SNOMED CT Implementation Guide for FHIR, published by SNOMED on FHIR project group. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHTSDO/snomed-ig/ and changes regularly. See the Directory of published versions

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Resource Profile: Allergy Intolerance - Substance Focused

Profile of Allergy Intolerance resource with bindings to SNOMED CT Substances as well as additional constraints to avoid overlap with the binding.

Usage:

• Examples for this Resource Profile: AllergyIntolerance/AllergyIntoleranceExample1-2, AllergyIntolerance/AllergyIntoleranceExample2, AllergyIntolerance/AllergyIntoleranceExample3, AllergyIntolerance/AllergyIntoleranceExample5... Show 3 more, AllergyIntolerance/AllergyIntoleranceExample6, AllergyIntolerance/AllergyIntoleranceExample7 and AllergyIntolerance/AllergyIntoleranceExample8-alt

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AllergyIntolerance	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 dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance. ele-1: All FHIR elements must have a @value or children
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. ele-1: All FHIR elements must have a @value or children
code	Σ	0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible) ele-1: All FHIR elements must have a @value or children
patient	Σ	1..1	Reference(Patient)	Who the sensitivity is for ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1 from the FHIR Standard
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard

This structure is derived from AllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
category		0..0
code		0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible)
coding
system		0..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
reaction
substance		0..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (extensible)
manifestation		1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
exposureRoute		0..1	CodeableConcept	How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.manifestation	extensible	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	extensible	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AllergyIntolerance	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
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External ids for this item
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	0..1	code	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
criticality	Σ	0..1	code	low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code	Σ	0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient)	Who the sensitivity is for
encounter		0..1	Reference(Encounter)	Encounter when the allergy or intolerance was asserted
onset[x]		0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
recordedDate		0..1	dateTime	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	Date(/time) of last known occurrence of a reaction
note		0..*	Annotation	Additional text not captured in other fields
reaction		0..*	BackboneElement	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 (extensible)
manifestation		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	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 (extensible)
note		0..*	Annotation	Text about event not captured in other fields
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
AllergyIntolerance.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1 from the FHIR Standard
AllergyIntolerance.type	required	AllergyIntoleranceType http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1 from the FHIR Standard
AllergyIntolerance.criticality	required	AllergyIntoleranceCriticality http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1 from the FHIR Standard
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.manifestation	extensible	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	extensible	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

This structure is derived from AllergyIntolerance

Summary

Prohibited: 1 element

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AllergyIntolerance	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 dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance. ele-1: All FHIR elements must have a @value or children
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. ele-1: All FHIR elements must have a @value or children
code	Σ	0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible) ele-1: All FHIR elements must have a @value or children
patient	Σ	1..1	Reference(Patient)	Who the sensitivity is for ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1 from the FHIR Standard
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard

Differential View

This structure is derived from AllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AllergyIntolerance	Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
category		0..0
code		0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible)
coding
system		0..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
reaction
substance		0..1	CodeableConcept	Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (extensible)
manifestation		1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
exposureRoute		0..1	CodeableConcept	How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.manifestation	extensible	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	extensible	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AllergyIntolerance	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
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External ids for this item
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type	Σ	0..1	code	allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
criticality	Σ	0..1	code	low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code	Σ	0..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: SubstanceCode (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
patient	Σ	1..1	Reference(Patient)	Who the sensitivity is for
encounter		0..1	Reference(Encounter)	Encounter when the allergy or intolerance was asserted
onset[x]		0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
recordedDate		0..1	dateTime	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	Date(/time) of last known occurrence of a reaction
note		0..*	Annotation	Additional text not captured in other fields
reaction		0..*	BackboneElement	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 (extensible)
manifestation		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	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 (extensible)
note		0..*	Annotation	Text about event not captured in other fields
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
AllergyIntolerance.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
AllergyIntolerance.clinicalStatus	required	AllergyIntoleranceClinicalStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1 from the FHIR Standard
AllergyIntolerance.verificationStatus	required	AllergyIntoleranceVerificationStatusCodes http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1 from the FHIR Standard
AllergyIntolerance.type	required	AllergyIntoleranceType http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1 from the FHIR Standard
AllergyIntolerance.criticality	required	AllergyIntoleranceCriticality http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1 from the FHIR Standard
AllergyIntolerance.code	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.substance	extensible	SubstanceCode http://hl7.org/fhir/ValueSet/substance-code from the FHIR Standard
AllergyIntolerance.reaction.manifestation	extensible	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	extensible	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard

This structure is derived from AllergyIntolerance

Summary

Prohibited: 1 element

Other representations of profile: CSV, Excel, Schematron