AU Core Implementation Guide
1.1.0-ci-build - CI Build Australia flag

AU Core Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/au-fhir-core/ and changes regularly. See the Directory of published versions

Resource Profile: AU Core AllergyIntolerance

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance Version: 1.1.0-ci-build
Standards status: Trial-use Maturity Level: 2 Computable Name: AUCoreAllergyIntolerance

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for an AllergyIntolerance resource to record, search, and fetch allergies/adverse reactions associated with a patient. It is based on the AU Base Allergy Intolerance profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the AllergyIntolerance resource when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

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

Profile specific implementation guidance

  • 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 1003774007 |No known Hevea brasiliensis latex allergy|) is used in AllergyIntolerance.code
  • The use of coding can vary significantly across systems, requesters need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Responders SHOULD populate AllergyIntolerance.code.text and/or AllergyIntolerance.code.coding.display so that requesters can at least display the condition even if the requester 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. 1003755004 |Allergy to latex|), the substance is sent in AllergyIntolerance.code

Usage:

Changes since version 1.0.0:

  • The resource metadata has changed (description)

    • Formal Views of Profile Content

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

    This structure is derived from AUBaseAllergyIntolerance

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. AllergyIntolerance 0..* AUBaseAllergyIntolerance An allergy or intolerance statement in an Australian healthcare context
    ... clinicalStatus SO 0..1 CodeableConcept active | inactive | resolved
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... verificationStatus SO 0..1 CodeableConcept unconfirmed | confirmed | refuted | entered-in-error
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... code SO 1..1 CodeableConcept Code that identifies the allergy or intolerance
    Binding: Indicator of Hypersensitivity or Intolerance to Substance . (extensible)
    Additional BindingsPurpose
    Adverse Reaction Substances and Negated Findings . candidate
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... onset[x] SO 0..1 When allergy or intolerance was identified
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... onsetDateTime dateTime
    .... onsetAge Age
    .... onsetPeriod Period
    .... onsetRange Range
    ... reaction SO 0..* BackboneElement Adverse Reaction Events linked to exposure to substance
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... manifestation SO 1..* CodeableConcept Clinical symptoms/signs associated with the Event
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... severity SO 0..1 code mild | moderate | severe (of event as a whole)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    AllergyIntolerance.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    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.

    Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
    patient SHALL reference The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both.

    The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
    patient+clinical-status SHOULD reference+token
    clinical-status MAY token The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder SHALL support both.

    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)