Usage scenarios

The following are supported usage scenarios for this profile:

• Query for a patient’s allergies/adverse reactions
• Record or update a patient’s allergies/adverse reactions

Comparison with other national and international IGs

A resource conforming to this profile is conformant to:

• IPA-AllergyIntolerance
• US Core AllergyIntolerance
• and MAY be conformant to Allergy Intolerance (IPS) if patient is supported as AllergyIntolerance.patient.reference

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access, International Patient Summary, or US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

• AllergyIntolerance.verificationStatus is “unconfirmed” where a sending system does not clearly have this element or “confirmed” depending on the level of certainty
• To represent that a patient does not have an allergy or category of allergies, an appropriate negation code (e.g. 716186003 |No known allergy| or 716184000 |No known latex allergy|) is used in AllergyIntolerance.code
• The use of coding can vary significantly across systems, client applications need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Servers SHOULD populate AllergyIntolerance.code.text and/or AllergyIntolerance.code.coding.display so that client applications can at least display the condition even if the client application does not recognise the code supplied.
• Refutation is not expected to be handled except as above - an appropriate negation code in AllergyIntolerance.code and AllergyIntolerance.verificationStatus of “confirmed” or “unconfirmed”
• Where only substance is known (e.g. 111088007 |Latex|) and not a statement of allergy or intolerance (e.g. 300916003 |Allergy to latex|), the substance is sent in AllergyIntolerance.code

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

This structure is derived from AUBaseAllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context
clinicalStatus	S	0..1	CodeableConcept	active | inactive | resolved
verificationStatus	S	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error
code	S	1..1	CodeableConcept	Code that identifies the allergy or intolerance
patient	S	1..1	Reference(AU Core Patient)	Who the sensitivity is for
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
note	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	0..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event
severity	S	0..1	code	mild | moderate | severe (of event as a whole)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context 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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!SΣC	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.
code	SΣ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (preferred)
patient	SΣ	1..1	Reference(AU Core Patient)	Who the sensitivity is for
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
note	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	0..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
severity	S	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.
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	preferred	IndicatorOfHypersensitivityOrIntoleranceToSubstance https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ait-1	error	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	error	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	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	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	error	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	error	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context 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	?!SΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!SΣC	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.
category	Σ	0..*	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
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	SΣ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (preferred)
patient	SΣ	1..1	Reference(AU Core Patient)	Who the sensitivity is for
encounter		0..1	Reference(Encounter)	Encounter when the allergy or intolerance was asserted
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
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	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	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: Adverse Reaction Agent (preferred)
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
description		0..1	string	Description of the event as a whole
onset		0..1	dateTime	Date(/time) when manifestations showed
severity	S	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: Route of Administration (preferred)
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 Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
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.category	required	AllergyIntoleranceCategory http://hl7.org/fhir/ValueSet/allergy-intolerance-category|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	preferred	IndicatorOfHypersensitivityOrIntoleranceToSubstance https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.substance	preferred	AdverseReactionAgent https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	preferred	RouteOfAdministration https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
ait-1	error	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	error	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	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	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	error	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	error	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from AUBaseAllergyIntolerance

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance		0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context
clinicalStatus	S	0..1	CodeableConcept	active | inactive | resolved
verificationStatus	S	0..1	CodeableConcept	unconfirmed | confirmed | refuted | entered-in-error
code	S	1..1	CodeableConcept	Code that identifies the allergy or intolerance
patient	S	1..1	Reference(AU Core Patient)	Who the sensitivity is for
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
note	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	0..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event
severity	S	0..1	code	mild | moderate | severe (of event as a whole)
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context 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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!SΣC	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.
code	SΣ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (preferred)
patient	SΣ	1..1	Reference(AU Core Patient)	Who the sensitivity is for
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
note	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	0..*	BackboneElement	Adverse Reaction Events linked to exposure to substance
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
severity	S	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.
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	preferred	IndicatorOfHypersensitivityOrIntoleranceToSubstance https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ait-1	error	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	error	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	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	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	error	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	error	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
AllergyIntolerance	C	0..*	AUBaseAllergyIntolerance	An allergy or intolerance statement in an Australian healthcare context 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	?!SΣC	0..1	CodeableConcept	active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus	?!SΣC	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.
category	Σ	0..*	code	food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
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	SΣ	1..1	CodeableConcept	Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (preferred)
patient	SΣ	1..1	Reference(AU Core Patient)	Who the sensitivity is for
encounter		0..1	Reference(Encounter)	Encounter when the allergy or intolerance was asserted
onset[x]	S	0..1		When allergy or intolerance was identified
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
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	S	0..*	Annotation	Additional text not captured in other fields
reaction	S	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: Adverse Reaction Agent (preferred)
manifestation	S	1..*	CodeableConcept	Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
description		0..1	string	Description of the event as a whole
onset		0..1	dateTime	Date(/time) when manifestations showed
severity	S	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: Route of Administration (preferred)
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 Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
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.category	required	AllergyIntoleranceCategory http://hl7.org/fhir/ValueSet/allergy-intolerance-category|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	preferred	IndicatorOfHypersensitivityOrIntoleranceToSubstance https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.substance	preferred	AdverseReactionAgent https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation	preferred	ClinicalFinding https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1 from https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity	required	AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 from the FHIR Standard
AllergyIntolerance.reaction.exposureRoute	preferred	RouteOfAdministration https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1 from https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
ait-1	error	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	error	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	error	AllergyIntolerance	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	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	error	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	error	AllergyIntolerance	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	AllergyIntolerance	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from AUBaseAllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)

Maturity: 0

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

1. SHALL support searching using the patient search parameter:
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

   GET [base]/AllergyIntolerance?patient={Type/}[id] or optionally GET [base]/AllergyIntolerance?patient.identifier=[system|][code]

   Example:

   1. GET [base]/AllergyIntolerance?patient=5678
   2. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
   3. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

   Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient (how to search by reference and how to search by token)

Optional Search Parameters

The following search parameters and search parameter combinations SHOULD be supported:

1. SHOULD support searching using the combination of the patient and clinical-status search parameters:
   • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

   GET [base]/AllergyIntolerance?patient={Type/}[id]&clinical-status={system|}[code]{,{system|}[code],...}

   Example:

   1. GET [base]/AllergyIntolerance?patient=5678&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical

      active

   Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient and status (how to search by reference and how to search by token)