US Quality Core Implementation Guide
0.1.0 - cibuild

US Quality Core Implementation Guide, published by ASTP. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : AllergyIntolerance example - JSON Representation

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    {
      "resourceType" : "AllergyIntolerance",
      "id" : "example",
      "meta" : {
        "profile" : [
          🔗 "http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-allergyintolerance"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: AllergyIntolerance example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-quality-core-allergyintolerance.html\">US Quality Core AllergyIntolerance</a></p></div><p><b>identifier</b>: <code>http://acme.com/ids/patients/risks</code>/49476534</p><p><b>clinicalStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active}\">Active</span></p><p><b>verificationStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/allergyintolerance-verification confirmed}\">Confirmed</span></p><p><b>type</b>: Allergy</p><p><b>category</b>: Food</p><p><b>criticality</b>: High Risk</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 227493005}\">Cashew nuts</span></p><p><b>patient</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>onset</b>: 2004</p><p><b>recordedDate</b>: 2014-10-09 14:58:00+1100</p><p><b>recorder</b>: <a href=\"Practitioner-example.html\">Practitioner Adam Careful </a></p><p><b>asserter</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>lastOccurrence</b>: 2012-06-02 01:45:31+0000</p><p><b>note</b>: </p><blockquote><div><p>The criticality is high becasue of the observed anaphylactic reaction when challenged     with cashew extract.</p>\n</div></blockquote><blockquote><p><b>reaction</b></p><p><b>substance</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 1160593}\">cashew nut allergenic extract Injectable Product</span></p><p><b>manifestation</b>: <span title=\"Codes:{http://snomed.info/sct 39579001}\">Anaphylactic reaction</span></p><p><b>description</b>: Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered</p><p><b>onset</b>: 2012-06-12</p><p><b>severity</b>: Severe</p><p><b>exposureRoute</b>: <span title=\"Codes:{http://snomed.info/sct 34206005}\">Subcutaneous route</span></p></blockquote><blockquote><p><b>reaction</b></p><p><b>manifestation</b>: <span title=\"Codes:{http://snomed.info/sct 64305001}\">Urticaria</span></p><p><b>onset</b>: 2004</p><p><b>severity</b>: Moderate</p><p><b>note</b>: </p><blockquote><div><p>The patient reports that the onset of urticaria was within 15 minutes of eating cashews.</p>\n</div></blockquote></blockquote></div>"
      },
      "identifier" : [
        //     an identifier used for this allergic propensity (adverse reaction risk)
        {
          "system" : "http://acme.com/ids/patients/risks",
          "value" : "49476534"
        }
      ],
      "clinicalStatus" : //     this individual has had several reactions
      {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
            "code" : "active"
          }
        ]
      },
      "verificationStatus" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
            "code" : "confirmed"
          }
        ]
      },
      "type" : "allergy",
      "category" : [
        "food"
      ],
      "criticality" : "high",
      "code" : //     note: it's often unknown whether an allergy is mediated by an immune response, and
       not as significant as once thought
      //     this categorisation is implied by "cashew nut" and therefore basically
        redundant, but many systems collect this field anyway, since it's either
        useful when the substance is not coded, or it's quicker to sort/filter on
        than using terminology based reasoning
      //     there is no question that the allergy is real and serious
      //     Allergy or intolerance code (substance, product, condition or negated/excluded statement)
       or text. A few times,
        there's a full description of a complex substance/product - in these caes, use the
        extension [url] to refer to a Substance resource.
      {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "227493005",
            "display" : "Cashew nuts"
          }
        ]
      },
      "patient" : //     the patient that actually has the risk of adverse reaction
      {
        🔗 "reference" : "Patient/example"
      },
      "onsetDateTime" : "2004",
      "recordedDate" : "2014-10-09T14:58:00+11:00",
      "recorder" : //     when the allergy was first noted (in this case the same as reaction.onset of the first
       occurrence)
      //     the date that this entry was recorded
      //     who made the record / last updated it
      {
        🔗 "reference" : "Practitioner/example"
      },
      "asserter" : //     the patient is the reporter in this case
      {
        🔗 "reference" : "Patient/example"
      },
      "lastOccurrence" : "2012-06-02T01:45:31+00:00",
      "note" : [
        //     last happened June 2012. Typically, systems either track lastOccurrence,
         or a list of events.
        //     an additional note about the allergy propensity by the recorder
        {
          "text" : "The criticality is high becasue of the observed anaphylactic reaction when challenged     with cashew extract."
        }
      ],
      "reaction" : [
        //     past events. There's no claim that this is all the events, and
         that should not be assumed
        {
          "substance" : //
          It's possible to list specific things to which the patient responded,
          e.g. chocolate (that happened to contain cashew nuts). This event has
          such a specific substance. Note that systems should ensure that what
          goes in here does not conflict with the substance above, and systems
          processing the data can be sure that what is here does not contravene
          the substance above

          {
            "coding" : [
              {
                "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
                "code" : "1160593",
                "display" : "cashew nut allergenic extract Injectable Product"
              }
            ]
          },
          "manifestation" : [
            {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "39579001",
                  "display" : "Anaphylactic reaction"
                }
              ]
            }
          ],
          "description" : "Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered",
          "onset" : "2012-06-12",
          "severity" : "severe",
          "exposureRoute" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "34206005",
                "display" : "Subcutaneous route"
              }
            ]
          }
        },
        {
          "manifestation" : [
            {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "64305001",
                  "display" : "Urticaria"
                }
              ]
            }
          ],
          "onset" : "2004",
          "severity" : "moderate",
          "note" : [
            //     an additional note about the reaction by the recorder
            {
              "text" : "The patient reports that the onset of urticaria was within 15 minutes of eating cashews."
            }
          ]
        }
      ]
    }