Primary Care Practice-to-Practice
0.0.3 - CI Build

Primary Care Practice-to-Practice, published by . This is not an authorized publication; it is the continuous build for version 0.0.3). This version is based on the current content of https://github.com/aehrc/primary-care-data-technical/ and changes regularly. See the Directory of published versions

Resource Profile: AU Primary Care Allergy Intolerance

Defining URL:https://aehrc.com/fhir/StructureDefinition/AUPrimaryCareAllergyIntolerance
Version:0.0.3
Name:AUPrimaryCareAllergyIntolerance
Title:AU Primary Care Allergy Intolerance
Status:Active as of 2021-06-27T13:53:23+00:00
Definition:

Risk of harmful or undesirable physiological response which is unique to the individual and associated with exposure to a known substance.

Usage

Use to provide a single place within the health record to document a range of clinical statements about adverse reactions, including:

  • record a clinical assessment of the individual’s propensity for a potential future reaction upon re-exposure; and
  • record cumulative information about the reaction to each exposure.

Use to record information about the positive presence of the risk of an adverse reaction:

  • to support direct clinical care of an individual;
  • as part of a managed adverse reaction or allergy/intolerance list;
  • to support exchange of information about the propensity and events related to adverse reactions;
  • to inform adverse reaction reporting; and
  • to assist computerised knowledge-based activities such as clinical decision support and alerts.

Use to record information about the risk of adverse reactions to a broad range of substances, including: incipients and excipients in medicinal preparations; biological products; metal salts; and organic chemical compounds.

Adverse reaction may be:

  • an immune mediated reaction - Types I-IV (including allergic reactions and hypersensitivities); or
  • a non-immune mediated reaction - including pseudo-allergic reactions, side effects, intolerances, drug toxicities (eg to Gentamicin). In clinical practice distinguishing between immune-mediated and non-immune mediated reactions is difficult and often not practical. Identification of the type of reaction is not a proxy for seriousness or risk of harm to the patient, which is better expressed by the manifestation in clinical practice.

The risk of an adverse reaction event or manifestation should not be recorded without identifying a proposed causative substance or class of substance. If there is uncertainty that a specific substance is the cause, this uncertainty can be recorded using the ‘Verification status’ data element. If there are multiple possible substances that may have caused a reaction/manifestation, each substance should be recorded using a separate instance of this adverse reaction archetype with the ‘Status’ set to an initial state of ‘Unconfirmed’ so that adverse reaction checking can be activated in clinical systems. Once the substance, agent or class is later proven not to be the cause for a given reaction then the ‘Status’ can be modified to ‘Refuted’.

This item has been designed to allow recording of information about a specific substance (amoxycillin, oysters, or bee sting venom) or, alternatively, a class of substance (eg Penicillins). If a class of substance is recorded then identification of the exact substance can be recorded on a per exposure basis.

Source Resource:XML / JSON / Turtle

The official URL for this profile is:

https://aehrc.com/fhir/StructureDefinition/AUPrimaryCareAllergyIntolerance

Formal Views of Profile Content

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

This structure is derived from AUBaseAllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

This structure is derived from AUBaseAllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... meta
.... lastUpdated S0..1instantWhen the resource version last changed
... verificationStatus S0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
... criticality S0..1codelow | high | unable-to-assess
... patient 1..1Reference(AU Primary Care Patient)Who the sensitivity is for
... recordedDate S0..1dateTimeDate first version of the resource instance was recorded
... note
.... text S1..1markdownThe annotation - text content (as markdown)
... reaction
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!ΣI0..1CodeableConceptactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | 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 Σ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 (preferred): Preferred SNOMED-CT coding for type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

... patient Σ1..1Reference(AU Primary Care Patient)Who the sensitivity is for
... encounter 0..1Reference(Encounter)Encounter when the allergy or intolerance was asserted
... onset[x] 0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... recordedDate S0..1dateTimeDate first version of the resource instance was recorded
... recorder 0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the sensitivity
... asserter Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorReferenceReference(Practitioner | Patient | RelatedPerson | Organization)
..... authorStringstring
.... time Σ0..1dateTimeWhen the annotation was made
.... text SΣ1..1markdownThe annotation - text content (as markdown)
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1 (preferred): Preferred SNOMED-CT coding defining the type of the substance (including pharmaceutical products).

.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 (preferred): Preferred SNOMED-CT coding of clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | 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..1CodeableConceptHow 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..*AnnotationText about event not captured in other fields

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... meta Σ0..1MetaMetadata about the resource
.... lastUpdated Σ0..1instantWhen the resource version last changed
... verificationStatus ?!ΣI0..1CodeableConceptunconfirmed | 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.

... criticality Σ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... recordedDate 0..1dateTimeDate first version of the resource instance was recorded
... note 0..*AnnotationAdditional text not captured in other fields
.... text Σ1..1markdownThe annotation - text content (as markdown)
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1 (preferred): Preferred SNOMED-CT coding defining the type of the substance (including pharmaceutical products).

.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 (preferred): Preferred SNOMED-CT coding of clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.



doco Documentation for this format

This structure is derived from AUBaseAllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 8 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from AUBaseAllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... meta
.... lastUpdated S0..1instantWhen the resource version last changed
... verificationStatus S0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
... criticality S0..1codelow | high | unable-to-assess
... patient 1..1Reference(AU Primary Care Patient)Who the sensitivity is for
... recordedDate S0..1dateTimeDate first version of the resource instance was recorded
... note
.... text S1..1markdownThe annotation - text content (as markdown)
... reaction
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!ΣI0..1CodeableConceptactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | 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 Σ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 (preferred): Preferred SNOMED-CT coding for type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

... patient Σ1..1Reference(AU Primary Care Patient)Who the sensitivity is for
... encounter 0..1Reference(Encounter)Encounter when the allergy or intolerance was asserted
... onset[x] 0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... recordedDate S0..1dateTimeDate first version of the resource instance was recorded
... recorder 0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the sensitivity
... asserter Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorReferenceReference(Practitioner | Patient | RelatedPerson | Organization)
..... authorStringstring
.... time Σ0..1dateTimeWhen the annotation was made
.... text SΣ1..1markdownThe annotation - text content (as markdown)
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1 (preferred): Preferred SNOMED-CT coding defining the type of the substance (including pharmaceutical products).

.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 (preferred): Preferred SNOMED-CT coding of clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | 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..1CodeableConceptHow 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..*AnnotationText about event not captured in other fields

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.meta.securityextensibleAll Security Labels
AllergyIntolerance.meta.tagexampleCommonTags
AllergyIntolerance.languagepreferredCommonLanguages
Max Binding: AllLanguages
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codepreferredhttps://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
AllergyIntolerance.reaction.substancepreferredhttps://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1
AllergyIntolerance.reaction.manifestationpreferredhttps://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes