XpanDH Hospital Discharge Report
0.1.0 - ci-build 150

XpanDH Hospital Discharge Report, published by XpanDH Project. 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-eu/xpandh-hdr/ and changes regularly. See the Directory of published versions

Resource Profile: Xpandh Alergy Intolerance Profile

Official URL: http://hl7.eu/fhir/ig/xpandh/hdr/StructureDefinition/allergy-intolerance-xpandh Version: 0.1.0
Draft as of 2024-11-05 Computable Name: AllergyIntoleranceXpandh

Copyright/Legal: Used by permission of the XpanDH project, all rights reserved Creative Commons License

This profile represents the constraints applied to the AllergyIntolerance resource by the Xpandh Hospital Discharge Report FHIR Implementation Guide.

It documents the relevant allergies or intolerances (conditions) for a patient, describing the kind of reaction (e.g. rash, anaphylaxis,..); preferably the agents that cause it; and optionally the criticality and the certainty of the allergy.

Usage:

Formal Views of Profile Content

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

This structure is derived from AllergyIntoleranceUvIps

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance AllergyIntoleranceUvIps
... code 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient 1..1 Reference(Patient: HDR) Who the sensitivity is for

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntoleranceUvIps Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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
... Slices for extension Content/Rules for all slices
.... abatement-datetime 0..1 dateTime Abatement datetime
URL: http://hl7.org/fhir/uv/ips/StructureDefinition/abatement-dateTime-uv-ips
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code S 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
Allergy Intolerance - SNOMED CT IPS Free Set candidate
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient SΣ 1..1 Reference(Patient: HDR) Who the sensitivity is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... onset[x] S 0..1 When allergy or intolerance was identified
.... onsetDateTime dateTime
... 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..* CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Reaction - SNOMED CT IPS Free Set (preferred): Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).


.... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG
AllergyIntolerance.reaction.manifestationpreferredAllergyReactionSnomedCtIpsFreeSet
http://hl7.org/fhir/uv/ips/ValueSet/allergy-reaction-snomed-ct-ips-free-set
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf 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-4errorAllergyIntoleranceIf 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-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntoleranceUvIps Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... abatement-datetime 0..1 dateTime Abatement datetime
URL: http://hl7.org/fhir/uv/ips/StructureDefinition/abatement-dateTime-uv-ips
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

... type SΣ 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 S 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
Allergy Intolerance - SNOMED CT IPS Free Set candidate
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient SΣ 1..1 Reference(Patient: HDR) 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 SΣC 1..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
.... display Σ 0..1 string Text alternative for the resource
... 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 S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... 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 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..* CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Reaction - SNOMED CT IPS Free Set (preferred): Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).


.... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG
AllergyIntolerance.patient.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
AllergyIntolerance.reaction.substanceexampleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationpreferredAllergyReactionSnomedCtIpsFreeSet
http://hl7.org/fhir/uv/ips/ValueSet/allergy-reaction-snomed-ct-ips-free-set
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf 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-4errorAllergyIntoleranceIf 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-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from AllergyIntoleranceUvIps

Summary

Structures

This structure refers to these other structures:

Differential View

This structure is derived from AllergyIntoleranceUvIps

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance AllergyIntoleranceUvIps
... code 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient 1..1 Reference(Patient: HDR) Who the sensitivity is for

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntoleranceUvIps Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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
... Slices for extension Content/Rules for all slices
.... abatement-datetime 0..1 dateTime Abatement datetime
URL: http://hl7.org/fhir/uv/ips/StructureDefinition/abatement-dateTime-uv-ips
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code S 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
Allergy Intolerance - SNOMED CT IPS Free Set candidate
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient SΣ 1..1 Reference(Patient: HDR) Who the sensitivity is for
.... reference SΣC 1..1 string Literal reference, Relative, internal or absolute URL
... onset[x] S 0..1 When allergy or intolerance was identified
.... onsetDateTime dateTime
... 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..* CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Reaction - SNOMED CT IPS Free Set (preferred): Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).


.... 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.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG
AllergyIntolerance.reaction.manifestationpreferredAllergyReactionSnomedCtIpsFreeSet
http://hl7.org/fhir/uv/ips/ValueSet/allergy-reaction-snomed-ct-ips-free-set
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf 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-4errorAllergyIntoleranceIf 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-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntoleranceUvIps Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
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
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... abatement-datetime 0..1 dateTime Abatement datetime
URL: http://hl7.org/fhir/uv/ips/StructureDefinition/abatement-dateTime-uv-ips
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

... type SΣ 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 S 0..1 CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Intolerance - Xpandh (preferred): Type of the substance/product, allergy or intolerance condition or or a code for absent/unknown allergy.

Additional BindingsPurpose
Allergy Intolerance - SNOMED CT IPS Free Set candidate
WHO ATC - IPS candidate
Absent or Unknown Allergies - IPS candidate
... patient SΣ 1..1 Reference(Patient: HDR) 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 SΣC 1..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
.... display Σ 0..1 string Text alternative for the resource
... 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 S
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... 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 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..* CodeableConceptIPS Concept - reference to a terminology or just text
Binding: Allergy Reaction - SNOMED CT IPS Free Set (preferred): Code for the allergy or intolerance reaction manifestation from the SNOMED International Patient Set (IPS) subset of SNOMED CT (IPS Free Set).


.... 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codepreferredAllergyIntoleranceXpandhVS
http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/allergy-intolerance-xpandh-vs
from this IG
AllergyIntolerance.patient.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
AllergyIntolerance.reaction.substanceexampleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationpreferredAllergyReactionSnomedCtIpsFreeSet
http://hl7.org/fhir/uv/ips/ValueSet/allergy-reaction-snomed-ct-ips-free-set
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceAllergyIntolerance.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-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf 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-4errorAllergyIntoleranceIf 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-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from AllergyIntoleranceUvIps

Summary

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