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

AU Core Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-core/ and changes regularly. See the Directory of published versions

Resource Profile: AU Core AllergyIntolerance

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance Version: 1.0.0-ci-build
Standards status: Draft Maturity Level: 1 Computable Name: AUCoreAllergyIntolerance

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

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

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

Usage scenarios

The following are supported usage scenarios for this profile:

  • Query for a patient’s allergies/adverse reactions
  • Record or update a patient’s allergies/adverse reactions

Profile specific implementation guidance

  • To represent that a patient does not have an allergy or category of allergies, an appropriate negation code (e.g. 716186003 |No known allergy| or 716184000 |No known latex allergy|) is used in AllergyIntolerance.code
  • The use of coding can vary significantly across systems, requesters need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Responders SHOULD populate AllergyIntolerance.code.text and/or AllergyIntolerance.code.coding.display so that requesters can at least display the condition even if the requester does not recognise the code supplied.
  • Refutation is not expected to be handled except as above - an appropriate negation code in AllergyIntolerance.code and AllergyIntolerance.verificationStatus of “confirmed” or “unconfirmed”
  • Where only substance is known (e.g. 111088007 |Latex|) and not a statement of allergy or intolerance (e.g. 300916003 |Allergy to latex|), the substance is sent in AllergyIntolerance.code

Usage:

Changes since version 1.0.0-ballot:

  • No changes
  • Formal Views of Profile Content

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

    This structure is derived from AUBaseAllergyIntolerance

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

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    AllergyIntolerance.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. AllergyIntolerance C 0..* AUBaseAllergyIntolerance An allergy or intolerance statement in an Australian healthcare context
    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
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... clinicalStatus ?!SOΣC 0..1 CodeableConcept active | inactive | resolved
    Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... code SOΣ 1..1 CodeableConcept Code that identifies the allergy or intolerance
    Binding: Indicator of Hypersensitivity or Intolerance to Substance . (extensible)
    Additional BindingsPurpose
    Adverse Reaction Substances and Negated Findings . candidate
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... patient SOΣ 1..1 Reference(AU Core Patient) Who the sensitivity is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... onset[x] SO 0..1 When allergy or intolerance was identified
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... onsetDateTime dateTime
    .... onsetAge Age
    .... onsetPeriod Period
    .... onsetRange Range
    ... reaction SO 0..* BackboneElement Adverse Reaction Events linked to exposure to substance
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... manifestation SO 1..* CodeableConcept Clinical symptoms/signs associated with the Event
    Binding: Clinical Finding . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... severity SO 0..1 code mild | moderate | severe (of event as a whole)
    Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    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.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
    AllergyIntolerance.reaction.manifestationpreferredClinicalFinding .
    https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1
    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..* AUBaseAllergyIntolerance An allergy or intolerance statement in an Australian healthcare context
    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
    ... 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 ?!SOΣC 0..1 CodeableConcept active | inactive | resolved
    Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... verificationStatus ?!SOΣC 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.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... type Σ 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 SOΣ 1..1 CodeableConcept Code that identifies the allergy or intolerance
    Binding: Indicator of Hypersensitivity or Intolerance to Substance . (extensible)
    Additional BindingsPurpose
    Adverse Reaction Substances and Negated Findings . candidate
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... patient SOΣ 1..1 Reference(AU Core Patient) Who the sensitivity is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
    ... onset[x] SO 0..1 When allergy or intolerance was identified
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... onsetDateTime dateTime
    .... onsetAge Age
    .... onsetPeriod Period
    .... onsetRange Range
    ... 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 SO 0..* BackboneElement Adverse Reaction Events linked to exposure to substance
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... 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: Adverse Reaction Agent . (preferred)
    .... manifestation SO 1..* CodeableConcept Clinical symptoms/signs associated with the Event
    Binding: Clinical Finding . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... description 0..1 string Description of the event as a whole
    .... onset 0..1 dateTime Date(/time) when manifestations showed
    .... severity SO 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.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
    Binding: Route of Administration . (preferred)
    .... 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.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
    AllergyIntolerance.reaction.substancepreferredAdverseReactionAgent .
    https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1
    AllergyIntolerance.reaction.manifestationpreferredClinicalFinding .
    https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1
    AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
    http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
    from the FHIR Standard
    AllergyIntolerance.reaction.exposureRoutepreferredRouteOfAdministration .
    https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1

    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 AUBaseAllergyIntolerance

    Summary

    Mandatory: 1 element
    Must-Support: 8 elements

    Structures

    This structure refers to these other structures:

    Maturity: 1

    Differential View

    This structure is derived from AUBaseAllergyIntolerance

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

    doco Documentation for this format

    Terminology Bindings (Differential)

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

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. AllergyIntolerance C 0..* AUBaseAllergyIntolerance An allergy or intolerance statement in an Australian healthcare context
    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
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... clinicalStatus ?!SOΣC 0..1 CodeableConcept active | inactive | resolved
    Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... code SOΣ 1..1 CodeableConcept Code that identifies the allergy or intolerance
    Binding: Indicator of Hypersensitivity or Intolerance to Substance . (extensible)
    Additional BindingsPurpose
    Adverse Reaction Substances and Negated Findings . candidate
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... patient SOΣ 1..1 Reference(AU Core Patient) Who the sensitivity is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... onset[x] SO 0..1 When allergy or intolerance was identified
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... onsetDateTime dateTime
    .... onsetAge Age
    .... onsetPeriod Period
    .... onsetRange Range
    ... reaction SO 0..* BackboneElement Adverse Reaction Events linked to exposure to substance
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... manifestation SO 1..* CodeableConcept Clinical symptoms/signs associated with the Event
    Binding: Clinical Finding . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... severity SO 0..1 code mild | moderate | severe (of event as a whole)
    Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    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.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
    AllergyIntolerance.reaction.manifestationpreferredClinicalFinding .
    https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1
    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..* AUBaseAllergyIntolerance An allergy or intolerance statement in an Australian healthcare context
    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
    ... 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 ?!SOΣC 0..1 CodeableConcept active | inactive | resolved
    Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... verificationStatus ?!SOΣC 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.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... type Σ 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 SOΣ 1..1 CodeableConcept Code that identifies the allergy or intolerance
    Binding: Indicator of Hypersensitivity or Intolerance to Substance . (extensible)
    Additional BindingsPurpose
    Adverse Reaction Substances and Negated Findings . candidate
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... patient SOΣ 1..1 Reference(AU Core Patient) Who the sensitivity is for
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    ... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
    ... onset[x] SO 0..1 When allergy or intolerance was identified
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... onsetDateTime dateTime
    .... onsetAge Age
    .... onsetPeriod Period
    .... onsetRange Range
    ... 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 SO 0..* BackboneElement Adverse Reaction Events linked to exposure to substance
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... 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: Adverse Reaction Agent . (preferred)
    .... manifestation SO 1..* CodeableConcept Clinical symptoms/signs associated with the Event
    Binding: Clinical Finding . (preferred)
    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... description 0..1 string Description of the event as a whole
    .... onset 0..1 dateTime Date(/time) when manifestations showed
    .... severity SO 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.

    ObligationsActor
    SHALL:populate-if-known AU Core Responder
    SHALL:no-error AU Core Requester
    .... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
    Binding: Route of Administration . (preferred)
    .... 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.codeextensibleIndicatorOfHypersensitivityOrIntoleranceToSubstance .
    https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2
    AllergyIntolerance.reaction.substancepreferredAdverseReactionAgent .
    https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1
    AllergyIntolerance.reaction.manifestationpreferredClinicalFinding .
    https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1
    AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
    http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
    from the FHIR Standard
    AllergyIntolerance.reaction.exposureRoutepreferredRouteOfAdministration .
    https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1

    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 AUBaseAllergyIntolerance

    Summary

    Mandatory: 1 element
    Must-Support: 8 elements

    Structures

    This structure refers to these other structures:

    Maturity: 1

     

    Other representations of profile: CSV, Excel, Schematron

    Notes:

    Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

    FHIR search operations are described here and the syntax used to describe AU Core interactions is defined here.

    Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

    Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
    patient SHALL reference The requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both.
    patient+clinical-status SHOULD reference+token
    patient.identifier SHOULD reference.token The requester SHALL provide both the system and code values. The responder SHALL support both.

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

    Mandatory Search Parameters

    The following search parameters and search parameter combinations SHALL be supported:

    1. SHALL support searching using the patient search parameter:
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

      GET [base]/AllergyIntolerance?patient={Type/}[id] or optionally GET [base]/AllergyIntolerance?patient.identifier=[system|][code]

      Example:

      1. GET [base]/AllergyIntolerance?patient=5678
      2. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
      3. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

      Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient (how to search by reference and how to search by token)

    Optional Search Parameters

    The following search parameters and search parameter combinations SHOULD be supported:

    1. SHOULD support searching using the combination of the patient and clinical-status search parameters:
      • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

      GET [base]/AllergyIntolerance?patient={Type/}[id]&clinical-status={system|}[code]{,{system|}[code],...}

      Example:

      1. GET [base]/AllergyIntolerance?patient=5678&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical|active

      Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient and status (how to search by reference and how to search by token)