AU Patient Summary Implementation Guide
0.5.0-cibuild - CI Build Australia flag

AU Patient Summary Implementation Guide, published by HL7 Australia. This guide is not an authorized publication; it is the continuous build for version 0.5.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7au/au-fhir-ps/ and changes regularly. See the Directory of published versions

Resource Profile: AUPSAllergyIntolerance - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the au-ps-allergyintolerance resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. AllergyIntolerance
Complies with ProfileThis profile complies with the profile
2. AllergyIntolerance.clinicalStatus
TypeCodeableConcept(Codeable Concept (IPS))
Obligations
    ObligationsActor
    SHALL:populate-if-knownAU PS Producer
    SHALL:handleAU PS Consumer
    SHOULD:displayAU PS Consumer
    4. AllergyIntolerance.verificationStatus
    TypeCodeableConcept(Codeable Concept (IPS))
    Obligations
      ObligationsActor
      SHALL:populate-if-knownAU PS Producer
      SHALL:handleAU PS Consumer
      SHOULD:displayAU PS Consumer
      6. AllergyIntolerance.type
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:populate-if-knownAU PS Producer
        SHALL:handleAU PS Consumer
        SHOULD:displayAU PS Consumer
        8. AllergyIntolerance.code
        TypeCodeableConcept(Codeable Concept (IPS))
        Obligations
          ObligationsActor
          SHALL:populate-if-knownAU PS Producer
          SHALL:handleAU PS Consumer
          SHOULD:displayAU PS Consumer
          10. AllergyIntolerance.patient
          TypeReference(AU PS Patient)
          Obligations
            ObligationsActor
            SHALL:populate-if-knownAU PS Producer
            SHALL:handleAU PS Consumer
            SHOULD:displayAU PS Consumer
            12. AllergyIntolerance.patient.reference
            Control1..?
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:populate-if-knownAU PS Producer
              SHALL:handleAU PS Consumer
              14. AllergyIntolerance.onset[x]
              TypeChoice of: dateTime, Age, Period, Range
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Obligations
                ObligationsActor
                SHALL:populate-if-knownAU PS Producer
                SHALL:handleAU PS Consumer
                SHOULD:displayAU PS Consumer
                16. AllergyIntolerance.note
                Obligations
                  ObligationsActor
                  SHALL:populate-if-knownAU PS Producer
                  SHALL:handleAU PS Consumer
                  SHOULD:displayAU PS Consumer
                  18. AllergyIntolerance.reaction
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownAU PS Producer
                    SHALL:handleAU PS Consumer
                    SHOULD:displayAU PS Consumer
                    20. AllergyIntolerance.reaction.manifestation
                    TypeCodeableConcept(Codeable Concept (IPS))
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownAU PS Producer
                      SHALL:handleAU PS Consumer
                      SHOULD:displayAU PS Consumer
                      22. AllergyIntolerance.reaction.severity
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownAU PS Producer
                        SHALL:handleAU PS Consumer
                        SHOULD:displayAU PS Consumer

                        Guidance on how to interpret the contents of this table can be foundhere

                        0. AllergyIntolerance
                        Definition

                        Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

                        ShortAn allergy or intolerance statement in an Australian healthcare contextAllergy or Intolerance (generally: Risk of adverse reaction to a substance)
                        Comments

                        Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

                        Control0..*
                        Is Modifierfalse
                        Complies with ProfileThis profile complies with the profile
                        Summaryfalse
                        Alternate NamesAllergy, Intolerance, Adverse Reaction
                        Invariantsait-1: 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: 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: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                        ait-1: 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: 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())
                        2. AllergyIntolerance.implicitRules
                        Definition

                        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                        ShortA set of rules under which this content was created
                        Comments

                        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        4. AllergyIntolerance.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        6. AllergyIntolerance.clinicalStatus
                        Definition

                        The clinical status of the allergy or intolerance.

                        Shortactive | inactive | resolved
                        Comments

                        Refer to discussion if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                        Control0..1
                        This element is affected by the following invariants: ait-1, ait-2
                        BindingThe codes SHALL be taken from AllergyIntoleranceClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
                        (required to http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1)

                        The clinical status of the allergy or intolerance.

                        TypeCodeableConcept(Codeable Concept (IPS))
                        Is Modifiertrue because This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownAU PS Producer
                          SHALL:handleAU PS Consumer
                          SHOULD:displayAU PS Consumer
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          8. AllergyIntolerance.verificationStatus
                          Definition

                          Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

                          Shortunconfirmed | confirmed | refuted | entered-in-error
                          Comments

                          The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                          Control0..1
                          This element is affected by the following invariants: ait-1, ait-2
                          BindingThe codes SHALL be taken from AllergyIntoleranceVerificationStatusCodeshttp://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
                          (required to http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1)

                          Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

                          TypeCodeableConcept(Codeable Concept (IPS))
                          Is Modifiertrue because This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownAU PS Producer
                            SHALL:handleAU PS Consumer
                            SHOULD:displayAU PS Consumer
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            10. AllergyIntolerance.type
                            Definition

                            Identification of the underlying physiological mechanism for the reaction risk.

                            Shortallergy | intolerance - Underlying mechanism (if known)
                            Comments

                            Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

                            Control0..1
                            BindingThe codes SHALL be taken from AllergyIntoleranceTypehttp://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
                            (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1)

                            Identification of the underlying physiological mechanism for a Reaction Risk.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownAU PS Producer
                              SHALL:handleAU PS Consumer
                              SHOULD:displayAU PS Consumer
                              Summarytrue
                              Alternate NamesCategory, Class
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              12. AllergyIntolerance.code
                              Definition

                              Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

                              ShortCode that identifies the allergy or intolerance
                              Comments

                              It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

                              When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

                              The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

                              Control10..1
                              BindingUnless not suitable, these codes SHALL be taken from For example codes, see Indicator of Hypersensitivity or Intolerance to Substance .http://hl7.org/fhir/ValueSet/allergyintolerance-code
                              (extensible to https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2)
                              TypeCodeableConcept(Codeable Concept (IPS))
                              Is Modifierfalse
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownAU PS Producer
                                SHALL:handleAU PS Consumer
                                SHOULD:displayAU PS Consumer
                                Summarytrue
                                Alternate NamesCode
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                14. AllergyIntolerance.patient
                                Definition

                                The patient who has the allergy or intolerance.

                                ShortWho the sensitivity is for
                                Control1..1
                                TypeReference(AU PS Patient, Patient)
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownAU PS Producer
                                  SHALL:handleAU PS Consumer
                                  SHOULD:displayAU PS Consumer
                                  Summarytrue
                                  Alternate NamesPatient
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  16. AllergyIntolerance.patient.reference
                                  Definition

                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                  ShortLiteral reference, Relative, internal or absolute URL
                                  Comments

                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                  Control10..1
                                  This element is affected by the following invariants: ref-1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownAU PS Producer
                                    SHALL:handleAU PS Consumer
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    18. AllergyIntolerance.onset[x]
                                    Definition

                                    Estimated or actual date, date-time, or age when allergy or intolerance was identified.

                                    ShortWhen allergy or intolerance was identified
                                    Control0..1
                                    TypeChoice of: dateTime, Age, Period, Range, string
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Must Support TypesdateTime
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownAU PS Producer
                                      SHALL:handleAU PS Consumer
                                      SHOULD:displayAU PS Consumer
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      20. AllergyIntolerance.note
                                      Definition

                                      Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

                                      ShortAdditional text not captured in other fields
                                      Comments

                                      For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

                                      Control0..*
                                      TypeAnnotation
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownAU PS Producer
                                        SHALL:handleAU PS Consumer
                                        SHOULD:displayAU PS Consumer
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        22. AllergyIntolerance.reaction
                                        Definition

                                        Details about each adverse reaction event linked to exposure to the identified substance.

                                        ShortAdverse Reaction Events linked to exposure to substance
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownAU PS Producer
                                          SHALL:handleAU PS Consumer
                                          SHOULD:displayAU PS Consumer
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          24. AllergyIntolerance.reaction.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          26. AllergyIntolerance.reaction.manifestation
                                          Definition

                                          Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

                                          ShortClinical symptoms/signs associated with the Event
                                          Comments

                                          Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

                                          Control1..*
                                          BindingThe codes SHOULD be taken from For example codes, see Clinical Finding .http://hl7.org/fhir/ValueSet/clinical-findings
                                          (preferred to https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1)
                                          TypeCodeableConcept(Codeable Concept (IPS))
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownAU PS Producer
                                            SHALL:handleAU PS Consumer
                                            SHOULD:displayAU PS Consumer
                                            Summaryfalse
                                            Alternate NamesSymptoms, Signs
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            28. AllergyIntolerance.reaction.severity
                                            Definition

                                            Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

                                            Shortmild | moderate | severe (of event as a whole)
                                            Comments

                                            It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

                                            Control0..1
                                            BindingThe codes SHALL be taken from AllergyIntoleranceSeverityhttp://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
                                            (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1)

                                            Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

                                            Typecode
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownAU PS Producer
                                              SHALL:handleAU PS Consumer
                                              SHOULD:displayAU PS Consumer
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                              Guidance on how to interpret the contents of this table can be foundhere

                                              0. AllergyIntolerance
                                              Definition

                                              Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

                                              ShortAn allergy or intolerance statement in an Australian healthcare context
                                              Comments

                                              Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

                                              Control0..*
                                              Is Modifierfalse
                                              Complies with ProfileThis profile complies with the profile
                                              Summaryfalse
                                              Alternate NamesAllergy, Intolerance, Adverse Reaction
                                              Invariantsait-1: 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: 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: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                              dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                              dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                              2. AllergyIntolerance.id
                                              Definition

                                              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                              ShortLogical id of this artifact
                                              Comments

                                              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                              Control0..1
                                              Typeid
                                              Is Modifierfalse
                                              Summarytrue
                                              4. AllergyIntolerance.meta
                                              Definition

                                              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                              ShortMetadata about the resource
                                              Control0..1
                                              TypeMeta
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              6. AllergyIntolerance.implicitRules
                                              Definition

                                              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                              ShortA set of rules under which this content was created
                                              Comments

                                              Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                              Control0..1
                                              Typeuri
                                              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              8. AllergyIntolerance.language
                                              Definition

                                              The base language in which the resource is written.

                                              ShortLanguage of the resource content
                                              Comments

                                              Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                              Control0..1
                                              BindingThe codes SHOULD be taken from CommonLanguages
                                              (preferred to http://hl7.org/fhir/ValueSet/languages)

                                              A human language.

                                              Additional BindingsPurpose
                                              AllLanguagesMax Binding
                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              10. AllergyIntolerance.text
                                              Definition

                                              A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                              ShortText summary of the resource, for human interpretation
                                              Comments

                                              Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                              Control0..1
                                              TypeNarrative
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesnarrative, html, xhtml, display
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              12. AllergyIntolerance.contained
                                              Definition

                                              These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                              ShortContained, inline Resources
                                              Comments

                                              This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                              Control0..*
                                              TypeResource
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesinline resources, anonymous resources, contained resources
                                              14. AllergyIntolerance.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              16. AllergyIntolerance.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                              Summaryfalse
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              18. AllergyIntolerance.identifier
                                              Definition

                                              Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                                              ShortExternal ids for this item
                                              Comments

                                              This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                              Control0..*
                                              TypeIdentifier
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              20. AllergyIntolerance.clinicalStatus
                                              Definition

                                              The clinical status of the allergy or intolerance.

                                              Shortactive | inactive | resolved
                                              Comments

                                              Refer to discussion if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                                              Control0..1
                                              This element is affected by the following invariants: ait-1, ait-2
                                              BindingThe codes SHALL be taken from AllergyIntoleranceClinicalStatusCodes
                                              (required to http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1)

                                              The clinical status of the allergy or intolerance.

                                              TypeCodeableConcept(Codeable Concept (IPS))
                                              Is Modifiertrue because This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownAU PS Producer
                                                SHALL:handleAU PS Consumer
                                                SHOULD:displayAU PS Consumer
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                22. AllergyIntolerance.verificationStatus
                                                Definition

                                                Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

                                                Shortunconfirmed | confirmed | refuted | entered-in-error
                                                Comments

                                                The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                                                Control0..1
                                                This element is affected by the following invariants: ait-1, ait-2
                                                BindingThe codes SHALL be taken from AllergyIntoleranceVerificationStatusCodes
                                                (required to http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1)

                                                Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

                                                TypeCodeableConcept(Codeable Concept (IPS))
                                                Is Modifiertrue because This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownAU PS Producer
                                                  SHALL:handleAU PS Consumer
                                                  SHOULD:displayAU PS Consumer
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  24. AllergyIntolerance.type
                                                  Definition

                                                  Identification of the underlying physiological mechanism for the reaction risk.

                                                  Shortallergy | intolerance - Underlying mechanism (if known)
                                                  Comments

                                                  Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from AllergyIntoleranceType
                                                  (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1)

                                                  Identification of the underlying physiological mechanism for a Reaction Risk.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownAU PS Producer
                                                    SHALL:handleAU PS Consumer
                                                    SHOULD:displayAU PS Consumer
                                                    Summarytrue
                                                    Alternate NamesCategory, Class
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    26. AllergyIntolerance.category
                                                    Definition

                                                    Category of the identified substance.

                                                    Shortfood | medication | environment | biologic
                                                    Comments

                                                    This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

                                                    Control0..*
                                                    BindingThe codes SHALL be taken from AllergyIntoleranceCategory
                                                    (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1)

                                                    Category of an identified substance associated with allergies or intolerances.

                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Alternate NamesCategory, Type, Reaction Type, Class
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    28. AllergyIntolerance.criticality
                                                    Definition

                                                    Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.

                                                    Shortlow | high | unable-to-assess
                                                    Comments

                                                    The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

                                                    Control0..1
                                                    BindingThe codes SHALL be taken from AllergyIntoleranceCriticality
                                                    (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1)

                                                    Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Alternate NamesSeverity, Seriousness, Contra-indication, Risk
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    30. AllergyIntolerance.code
                                                    Definition

                                                    Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

                                                    ShortCode that identifies the allergy or intolerance
                                                    Comments

                                                    It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

                                                    When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

                                                    The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

                                                    Control1..1
                                                    BindingUnless not suitable, these codes SHALL be taken from Indicator of Hypersensitivity or Intolerance to Substance .
                                                    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2)
                                                    TypeCodeableConcept(Codeable Concept (IPS))
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populate-if-knownAU PS Producer
                                                      SHALL:handleAU PS Consumer
                                                      SHOULD:displayAU PS Consumer
                                                      Summarytrue
                                                      Alternate NamesCode
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      32. AllergyIntolerance.patient
                                                      Definition

                                                      The patient who has the allergy or intolerance.

                                                      ShortWho the sensitivity is for
                                                      Control1..1
                                                      TypeReference(AU PS Patient)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-knownAU PS Producer
                                                        SHALL:handleAU PS Consumer
                                                        SHOULD:displayAU PS Consumer
                                                        Summarytrue
                                                        Alternate NamesPatient
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        34. AllergyIntolerance.patient.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        36. AllergyIntolerance.patient.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on AllergyIntolerance.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 38. AllergyIntolerance.patient.reference
                                                          Definition

                                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                          Comments

                                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                          Control1..1
                                                          This element is affected by the following invariants: ref-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populate-if-knownAU PS Producer
                                                            SHALL:handleAU PS Consumer
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            40. AllergyIntolerance.patient.type
                                                            Definition

                                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                            ShortType the reference refers to (e.g. "Patient")
                                                            Comments

                                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                            Control0..1
                                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                            Aa resource (or, for logical models, the URI of the logical model).

                                                            Typeuri
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            42. AllergyIntolerance.patient.identifier
                                                            Definition

                                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                            ShortLogical reference, when literal reference is not known
                                                            Comments

                                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                                            Control0..1
                                                            TypeIdentifier
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            44. AllergyIntolerance.patient.display
                                                            Definition

                                                            Plain text narrative that identifies the resource in addition to the resource reference.

                                                            ShortText alternative for the resource
                                                            Comments

                                                            This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            46. AllergyIntolerance.encounter
                                                            Definition

                                                            The encounter when the allergy or intolerance was asserted.

                                                            ShortEncounter when the allergy or intolerance was asserted
                                                            Control0..1
                                                            TypeReference(Encounter)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            48. AllergyIntolerance.onset[x]
                                                            Definition

                                                            Estimated or actual date, date-time, or age when allergy or intolerance was identified.

                                                            ShortWhen allergy or intolerance was identified
                                                            Control0..1
                                                            TypeChoice of: dateTime, Age, Period, Range
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supporttrue
                                                            Must Support TypesdateTime
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populate-if-knownAU PS Producer
                                                              SHALL:handleAU PS Consumer
                                                              SHOULD:displayAU PS Consumer
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              50. AllergyIntolerance.recordedDate
                                                              Definition

                                                              The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.

                                                              ShortDate first version of the resource instance was recorded
                                                              Control0..1
                                                              TypedateTime
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              52. AllergyIntolerance.recorder
                                                              Definition

                                                              Individual who recorded the record and takes responsibility for its content.

                                                              ShortWho recorded the sensitivity
                                                              Control0..1
                                                              TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate NamesAuthor
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              54. AllergyIntolerance.asserter
                                                              Definition

                                                              The source of the information about the allergy that is recorded.

                                                              ShortSource of the information about the allergy
                                                              Comments

                                                              The recorder takes responsibility for the content, but can reference the source from where they got it.

                                                              Control0..1
                                                              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                                                              Is Modifierfalse
                                                              Summarytrue
                                                              Alternate NamesSource, Informant
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              56. AllergyIntolerance.lastOccurrence
                                                              Definition

                                                              Represents the date and/or time of the last known occurrence of a reaction event.

                                                              ShortDate(/time) of last known occurrence of a reaction
                                                              Comments

                                                              This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

                                                              Control0..1
                                                              TypedateTime
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              58. AllergyIntolerance.note
                                                              Definition

                                                              Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

                                                              ShortAdditional text not captured in other fields
                                                              Comments

                                                              For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

                                                              Control0..*
                                                              TypeAnnotation
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:populate-if-knownAU PS Producer
                                                                SHALL:handleAU PS Consumer
                                                                SHOULD:displayAU PS Consumer
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                60. AllergyIntolerance.reaction
                                                                Definition

                                                                Details about each adverse reaction event linked to exposure to the identified substance.

                                                                ShortAdverse Reaction Events linked to exposure to substance
                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:populate-if-knownAU PS Producer
                                                                  SHALL:handleAU PS Consumer
                                                                  SHOULD:displayAU PS Consumer
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  62. AllergyIntolerance.reaction.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  64. AllergyIntolerance.reaction.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  66. AllergyIntolerance.reaction.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  68. AllergyIntolerance.reaction.substance
                                                                  Definition

                                                                  Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

                                                                  ShortSpecific substance or pharmaceutical product considered to be responsible for event
                                                                  Comments

                                                                  Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

                                                                  Control0..1
                                                                  BindingThe codes SHOULD be taken from Adverse Reaction Agent .
                                                                  (preferred to https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  70. AllergyIntolerance.reaction.manifestation
                                                                  Definition

                                                                  Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

                                                                  ShortClinical symptoms/signs associated with the Event
                                                                  Comments

                                                                  Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

                                                                  Control1..*
                                                                  BindingThe codes SHOULD be taken from Clinical Finding .
                                                                  (preferred to https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1)
                                                                  TypeCodeableConcept(Codeable Concept (IPS))
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-knownAU PS Producer
                                                                    SHALL:handleAU PS Consumer
                                                                    SHOULD:displayAU PS Consumer
                                                                    Summaryfalse
                                                                    Alternate NamesSymptoms, Signs
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    72. AllergyIntolerance.reaction.description
                                                                    Definition

                                                                    Text description about the reaction as a whole, including details of the manifestation if required.

                                                                    ShortDescription of the event as a whole
                                                                    Comments

                                                                    Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Alternate NamesNarrative, Text
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    74. AllergyIntolerance.reaction.onset
                                                                    Definition

                                                                    Record of the date and/or time of the onset of the Reaction.

                                                                    ShortDate(/time) when manifestations showed
                                                                    Control0..1
                                                                    TypedateTime
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    76. AllergyIntolerance.reaction.severity
                                                                    Definition

                                                                    Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

                                                                    Shortmild | moderate | severe (of event as a whole)
                                                                    Comments

                                                                    It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

                                                                    Control0..1
                                                                    BindingThe codes SHALL be taken from AllergyIntoleranceSeverity
                                                                    (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1)

                                                                    Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

                                                                    Typecode
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:populate-if-knownAU PS Producer
                                                                      SHALL:handleAU PS Consumer
                                                                      SHOULD:displayAU PS Consumer
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      78. AllergyIntolerance.reaction.exposureRoute
                                                                      Definition

                                                                      Identification of the route by which the subject was exposed to the substance.

                                                                      ShortHow the subject was exposed to the substance
                                                                      Comments

                                                                      Coding of the route of exposure with a terminology should be used wherever possible.

                                                                      Control0..1
                                                                      BindingThe codes SHOULD be taken from Route of Administration .
                                                                      (preferred to https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1)
                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      80. AllergyIntolerance.reaction.note
                                                                      Definition

                                                                      Additional text about the adverse reaction event not captured in other fields.

                                                                      ShortText about event not captured in other fields
                                                                      Comments

                                                                      Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

                                                                      Control0..*
                                                                      TypeAnnotation
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))