De-Identified, Anonymized FHIR Profiles Library
0.1.0 - STU1 Release 1 - Standard for Trial-Use

De-Identified, Anonymized FHIR Profiles Library, published by HL7 International / Cross Group Projects. 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/HL7/fhir-dapl/ and changes regularly. See the Directory of published versions

## Resource Profile: De-Identified UDS Plus AllergyIntolerance

Official URL: http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-allergyintolerance | Version: 0.1.0
Standards status: Trial-use | Maturity Level: 1 | Computable Name: UDSPlusAllergyIntolerance

The UDS+ profile is based on the AllergyIntolerance resource and establishes the core elements, extensions, vocabularies and value sets for representing Allergies and Intolerances for UDS+ program.

All canonical (Official) URLs will be changed in the future and are not available currently on the web.

### Introduction

This profile is used to represent de-identified AllergyIntolerance information. The de-identification process has to remove all data elements not explicitly identified as "SUPPORTED" in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes AllergyIntolerance.recorded and onset elements.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a AllergyIntolerance resource text element may contain information such as the AllergyIntolerance dates, patient information. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Ids and References

The original AllergyIntolerance resource id should not be included in the De-identified AllergyIntolerance instance. Instead a new id should be created and provided as part of the FHIR resource. The Data Submitter should be capable of using the generated id to relink the data to the original AllergyIntolerance. All resource references to the AllergyIntolerance submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

- patient

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

- onset
- recordedDate

Usages:

- This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance Constraints: ait-1, ait-2
id | S Σ | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ C | 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 | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S 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 | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus 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 |
onsetString |  |  | string |
recordedDate | S | 0..1 | dateTime | Date first version of the resource instance was recorded
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: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
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 | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📍4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24
AllergyIntolerance.reaction.​manifestation | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance
id | S | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
type | S | 0..1 | code | allergy | intolerance - Underlying mechanism (if known)
category | S | 0..* | code | food | medication | environment | biologic
criticality | S | 0..1 | code | low | high | unable-to-assess
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who the sensitivity is for
display |  | 0..0 |  | Text alternative for the resource
onset[x] | S | 0..1 | dateTime, Age, Period, Range, string | When allergy or intolerance was identified
recordedDate | S | 0..1 | dateTime | Date first version of the resource instance was recorded
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

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance Constraints: ait-1, ait-2
id | S Σ | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
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
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 | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ C | 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 | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S 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 | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who the sensitivity is for
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
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 |
onsetString |  |  | string |
recordedDate | S | 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 |  | 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: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
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: 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..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📍4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24
AllergyIntolerance.patient.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​manifestation | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​exposureRoute | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 AllergyIntolerance

Summary

Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 13 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance Constraints: ait-1, ait-2
id | S Σ | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ C | 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 | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S 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 | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus 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 |
onsetString |  |  | string |
recordedDate | S | 0..1 | dateTime | Date first version of the resource instance was recorded
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: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
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 | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📍4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24
AllergyIntolerance.reaction.​manifestation | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance
id | S | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
text |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data.
contained |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data.
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
type | S | 0..1 | code | allergy | intolerance - Underlying mechanism (if known)
category | S | 0..* | code | food | medication | environment | biologic
criticality | S | 0..1 | code | low | high | unable-to-assess
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S | 1..1 | Reference(De-Identified UDS Plus Patient) | Who the sensitivity is for
display |  | 0..0 |  | Text alternative for the resource
onset[x] | S | 0..1 | dateTime, Age, Period, Range, string | When allergy or intolerance was identified
recordedDate | S | 0..1 | dateTime | Date first version of the resource instance was recorded
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

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | De-Identified UDS Plus AllergyIntolerance Constraints: ait-1, ait-2
id | S Σ | 0..1 | id | The de-identified AllergyIntolerance identifier created by the health center to send data to UDS+ Data Receiver
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
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 | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ C | 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 | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S 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 | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible): The set of codes indicating the allergy or intolerance
patient | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Who the sensitivity is for
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
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 |
onsetString |  |  | string |
recordedDate | S | 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 |  | 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: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
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: 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..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📍4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📍4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Common substances for allergy and intolerance documentation including refutations | 📦20240625 | VSAC v0.24
AllergyIntolerance.patient.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​manifestation | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​exposureRoute | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 AllergyIntolerance

Summary

Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 13 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

- De-Identified UDS Plus Patient (http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient)

Maturity: 1

Other representations of profile: CSV, Excel, Schematron