US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-allergyintolerance | Version: 1.0.0-ballot | ||||
| Standards status: Trial-use | Maturity Level: 4 | Computable Name: USQualityCoreAllergyIntolerance | |||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.2 | |||||
Profile of AllergyIntolerance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.
The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.
USCDI+ Quality Elements:
| Profile element | Description | USCDI+ Quality Data Element(s) |
|---|---|---|
code |
Code that identifies the allergy or intolerance | Allergies and Intolerances: Drug Class Allergy Intolerance, Allergies and Intolerances: Medication Allergy Intolerance, Allergies and Intolerances: Non-Medication Allergy Intolerance |
lastOccurrence |
Date(/time) of last known occurrence of a reaction | Allergies and Intolerances: Reaction Date and Time |
onset[x] |
When allergy or intolerance was identified | Allergies and Intolerances: Allergy Intolerance Onset Date and Time |
reaction |
Adverse Reaction Events linked to exposure to substance | Allergies and Intolerances: Reaction |
recordedDate |
Date first version of the resource instance was recorded | Allergies and Intolerances: Allergy Intolerance Recorded Date and Time |
recorder |
Who recorded the sensitivity | Provenance: Author |
Because this profile is derived directly or indirectly from US Core, systems are also expected to support the Must Support and Additional USCDI requirements specified by the US Core profile this profile inherits from. For more information about those requirements, refer to the US Core AllergyIntolerance Profile. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2 |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
![]() ![]() |
SΣ | 1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible) |
![]() ![]() |
SΣ | 1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for |
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Age | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() ![]() |
Range | |||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |
![]() ![]() |
S | 0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance |
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() |
S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) |
Documentation for this format | ||||
| 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.code | Base | extensible |
Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations.
|
⏿20260321 | tx.fhir.org |
| AllergyIntolerance.reaction.manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| 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()
|
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) | |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance | |
![]() ![]() |
1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for | |
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Age | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() ![]() |
Range | |||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |
![]() ![]() |
0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance | |
Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2 | ||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..* | Identifier | External ids for this item | ||||
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) | ||||
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) | ||||
![]() ![]() |
Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk. | ||||
![]() ![]() |
Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. | ||||
![]() ![]() |
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. | ||||
![]() ![]() |
SΣ | 1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible) | ||||
![]() ![]() |
SΣ | 1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for | ||||
![]() ![]() |
0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted | |||||
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Age | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() ![]() |
Range | |||||||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |||||
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |||||
![]() ![]() |
Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy | ||||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |||||
![]() ![]() |
0..* | Annotation | Additional text not captured in other fields | |||||
![]() ![]() |
S | 0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() |
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). | |||||
![]() ![]() ![]() |
S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) | ||||
![]() ![]() ![]() |
0..1 | string | Description of the event as a whole | |||||
![]() ![]() ![]() |
0..1 | dateTime | Date(/time) when manifestations showed | |||||
![]() ![]() ![]() |
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. | |||||
![]() ![]() ![]() |
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. | |||||
![]() ![]() ![]() |
0..* | Annotation | Text about event not captured in other fields | |||||
Documentation for this format | ||||||||
| 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 |
Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations.
|
⏿20260321 | tx.fhir.org |
| AllergyIntolerance.reaction.substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std. |
| AllergyIntolerance.reaction.manifestation | Base | extensible | 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. |
| 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()
|
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
C | 0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2 |
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) |
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) |
![]() ![]() |
SΣ | 1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible) |
![]() ![]() |
SΣ | 1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for |
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Age | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() ![]() |
Range | |||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |
![]() ![]() |
S | 0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance |
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() |
S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) |
Documentation for this format | ||||
| 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.code | Base | extensible |
Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations.
|
⏿20260321 | tx.fhir.org |
| AllergyIntolerance.reaction.manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std. |
| 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
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
|---|---|---|---|---|
![]() |
0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) | |
![]() ![]() |
1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance | |
![]() ![]() |
1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for | |
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||
![]() ![]() ![]() |
dateTime | |||
![]() ![]() ![]() |
Age | |||
![]() ![]() ![]() |
Period | |||
![]() ![]() ![]() |
Range | |||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |
![]() ![]() |
0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance | |
Documentation for this format | ||||
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() |
C | 0..* | USCoreAllergyIntolerance(9.0.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2 | ||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() |
Σ | 0..* | Identifier | External ids for this item | ||||
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required) | ||||
![]() ![]() |
?!SΣC | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required) | ||||
![]() ![]() |
Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk. | ||||
![]() ![]() |
Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances. | ||||
![]() ![]() |
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. | ||||
![]() ![]() |
SΣ | 1..1 | CodeableConcept | (USCDI+ Quality) Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible) | ||||
![]() ![]() |
SΣ | 1..1 | Reference(US Quality Core Patient) | Who the sensitivity is for | ||||
![]() ![]() |
0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted | |||||
![]() ![]() |
0..1 | (USCDI+ Quality) When allergy or intolerance was identified | ||||||
![]() ![]() ![]() |
dateTime | |||||||
![]() ![]() ![]() |
Age | |||||||
![]() ![]() ![]() |
Period | |||||||
![]() ![]() ![]() |
Range | |||||||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded | |||||
![]() ![]() |
0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile) | (USCDI+ Quality) Who recorded the sensitivity | |||||
![]() ![]() |
Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy | ||||
![]() ![]() |
0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction | |||||
![]() ![]() |
0..* | Annotation | Additional text not captured in other fields | |||||
![]() ![]() |
S | 0..* | BackboneElement | (USCDI+ Quality) Adverse Reaction Events linked to exposure to substance | ||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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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). | |||||
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S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible) | ||||
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0..1 | string | Description of the event as a whole | |||||
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0..1 | dateTime | Date(/time) when manifestations showed | |||||
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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. | |||||
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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. | |||||
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0..* | Annotation | Text about event not captured in other fields | |||||
Documentation for this format | ||||||||
| 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 |
Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations.
|
⏿20260321 | tx.fhir.org |
| AllergyIntolerance.reaction.substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std. |
| AllergyIntolerance.reaction.manifestation | Base | extensible | 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. |
| 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()
|
Other representations of profile: CSV, Excel, Schematron
Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.
| Profile element | FHIR | US Core | US Quality Core |
|---|---|---|---|
clinicalStatus |
Must Support | ||
verificationStatus |
Must Support | ||
code |
Mandatory Must Support | USCDI+ Quality | |
patient |
Mandatory | Must Support | |
onset[x] |
USCDI+ Quality | ||
recordedDate |
USCDI+ Quality | ||
recorder |
Additional USCDI | USCDI+ Quality | |
lastOccurrence |
USCDI+ Quality | ||
reaction |
Must Support | USCDI+ Quality | |
reaction.manifestation |
Mandatory | Must Support |
Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.
The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.
Because this profile derives directly or indirectly from US Core, servers SHALL also support all mandatory searches described in the US Core Server CapabilityStatement requirements for AllergyIntolerance. When possible, this guide reuses mandatory searches from US Core and notes them with the EXISTING US CORE REQUIREMENT flag. While US Quality Core may restate US Core requirements to highlight searches directly relevant to USCDI+ Quality data access, US Core requirements not restated here remain applicable.
See the US Quality Core Server CapabilityStatement for complete requirements for the underlying AllergyIntolerance resource and Search Requirement Selection for how this focused set was selected.
Servers supporting this profile SHALL support the following search parameters and search parameter combinations:
SHALL support searching for all AllergyIntolerance resources for a patient using the patient search parameter. EXISTING US CORE REQUIREMENT
GET [base]/AllergyIntolerance?patient={Patient/}[id]
Example:
GET [base]/AllergyIntolerance?patient=Patient/example
Implementation Notes: Fetches a bundle of US Quality Core AllergyIntolerance resources matching the specified search criteria. See how to search by reference.
Rationale for inclusion: Supports patient-scoped retrieval of AllergyIntolerance resources for USCDI+ Quality workflows.