SNOMED CT Implementation Guide for FHIR
0.1.0 - CI Build
SNOMED CT Implementation Guide for FHIR
0.1.0 - CI Build
SNOMED CT Implementation Guide for FHIR, published by SNOMED International. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/IHTSDO/snomed-ig/ and changes regularly. See the Directory of published versions
Profile of Allergy Intolerance resource with bindings to SNOMED CT Substances as well as additional constraints to avoid overlap with the binding.
The official URL for this profile is:
http://snomed.info/fhir/StructureDefinition/AllergyIntolerance-SubstanceFocused
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from AllergyIntolerance
This structure is derived from AllergyIntolerance
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  AllergyIntolerance | 0..* | AllergyIntolerance | ||
  category | 0..0 | |||
 code | I | 0..1 | CodeableConcept | Code that identifies the substance or product which the patient has an allergy or intolerance to Binding: SubstanceCode (extensible) |
  coding | ||||
  system | 0..1 | uri | Fixed Value: http://snomed.info/sct | |
| reaction | ||||
| substance | 0..1 | CodeableConcept | Binding: SubstanceCode (extensible) | |
| manifestation | 1..* | CodeableConcept | Binding: SNOMEDCTClinicalFindings (extensible) | |
| exposureRoute | 0..1 | CodeableConcept | Binding: SNOMEDCTRouteCodes (extensible) | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| AllergyIntolerance | I | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) |
 id | Σ | 0..1 | string | Logical id of this artifact |
 meta | ΣI | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
| language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| contained | 0..* | Resource | Contained, inline Resources | |
 extension | I | 0..* | Extension | Additional content defined by implementations |
 modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
| identifier | ΣI | 0..* | Identifier | External ids for this item |
| clinicalStatus | ?!ΣI | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
| verificationStatus | ?!ΣI | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
| type | ΣI | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required) |
| criticality | ΣI | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required) |
| code | ΣI | 0..1 | CodeableConcept | Code that identifies the substance or product which the patient has an allergy or intolerance to Binding: SubstanceCode (extensible) |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| coding | ΣI | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| system | ΣI | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct |
| version | ΣI | 0..1 | string | Version of the system - if relevant |
| code | ΣI | 0..1 | code | Symbol in syntax defined by the system |
| display | ΣI | 0..1 | string | Representation defined by the system |
| userSelected | ΣI | 0..1 | boolean | If this coding was chosen directly by the user |
| text | ΣI | 0..1 | string | Plain text representation of the concept |
 patient | ΣI | 1..1 | Reference(Patient) | Who the sensitivity is for |
| encounter | I | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted |
 onset[x] | I | 0..1 | When allergy or intolerance was identified | |
| onsetDateTime | dateTime | |||
| onsetAge | Age | |||
| onsetPeriod | Period | |||
| onsetRange | Range | |||
| onsetString | string | |||
| recordedDate | I | 0..1 | dateTime | Date first version of the resource instance was recorded |
| recorder | I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity |
| asserter | ΣI | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy |
| lastOccurrence | I | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction |
| note | I | 0..* | Annotation | Additional text not captured in other fields |
| reaction | I | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations |
| modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| substance | I | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (extensible) |
| manifestation | I | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) |
| description | I | 0..1 | string | Description of the event as a whole |
| onset | I | 0..1 | dateTime | Date(/time) when manifestations showed |
| severity | I | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required) |
| exposureRoute | I | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (extensible) |
| note | I | 0..* | Annotation | Text about event not captured in other fields |
| Documentation for this format | ||||
This structure is derived from AllergyIntolerance
Differential View
This structure is derived from AllergyIntolerance
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| AllergyIntolerance | 0..* | AllergyIntolerance | ||
| category | 0..0 | |||
| code | I | 0..1 | CodeableConcept | Code that identifies the substance or product which the patient has an allergy or intolerance to Binding: SubstanceCode (extensible) |
| coding | ||||
| system | 0..1 | uri | Fixed Value: http://snomed.info/sct | |
| reaction | ||||
| substance | 0..1 | CodeableConcept | Binding: SubstanceCode (extensible) | |
| manifestation | 1..* | CodeableConcept | Binding: SNOMEDCTClinicalFindings (extensible) | |
| exposureRoute | 0..1 | CodeableConcept | Binding: SNOMEDCTRouteCodes (extensible) | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| AllergyIntolerance | I | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) |
| id | Σ | 0..1 | string | Logical id of this artifact |
| meta | ΣI | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!ΣI | 0..1 | uri | A set of rules under which this content was created |
| language | I | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages |
| text | I | 0..1 | Narrative | Text summary of the resource, for human interpretation |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | I | 0..* | Extension | Additional content defined by implementations |
| modifierExtension | ?!I | 0..* | Extension | Extensions that cannot be ignored |
| identifier | ΣI | 0..* | Identifier | External ids for this item |
| clinicalStatus | ?!ΣI | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
| verificationStatus | ?!ΣI | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
| type | ΣI | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required) |
| criticality | ΣI | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required) |
| code | ΣI | 0..1 | CodeableConcept | Code that identifies the substance or product which the patient has an allergy or intolerance to Binding: SubstanceCode (extensible) |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| coding | ΣI | 0..* | Coding | Code defined by a terminology system |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |
| system | ΣI | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct |
| version | ΣI | 0..1 | string | Version of the system - if relevant |
| code | ΣI | 0..1 | code | Symbol in syntax defined by the system |
| display | ΣI | 0..1 | string | Representation defined by the system |
| userSelected | ΣI | 0..1 | boolean | If this coding was chosen directly by the user |
| text | ΣI | 0..1 | string | Plain text representation of the concept |
| patient | ΣI | 1..1 | Reference(Patient) | Who the sensitivity is for |
| encounter | I | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted |
| onset[x] | I | 0..1 | When allergy or intolerance was identified | |
| onsetDateTime | dateTime | |||
| onsetAge | Age | |||
| onsetPeriod | Period | |||
| onsetRange | Range | |||
| onsetString | string | |||
| recordedDate | I | 0..1 | dateTime | Date first version of the resource instance was recorded |
| recorder | I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity |
| asserter | ΣI | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy |
| lastOccurrence | I | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction |
| note | I | 0..* | Annotation | Additional text not captured in other fields |
| reaction | I | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | I | 0..* | Extension | Additional content defined by implementations |
| modifierExtension | ?!ΣI | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| substance | I | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (extensible) |
| manifestation | I | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) |
| description | I | 0..1 | string | Description of the event as a whole |
| onset | I | 0..1 | dateTime | Date(/time) when manifestations showed |
| severity | I | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required) |
| exposureRoute | I | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (extensible) |
| note | I | 0..* | Annotation | Text about event not captured in other fields |
| Documentation for this format | ||||
Other representations of profile: Schematron
| Path | Conformance | ValueSet |
| AllergyIntolerance.language | preferred | CommonLanguages Max Binding: AllLanguages |
| AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes |
| AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes |
| AllergyIntolerance.type | required | AllergyIntoleranceType |
| AllergyIntolerance.criticality | required | AllergyIntoleranceCriticality |
| AllergyIntolerance.code | extensible | SubstanceCode |
| AllergyIntolerance.reaction.substance | extensible | SubstanceCode |
| AllergyIntolerance.reaction.manifestation | extensible | SNOMEDCTClinicalFindings |
| AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity |
| AllergyIntolerance.reaction.exposureRoute | extensible | SNOMEDCTRouteCodes |
| Id | Path | Details | Requirements |
| ait-1 | AllergyIntolerance | AllergyIntolerance.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-2 | AllergyIntolerance | AllergyIntolerance.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-2 | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | AllergyIntolerance | 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 : 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-4 | AllergyIntolerance | If 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-5 | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | AllergyIntolerance.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.clinicalStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.verificationStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.criticality | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| code-1 | AllergyIntolerance.code | A code or a note must exist : code.exists() or note.exists() | |
| ele-1 | AllergyIntolerance.code.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.code.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.code.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.code.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.code.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.code.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.patient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.onset[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.recordedDate | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.recorder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.asserter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.lastOccurrence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.reaction.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.reaction.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | AllergyIntolerance.reaction.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | AllergyIntolerance.reaction.substance | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.manifestation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.description | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.onset | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.severity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.exposureRoute | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | AllergyIntolerance.reaction.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |