Canadian Core
0.1.0 - CI Build

Canadian Core, published by Canadian FHIR Implementor Working Group. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/scratch-fhir-profiles/CA-Core/ and changes regularly. See the Directory of published versions

Resource Profile: AllergyIntolerance Profile

Defining URL:http://hl7.org/fhir/ca/core/StructureDefinition/profile-allergyintolerance
Version:0.1.0
Name:AllergyIntoleranceProfile
Title:AllergyIntolerance Profile
Status:Draft as of 2020-09-08
Definition:

Proposed constraints and extensions on the AllergyIntolerance Resource

Publisher:Canadian FHIR Implementor Working Group
Source Resource:XML / JSON / Turtle

The official URL for this profile is:

http://hl7.org/fhir/ca/core/StructureDefinition/profile-allergyintolerance

CA Baseline AllergyIntolerance Profile

This profile sets minimum expectations for the AllergyIntolerance resource to record, search and fetch allergies/adverse reactions associated with a patient. It documents the relevant allergies or intolerances (conditions) for a patient, describing the kind of reaction, agent(s) that cause it, criticality and the certainty of the allergy/adverse reaction.

This profile defines localization concepts for use in the Canadian context.

Mandatory Data Elements

All elements or attributes within the FHIR specification have cardinality as part of their definition - a minimum number of required appearances and a maximum number of allowable appearances.

Most elements in the FHIR specification have a minimum cardinality of 0, so most elements are not required and subsequently they may be missing from a resource when it is exchanged between systems.

Required elements in the AllergyIntolerance profile:

  • subject who has the allergy or intolerance (AllergyIntolerance.patient)

Must Support Data Elements

Some elements are marked as Must Support. This means that implementations generating, receiving, or otherwise using resources with Must Support elements SHALL provide support for those elements in some meaningful way (see Must Support definition).

The following elements are marked as Must Support in the AllergyIntolerance profile:

Must Support elements:

  • identifier
  • clinical status of the allergy or intolerance (AllergyIntolerance.clinicalStatus)
  • verification status (AllergyIntolerance.verificationStatus)
  • code of the allergy or intolerance (AllergyIntolerance.code)
  • reference to a subject (AllergyIntolerance.patient)
  • reaction to the allergy or intolerance (AllergyIntolerance.reaction)
  • substance that caused the adverse reaction event (AllergyIntolerance.reaction.substance)
  • manifestation of clinical symptoms (AllergyIntolerance.reaction.manifestation)
  • severity of the reaction event (AllergyIntolerance.reaction.severity)

Usage Note

The AllergyIntolerance resource instance use could be clinical decision support applications to generate/display warnings about potentially harmful medications; any intolerance to other agents (e.g. intolerance to soaps, dressings, latex, etc.) more relevant for at the bedside care.

Profile specific implementation guidance

History of Allergy or Intolerance

If the patient has been asked and has indicated a history of allergy or intolerance then this information is represented by:

  • AllergyIntolerance.code - an appropriate SNOMED CT code
  • AllergyIntolerance.verificationStatus element SHALL be one of the following: confirmed refuted entered-in-error

If a patient asserts a history of allergy or intolerance then the following elements SHOULD be populated:

  • AllergyIntolerance.criticality
  • AllergyIntolerance.severity
  • AllergyIntolerance.type

No Allergy

If a patient has been asked and has indicated no history of allergies or intolerance then this is represented by:

  • AllergyIntolerance.code = “716186003” No known allergy (situation) SNOMED CT code
  • AllergyIntolerance.verificationStatus element SHALL be one of the following: confirmed refuted entered-in-error

Not Asked

If the patient has NOT been asked or it is NOT possible to obtain information about any history of allergy or intolerance then this situation is represented with NullFlavor codes:

  • AllergyIntolerance.code - NullFalvor code, e.g., “NASK” (Not asked).

If NullFlavor is used then the following elements SHOULD NOT be populated:

  • AllergyIntolerance.clinicalStatus
  • AllergyIntolerance.verificationStatus
  • AllergyIntolerance.type
  • AllergyIntolerance.category
  • AllergyIntolerance.criticality

and other allergy related elements.

Formal Views of Profile Content

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

This structure is derived from AllergyIntolerance

Summary

Mandatory: 0 element (14 nested mandatory elements)
Must-Support: 16 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element AllergyIntolerance.verificationStatus.coding is sliced based on the value of value:system (Closed)
  • The element AllergyIntolerance.code.coding is sliced based on the value of value:system (Closed)
  • The element AllergyIntolerance.reaction.substance.coding is sliced based on the value of value:system (Closed)

This structure is derived from AllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AllergyIntoleranceAllergyIntolerance Profile
... identifier S0..*IdentifierExternal ids for this item
... clinicalStatus ?!S0..1CodeableConceptactive | inactive | resolved
... verificationStatus ?!S0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:StatusCode 0..1CodingCode for allergy or intolerance status
Binding: https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (preferred): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
..... coding:@default 1..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

...... system 1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
...... code 1..1codeSymbol in syntax defined by the system
... category S0..*codefood | medication | environment | biologic
... criticality S0..1codelow | high | unable-to-assess
... code SI0..1CodeableConceptCode that identifies the allergy or intolerance
ca-core-allergy: AllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:NotAsked I0..1CodingCode for NOT asked or NOT possible to obtain information about allergy or intolerance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor (preferred): Negation/exclusion codes for reporting no known allergies or not available data.


ca-core-allergy-notasked: if AllergyIntolerance.code is a NullFlavor value, then AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, AllergyIntolerance.type, AllergyIntolerance.category, AllergyIntolerance.criticality SHALL NOT be present
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/NullFlavor
...... code 1..1codeSymbol in syntax defined by the system
..... coding:NoAllergy I0..1CodingCode when a patient has been asked and has indicated no history of allergies or intolerance
Binding: http://snomed.info/sct (required): Negation/exclusion codes for reporting no known allergies


ca-core-allergy-noallergy: if AllergyIntolerance.code is '716186003' No known allergy, then AllergyIntolerance.verificationStatus SHALL be one of the following: confirmed | refuted | entered-in-error
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 716186003
..... coding:@default 0..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition.

... patient S1..1Reference(Patient Profile)Who the sensitivity is for
... encounter 0..1Reference(Encounter Profile)Encounter when the allergy or intolerance was asserted
... onsetDateTime:onsetDateTime S0..1dateTimeWhen allergy or intolerance was identified
... recorder 0..1Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Patient Profile)Who recorded the sensitivity
... asserter 0..1Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General))Source of the information about the allergy
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
..... coding S1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
...... coding:NonDrugAllergen 0..*CodingCode for the specific non-drug allergen
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NonDrugAllergenCode (preferred): Represents the specific non-drug allergen or other agent/substance to which the Client has an allergic reaction.

....... system 1..1uriIdentity of the terminology system
....... code 1..1codeSymbol in syntax defined by the system
...... coding:CCDD 0..*CodingMedicinal products for prescribing
Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): Represents subset of codes with commonly used medicinal products that are available for prescribing and dispensing in Canada.

....... system 1..1uriIdentity of the terminology system
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset
....... code 1..1codeSymbol in syntax defined by the system
...... coding:@default 0..*CodingSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
.... severity S0..1codemild | moderate | severe (of event as a whole)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/RouteOfAdministration (preferred): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.


doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AllergyIntoleranceAllergyIntolerance Profile
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierExternal ids for this item
... clinicalStatus ?!SΣI0..1CodeableConceptactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:StatusCode Σ0..1CodingCode for allergy or intolerance status
Binding: https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (preferred): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.


...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:@default Σ1..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.


...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... type SΣ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣI0..1CodeableConceptCode that identifies the allergy or intolerance
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.


ca-core-allergy: AllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:NotAsked ΣI0..1CodingCode for NOT asked or NOT possible to obtain information about allergy or intolerance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor (preferred): Negation/exclusion codes for reporting no known allergies or not available data.


ca-core-allergy-notasked: if AllergyIntolerance.code is a NullFlavor value, then AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, AllergyIntolerance.type, AllergyIntolerance.category, AllergyIntolerance.criticality SHALL NOT be present
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/NullFlavor
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:NoAllergy ΣI0..1CodingCode when a patient has been asked and has indicated no history of allergies or intolerance
Binding: http://snomed.info/sct (required): Negation/exclusion codes for reporting no known allergies


ca-core-allergy-noallergy: if AllergyIntolerance.code is '716186003' No known allergy, then AllergyIntolerance.verificationStatus SHALL be one of the following: confirmed | refuted | entered-in-error
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 716186003
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:@default Σ0..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition.


.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(Patient Profile)Who the sensitivity is for
... encounter 0..1Reference(Encounter Profile)Encounter when the allergy or intolerance was asserted
... onset[x] 0..1(Slice Definition)When allergy or intolerance was identified
Slice: Unordered, Closed by type:$this
.... onset[x]:onsetDateTime S0..1dateTimeWhen allergy or intolerance was identified
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded
... recorder 0..1Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Patient Profile)Who recorded the sensitivity
... asserter Σ0..1Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General))Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
...... coding:NonDrugAllergen Σ0..*CodingCode for the specific non-drug allergen
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NonDrugAllergenCode (preferred): Represents the specific non-drug allergen or other agent/substance to which the Client has an allergic reaction.


....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:CCDD Σ0..*CodingMedicinal products for prescribing
Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): Represents subset of codes with commonly used medicinal products that are available for prescribing and dispensing in Canada.


....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:@default Σ0..*CodingSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).


..... text Σ0..1stringPlain text representation of the concept
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/RouteOfAdministration (preferred): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AllergyIntoleranceAllergyIntolerance Profile
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!ΣI0..1CodeableConceptactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!ΣI0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

.... coding Σ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
... category Σ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code ΣI0..1CodeableConceptCode that identifies the allergy or intolerance
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.


ca-core-allergy: AllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
.... coding Σ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
... patient Σ1..1Reference(Patient Profile)Who the sensitivity is for
... onset[x]:onsetDateTime 0..1dateTimeWhen allergy or intolerance was identified
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

..... coding Σ1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... severity 0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.


doco Documentation for this format

This structure is derived from AllergyIntolerance

Summary

Mandatory: 0 element (14 nested mandatory elements)
Must-Support: 16 elements
Fixed Value: 5 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element AllergyIntolerance.verificationStatus.coding is sliced based on the value of value:system (Closed)
  • The element AllergyIntolerance.code.coding is sliced based on the value of value:system (Closed)
  • The element AllergyIntolerance.reaction.substance.coding is sliced based on the value of value:system (Closed)

Differential View

This structure is derived from AllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AllergyIntoleranceAllergyIntolerance Profile
... identifier S0..*IdentifierExternal ids for this item
... clinicalStatus ?!S0..1CodeableConceptactive | inactive | resolved
... verificationStatus ?!S0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:StatusCode 0..1CodingCode for allergy or intolerance status
Binding: https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (preferred): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
..... coding:@default 1..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

...... system 1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
...... code 1..1codeSymbol in syntax defined by the system
... category S0..*codefood | medication | environment | biologic
... criticality S0..1codelow | high | unable-to-assess
... code SI0..1CodeableConceptCode that identifies the allergy or intolerance
ca-core-allergy: AllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
.... coding S0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:NotAsked I0..1CodingCode for NOT asked or NOT possible to obtain information about allergy or intolerance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor (preferred): Negation/exclusion codes for reporting no known allergies or not available data.


ca-core-allergy-notasked: if AllergyIntolerance.code is a NullFlavor value, then AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, AllergyIntolerance.type, AllergyIntolerance.category, AllergyIntolerance.criticality SHALL NOT be present
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/NullFlavor
...... code 1..1codeSymbol in syntax defined by the system
..... coding:NoAllergy I0..1CodingCode when a patient has been asked and has indicated no history of allergies or intolerance
Binding: http://snomed.info/sct (required): Negation/exclusion codes for reporting no known allergies


ca-core-allergy-noallergy: if AllergyIntolerance.code is '716186003' No known allergy, then AllergyIntolerance.verificationStatus SHALL be one of the following: confirmed | refuted | entered-in-error
...... system 1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... code 1..1codeSymbol in syntax defined by the system
Fixed Value: 716186003
..... coding:@default 0..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition.

... patient S1..1Reference(Patient Profile)Who the sensitivity is for
... encounter 0..1Reference(Encounter Profile)Encounter when the allergy or intolerance was asserted
... onsetDateTime:onsetDateTime S0..1dateTimeWhen allergy or intolerance was identified
... recorder 0..1Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Patient Profile)Who recorded the sensitivity
... asserter 0..1Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General))Source of the information about the allergy
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
..... coding S1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
...... coding:NonDrugAllergen 0..*CodingCode for the specific non-drug allergen
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NonDrugAllergenCode (preferred): Represents the specific non-drug allergen or other agent/substance to which the Client has an allergic reaction.

....... system 1..1uriIdentity of the terminology system
....... code 1..1codeSymbol in syntax defined by the system
...... coding:CCDD 0..*CodingMedicinal products for prescribing
Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): Represents subset of codes with commonly used medicinal products that are available for prescribing and dispensing in Canada.

....... system 1..1uriIdentity of the terminology system
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset
....... code 1..1codeSymbol in syntax defined by the system
...... coding:@default 0..*CodingSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
.... severity S0..1codemild | moderate | severe (of event as a whole)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/RouteOfAdministration (preferred): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.


doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*AllergyIntoleranceAllergyIntolerance Profile
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..*IdentifierExternal ids for this item
... clinicalStatus ?!SΣI0..1CodeableConceptactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:StatusCode Σ0..1CodingCode for allergy or intolerance status
Binding: https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (preferred): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.


...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:@default Σ1..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.


...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... type SΣ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣI0..1CodeableConceptCode that identifies the allergy or intolerance
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.


ca-core-allergy: AllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ0..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
..... coding:NotAsked ΣI0..1CodingCode for NOT asked or NOT possible to obtain information about allergy or intolerance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor (preferred): Negation/exclusion codes for reporting no known allergies or not available data.


ca-core-allergy-notasked: if AllergyIntolerance.code is a NullFlavor value, then AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, AllergyIntolerance.type, AllergyIntolerance.category, AllergyIntolerance.criticality SHALL NOT be present
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v3/NullFlavor
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:NoAllergy ΣI0..1CodingCode when a patient has been asked and has indicated no history of allergies or intolerance
Binding: http://snomed.info/sct (required): Negation/exclusion codes for reporting no known allergies


ca-core-allergy-noallergy: if AllergyIntolerance.code is '716186003' No known allergy, then AllergyIntolerance.verificationStatus SHALL be one of the following: confirmed | refuted | entered-in-error
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 716186003
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... coding:@default Σ0..1CodingCode defined by a terminology system
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (example): Type of the substance/product, allergy or intolerance condition.


.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(Patient Profile)Who the sensitivity is for
... encounter 0..1Reference(Encounter Profile)Encounter when the allergy or intolerance was asserted
... onset[x] 0..1(Slice Definition)When allergy or intolerance was identified
Slice: Unordered, Closed by type:$this
.... onset[x]:onsetDateTime S0..1dateTimeWhen allergy or intolerance was identified
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded
... recorder 0..1Reference(Practitioner Profile (General) | PractitionerRole Profile (General) | Patient Profile)Who recorded the sensitivity
... asserter Σ0..1Reference(Patient Profile | Practitioner Profile (General) | PractitionerRole Profile (General))Source of the information about the allergy
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction
... note 0..*AnnotationAdditional text not captured in other fields
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Closed by value:system
...... coding:NonDrugAllergen Σ0..*CodingCode for the specific non-drug allergen
Binding: https://fhir.infoway-inforoute.ca/ValueSet/NonDrugAllergenCode (preferred): Represents the specific non-drug allergen or other agent/substance to which the Client has an allergic reaction.


....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:CCDD Σ0..*CodingMedicinal products for prescribing
Binding: https://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct (preferred): Represents subset of codes with commonly used medicinal products that are available for prescribing and dispensing in Canada.


....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/canadianclinicaldrugdataset
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:@default Σ0..*CodingSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).


..... text Σ0..1stringPlain text representation of the concept
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: https://fhir.infoway-inforoute.ca/ValueSet/RouteOfAdministration (preferred): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.languagepreferredCommonLanguages
Max Binding: AllLanguages
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.verificationStatus.coding:StatusCodepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode
AllergyIntolerance.verificationStatus.coding:@defaultrequiredAllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codeexampleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
AllergyIntolerance.code.coding:NotAskedpreferredhttps://fhir.infoway-inforoute.ca/ValueSet/NullFlavor
AllergyIntolerance.code.coding:NoAllergyrequiredFixed Value: SNOMED CT code 716186003
AllergyIntolerance.code.coding:@defaultexampleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
AllergyIntolerance.reaction.substanceexampleSubstanceCode
AllergyIntolerance.reaction.substance.coding:NonDrugAllergenpreferredhttps://fhir.infoway-inforoute.ca/ValueSet/NonDrugAllergenCode
AllergyIntolerance.reaction.substance.coding:CCDDpreferredhttps://fhir.infoway-inforoute.ca/ValueSet/prescriptionmedicinalproduct
AllergyIntolerance.reaction.substance.coding:@defaultexampleSubstanceCode
AllergyIntolerance.reaction.manifestationexampleSNOMEDCTClinicalFindings
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoutepreferredhttps://fhir.infoway-inforoute.ca/ValueSet/RouteOfAdministration

Constraints

IdPathDetailsRequirements
ait-1AllergyIntoleranceAllergyIntolerance.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-2AllergyIntoleranceAllergyIntolerance.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-2AllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3AllergyIntoleranceIf 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-4AllergyIntoleranceIf 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-5AllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6AllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1AllergyIntolerance.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.clinicalStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.verificationStatus.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.verificationStatus.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.verificationStatus.coding:StatusCode.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:StatusCode.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@defaultAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@default.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.verificationStatus.coding:@default.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.verificationStatus.coding:@default.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@default.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@default.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@default.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.coding:@default.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.verificationStatus.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.criticalityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ca-core-allergyAllergyIntolerance.codeAllergyIntolerance.verificationStatus SHALL be present if AllergyIntolerance.code represents NullFlavor concept
: AllergyIntolerance.code.coding.where(system = 'https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor').exists() or AllergyIntolerance.verificationStatus.exists()
ele-1AllergyIntolerance.code.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.code.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.code.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NotAskedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ca-core-allergy-notaskedAllergyIntolerance.code.coding:NotAskedif AllergyIntolerance.code is a NullFlavor value, then AllergyIntolerance.clinicalStatus, AllergyIntolerance.verificationStatus, AllergyIntolerance.type, AllergyIntolerance.category, AllergyIntolerance.criticality SHALL NOT be present
: AllergyIntolerance.code.coding.where(system = 'https://fhir.infoway-inforoute.ca/ValueSet/NullFlavor').exists() implies (AllergyIntolerance.verificationStatus.exists().not() and AllergyIntolerance.type.exists().not() and AllergyIntolerance.category.exists().not() and AllergyIntolerance.criticality.exists().not())
ele-1AllergyIntolerance.code.coding:NotAsked.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.code.coding:NotAsked.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.code.coding:NotAsked.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NotAsked.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NotAsked.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NotAsked.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NotAsked.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NoAllergyAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ca-core-allergy-noallergyAllergyIntolerance.code.coding:NoAllergyif AllergyIntolerance.code is '716186003' No known allergy, then AllergyIntolerance.verificationStatus SHALL be one of the following: confirmed | refuted | entered-in-error
: AllergyIntolerance.code.coding.where(system = 'http://snomed.info/sct' and code = '716186003').exists() and AllergyIntolerance.verificationStatus.coding.where(code = 'unconfirmed').empty()
ele-1AllergyIntolerance.code.coding:NoAllergy.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.code.coding:NoAllergy.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.code.coding:NoAllergy.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NoAllergy.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NoAllergy.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NoAllergy.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:NoAllergy.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.coding:@defaultAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.code.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.patientAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.onset[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.onset[x]:onsetDateTimeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.recordedDateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.lastOccurrenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reactionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.reaction.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.reaction.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.reaction.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.reaction.substanceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.reaction.substance.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.reaction.substance.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergenAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:NonDrugAllergen.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDDAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1AllergyIntolerance.reaction.substance.coding:CCDD.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.systemAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.versionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.displayAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:CCDD.userSelectedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.coding:@defaultAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.substance.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.manifestationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.descriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.onsetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.exposureRouteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1AllergyIntolerance.reaction.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

Notes:

Verification Status

The AllergyIntolerance.verificationStatus element is optional (i.e., cardinality is 0..1) in this profile since a typical use would involve clinical decision support that produces warnings when potentially dangerous medications/treatments might be prescribed.

There is potential for confounding/conflicting information if verification status “overrides” a clinical finding of an allergy or intolerance.

In addition allergies/intolerance are usually reported by the patient and rarely verified probable that this information is not collected and not available, therefore data element is not populated except by default (presumably as “unconfirmed”) again leading to problematic data for clinical decision support.

This is also problematic with respect to interoperability considerations.

Code

If the AllergyIntolerance.code element represents NullFlavor concept (i.e., no known allergy) then the verificationStatus element SHALL be present.

Rational is that recording “no known allergy” without an assessment would a patient safety issue and should not happen. It is not consistent with clinical practice.

Substance

The identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event uses Substance Code value set with Example binding. Consider use Canadian Clinical Drug Data set in case of medication allergy/intolerance, and SNOMED CT for other substances/agents.

Manifestation

The AllergyIntolerance.reaction.manifestation element is a required element to provide symptoms and/or signs that are observed or associated with the adverse reaction event.

-Consider developing a value set from MEDDRA for drug reactions