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

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

Profile of HL7 BMI profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 blood pressure profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 body height profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 body temperature profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 body weight profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 head circumference profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 heart rate profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 oxygen saturation profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of HL7 respiratory rate profile with SNOMED CT binding in addition to 'magic number' binding from base profile.

Profile of the Specimen resource for use with SNOMED CT coding.

Extension to allow detailed coding similar to AllergyIntolerance.type.

Extension to allow specific contexts of use (eg SNOMED Language Reference Sets, LOINC short name, long common name, consumer name, as well as ICD-10 rubrics) to be specified when working with designations

A value set with detailed type of allergy or intolerance to be used in addition to AllergeyIntolerance.type in R4. R5 have been amended with an update value set.

Codes describing the specimen collcetion bodysite.

Codes describing the specimen collection method.

Codes describing the specimen processing procedure.

Codes describing the type of specimen.

Scenario: A review of systems fails to reveal any other causes and the physician believes that the patient may be having an urticarial reaction to penicillin. He has lingering uncertainty about this and tells the patient to stop the penicillin and employ diphenhydramine for relief. He schedules him back in a week for follow-up and when recording his note for the visit, he adds to his assessment in the problem list: "Moderate urticarial reaction, possible penicillin allergy".

Scenario: A 34-year-old female is seen by her primary care provider for complaints of abdominal pain, bloating and change in bowel habits within hours or a few days after ingesting whole wheat bread. In addition, she complains of feeling tired but denies itching rash or wheezing. Those complaints are entered as observations in the EHR.

Scenario: A 34-year-old female is seen by her primary care provider for complaints of abdominal pain, bloating and change in bowel habits within hours or a few days after ingesting whole wheat bread. In addition, she complains of feeling tired but denies itching rash or wheezing. Those complaints are entered as observations in the EHR.

Scenario: A 34-year-old female is seen by her primary care provider for complaints of abdominal pain, bloating and change in bowel habits within hours or a few days after ingesting whole wheat bread. In addition, she complains of feeling tired but denies itching rash or wheezing. Those complaints are entered as observations in the EHR.

Scenario: Due to a family history of celiac disease, tissue transglutaminase IgG and IgA are ordered which are negative. The patient is also referred to a gastroenterologist, who performs an endoscopic biopsy, which is negative for celiac disease. (Both of these examination results can be recorded in the EHR as a FHIR observation using LOINC codes). The patient is advised to avoid wheat and gluten containing products. An encounter diagnosis of moderate wheat intolerance is documented in the patient’s health record and wheat is entered in the patient’s "allergy" list.

Scenario: A licensed nurse presents to her personal physician for recurring problems of a generalized rash and itching. She works in an intensive care unit and is constantly handing chemicals, disinfectants, assisting in surgical procedures and performing catheter cares for her patients. As a part of the health history, she noticed that she had an eruption on her hands after handling latex catheters. Additionally, she reports a serious allergic reaction to papaya in the past and has been careful in the fruits she eats as a consequence. The clinician suspects a latex allergy cross-reacting with foodstuffs and orders IgE testing for Hevea latex antibody. The serology testing is strongly positive and the clinician advises the nurse of his findings with warnings about other foods, which may cross react.

Scenario: A licensed nurse presents to her personal physician for recurring problems of a generalized rash and itching. She works in an intensive care unit and is constantly handing chemicals, disinfectants, assisting in surgical procedures and performing catheter cares for her patients. As a part of the health history, she noticed that she had an eruption on her hands after handling latex catheters. Additionally, she reports a serious allergic reaction to papaya in the past and has been careful in the fruits she eats as a consequence. The clinician suspects a latex allergy cross-reacting with foodstuffs and orders IgE testing for Hevea latex antibody. The serology testing is strongly positive and the clinician advises the nurse of his findings with warnings about other foods, which may cross react.

Scenario: A week later, the patient returns for follow-up with the itching and rash entirely resolved. He reports that the reaction subsided within days after stopping the penicillin. The physician adds “Penicillin allergy probable: moderate reaction of hives; criticality unable-to-assess” to the allergy list.

Scenario: A week later, the patient returns for follow-up with the itching and rash entirely resolved. He reports that the reaction subsided within days after stopping the penicillin. The physician adds “Penicillin allergy probable: moderate reaction of hives; criticality unable-to-assess” to the allergy list.

Scenario: Scenario: Several years later, the patient from scenario 4.1 who has since received an aortic valve replacement is seeing another physician within the organization for consultation on antibiotic prophylaxis for an upcoming dental procedure. The second physician decides that a penicillin class antibiotic is appropriate for the patient.
When the physician creates an order for amoxicillin 2 g orally as a single dose and commits to the electronic prescription, an alert appears which requires a response by the physician warning him of an allergy history to penicillin. The substance-based alert is generated by the EHR drug-disease interactions software, which uses the Allergy list as a reference. As the patient has not received penicillin class antibiotics for several years, the physician decides to refer the patient to an allergy specialist for clarification of current status of penicillin allergy. The specialist performs skin testing for penicillin allergy, the results of which are positive. The patient is confirmed as penicillin allergic and the results of the testing are documented in the patient’s medical record. The patient is subsequently prescribed azithromycin for his dental procedure.

Scenario: Scenario: Several years later, the patient from scenario 4.1 who has since received an aortic valve replacement is seeing another physician within the organization for consultation on antibiotic prophylaxis for an upcoming dental procedure. The second physician decides that a penicillin class antibiotic is appropriate for the patient.
When the physician creates an order for amoxicillin 2 g orally as a single dose and commits to the electronic prescription, an alert appears which requires a response by the physician warning him of an allergy history to penicillin. The substance-based alert is generated by the EHR drug-disease interactions software, which uses the Allergy list as a reference. As the patient has not received penicillin class antibiotics for several years, the physician decides to refer the patient to an allergy specialist for clarification of current status of penicillin allergy. The specialist performs skin testing for penicillin allergy, the results of which are positive. The patient is confirmed as penicillin allergic and the results of the testing are documented in the patient’s medical record. The patient is subsequently prescribed azithromycin for his dental procedure.

Scenario: Scenario: Several years later, the patient from scenario 4.1 who has since received an aortic valve replacement is seeing another physician within the organization for consultation on antibiotic prophylaxis for an upcoming dental procedure. The second physician decides that a penicillin class antibiotic is appropriate for the patient.
When the physician creates an order for amoxicillin 2 g orally as a single dose and commits to the electronic prescription, an alert appears which requires a response by the physician warning him of an allergy history to penicillin. The substance-based alert is generated by the EHR drug-disease interactions software, which uses the Allergy list as a reference. As the patient has not received penicillin class antibiotics for several years, the physician decides to refer the patient to an allergy specialist for clarification of current status of penicillin allergy. The specialist performs skin testing for penicillin allergy, the results of which are positive. The patient is confirmed as penicillin allergic and the results of the testing are documented in the patient’s medical record. The patient is subsequently prescribed azithromycin for his dental procedure.

Scenario: Scenario: Several years later, the patient from scenario 4.1 who has since received an aortic valve replacement is seeing another physician within the organization for consultation on antibiotic prophylaxis for an upcoming dental procedure. The second physician decides that a penicillin class antibiotic is appropriate for the patient.
When the physician creates an order for amoxicillin 2 g orally as a single dose and commits to the electronic prescription, an alert appears which requires a response by the physician warning him of an allergy history to penicillin. The substance-based alert is generated by the EHR drug-disease interactions software, which uses the Allergy list as a reference. As the patient has not received penicillin class antibiotics for several years, the physician decides to refer the patient to an allergy specialist for clarification of current status of penicillin allergy. The specialist performs skin testing for penicillin allergy, the results of which are positive. The patient is confirmed as penicillin allergic and the results of the testing are documented in the patient’s medical record. The patient is subsequently prescribed azithromycin for his dental procedure.

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: The physician records a peanut allergy in the EHR with anaphylaxis, hives and wheezing as reaction symptoms, records a criticality of high and reaction severity of "severe".

Scenario: A nurse is performing an intake examination on a patient that is new to the clinical practice. As part of the clinical interview, he inquires about medication and other allergies. The patient reports that she is not allergic to any medications, foods, chemicals or animals. The nurse opens the 'allergy list' in the EHR and documents 'No known allergies' which electronically validates that the nurse inquired of the patient and that the history was confirmed negative at the date and time recorded. This satisfies decision support criteria that allergies be documented before medication orders are written and is encoded in the EHR allergy list as confirmed absence of dispositions to adverse reactions.

Scenario: A nurse is performing an intake examination on a patient that is new to the clinical practice. As part of the clinical interview, he inquires about medication and other allergies. The patient reports that she is not allergic to any medications, foods, chemicals or animals. The nurse opens the 'allergy list' in the EHR and documents 'No known allergies' which electronically validates that the nurse inquired of the patient and that the history was confirmed negative at the date and time recorded. This satisfies decision support criteria that allergies be documented before medication orders are written and is encoded in the EHR allergy list as confirmed absence of dispositions to adverse reactions.

Scenario: A physician sees a patient in clinic for routine outpatient care. Recently the patient was prescribed penicillin V 500 mg orally two times daily x 10 days for streptococcal pharyngitis. He tells the physician that he has developed hives the previous week and on examination, the physician confirms the presence of generalized hives. He records this in the patient record as an Observation.

Scenario: Several years later, the patient from scenario 4.1 who has since received an aortic valve replacement is seeing another physician within the organization for consultation on antibiotic prophylaxis for an upcoming dental procedure. The second physician decides that a penicillin class antibiotic is appropriate for the patient.
When the physician creates an order for amoxicillin 2 g orally as a single dose and commits to the electronic prescription, an alert appears which requires a response by the physician warning him of an allergy history to penicillin. The substance-based alert is generated by the EHR drug-disease interactions software, which uses the Allergy list as a reference. As the patient has not received penicillin class antibiotics for several years, the physician decides to refer the patient to an allergy specialist for clarification of current status of penicillin allergy. The specialist performs skin testing for penicillin allergy, the results of which are positive. The patient is confirmed as penicillin allergic and the results of the testing are documented in the patient’s medical record. The patient is subsequently prescribed azithromycin for his dental procedure.

Scenario: A patient's mother reports to their child's physician that the child reacts violently to eating peanuts with symptoms that include generalized hives, wheezing and hypotension requiring use of epinephrine for resuscitation. The physician obtains a blood test which documents high levels of IgE antibody against the Arachis h2 peanut protein which is found in unrefined peanut oil (Arachis oil) - the sensitizing agent for clinical peanut allergy. Ara h2 is associated with a risk of severe reactions to peanut.

Scenario: A patient's mother reports to their child's physician that the child reacts violently to eating peanuts with symptoms that include generalized hives, wheezing and hypotension requiring use of epinephrine for resuscitation. The physician obtains a blood test which documents high levels of IgE antibody against the Arachis h2 peanut protein which is found in unrefined peanut oil (Arachis oil) - the sensitizing agent for clinical peanut allergy. Ara h2 is associated with a risk of severe reactions to peanut.

Scenario: While documenting the clinical encounter, he records a latex allergy in the allergy list. The EHR software supports selection of foods, chemicals and animal biological products as substances, which may be identified as source substances for an entry onto the allergy list or for recording of an adverse reaction.

Example of drug concepts with multiple designation uses

Example of drug concepts with multiple designations with different use contexts

Example of drug concepts with multiple designations with different use contexts

Example for Patient

Example for Patient

Example for Patient

Scenario: A 34-year-old female is seen by her primary care provider for complaints of abdominal pain, bloating and change in bowel habits within hours or a few days after ingesting whole wheat bread. In addition, she complains of feeling tired but denies itching rash or wheezing. Those complaints are entered as observations in the EHR.

Scenario: A 34-year-old female is seen by her primary care provider for complaints of abdominal pain, bloating and change in bowel habits within hours or a few days after ingesting whole wheat bread. In addition, she complains of feeling tired but denies itching rash or wheezing. Those complaints are entered as observations in the EHR.

Example of multiple contextual uses