         ] ;
    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:l <http://snomed.info/sct>         ] ;
    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:l <http://snomed.info/sct>         ] ;
    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