Standard Health Record FHIR Implementation Guide

SHR AllergyIntolerance Profile

 

The official URL for this profile is:

http://standardhealthrecord.org/fhir/StructureDefinition/shr-allergy-AllergyIntolerance

A finding related to the presence or absence of an individual's risk or sensitivity to a substance or class of substances. A finding can be taken as tantamount to a representation of an allergic condition, allowing it to be tracked over time.

This profile builds on US Core AllergyIntolerance Profile.

This profile was published on Tue Feb 27 00:00:00 EST 2018 as a draft by The MITRE Corporation: Standard Health Record Collaborative.

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

Summary

Mandatory: 0 element (1 nested mandatory element)

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

SHR Mapping Source

This structure represents the following SHR mapping definition:

shr.allergy.AllergyIntolerance maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance:
  Informant maps to asserter
  Author maps to recorder
  CodeableConcept maps to code
  ClinicalStatus maps to clinicalStatus
  _Entry.CreationTime maps to assertedDate
  Subject maps to patient
  Type maps to type
  Criticality maps to criticality
  SubstanceCategory maps to category
  VerificationStatus maps to verificationStatus
  Onset maps to onset[x]
  MostRecentOccurrenceTime maps to lastOccurrence
  AdverseReaction.AllergenIrritant maps to reaction.substance
  AdverseReaction.Manifestation maps to reaction.manifestation
  AdverseReaction.Details maps to reaction.description
  AdverseReaction.OccurrenceTime maps to reaction.onset
  AdverseReaction.Severity maps to reaction.severity
  AdverseReaction.RouteIntoBody maps to reaction.exposureRoute

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance SHR AllergyIntolerance Profile
... code Binding: SHR AllergenIrritantVS ValueSet (required)
... patient Reference(SHR Patient Profile)
... onset[x] dateTime, SHR Age Profile, SHR GestationalAge Profile, Period
... assertedDate 1..1
... recorder Reference(SHR Patient Profile)
... asserter Reference(SHR Patient Profile), Reference(SHR RelatedPerson Profile)
... reaction
.... substance Binding: SHR AllergenIrritantVS ValueSet (required)
.... manifestation Binding: SHR ManifestationVS ValueSet (required)
.... exposureRoute Binding: SNOMED CT Route Codes (required)
... shr-base-RelatedEncounter-extension 0..1Reference(SHR EncounterPerformed Profile)SHR RelatedEncounter Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-FindingMethod-extension 0..1CodeableConceptSHR FindingMethod Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension
... shr-finding-FindingStatus-extension 0..1CodeableConceptSHR FindingStatus Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension
Binding: ObservationStatus (required)
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-condition-Abatement-extension 0..1(Complex)SHR Abatement Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-condition-Abatement-extension

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*SHR AllergyIntolerance Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... shr-base-RelatedEncounter-extension 0..1Reference(SHR EncounterPerformed Profile)SHR RelatedEncounter Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-FindingMethod-extension 0..1CodeableConceptSHR FindingMethod Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension
... shr-finding-FindingStatus-extension 0..1CodeableConceptSHR FindingStatus Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension
Binding: ObservationStatus (required)
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-condition-Abatement-extension 0..1(Complex)SHR Abatement Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-condition-Abatement-extension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!SΣI0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required)
... verificationStatus ?!SΣI1..1codeunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatus (required)
... type Σ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required)
... category Σ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required)
... criticality Σ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required)
... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: SHR AllergenIrritantVS ValueSet (required)
... patient SΣ1..1Reference(SHR Patient Profile)Who the sensitivity is for
... onset[x] 0..1dateTime, SHR Age Profile, SHR GestationalAge Profile, PeriodWhen allergy or intolerance was identified
... assertedDate 1..1dateTimeDate record was believed accurate
... recorder 0..1Reference(SHR Patient Profile)Who recorded the sensitivity
... asserter Σ0..1Reference(SHR Patient Profile), Reference(SHR RelatedPerson Profile)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 I0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SHR AllergenIrritantVS ValueSet (required)
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SHR ManifestationVS ValueSet (required)
.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: SNOMED CT Route Codes (required)
.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format

Summary

Mandatory: 0 element (1 nested mandatory element)

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

SHR Mapping Source

This structure represents the following SHR mapping definition:

shr.allergy.AllergyIntolerance maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance:
  Informant maps to asserter
  Author maps to recorder
  CodeableConcept maps to code
  ClinicalStatus maps to clinicalStatus
  _Entry.CreationTime maps to assertedDate
  Subject maps to patient
  Type maps to type
  Criticality maps to criticality
  SubstanceCategory maps to category
  VerificationStatus maps to verificationStatus
  Onset maps to onset[x]
  MostRecentOccurrenceTime maps to lastOccurrence
  AdverseReaction.AllergenIrritant maps to reaction.substance
  AdverseReaction.Manifestation maps to reaction.manifestation
  AdverseReaction.Details maps to reaction.description
  AdverseReaction.OccurrenceTime maps to reaction.onset
  AdverseReaction.Severity maps to reaction.severity
  AdverseReaction.RouteIntoBody maps to reaction.exposureRoute

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance SHR AllergyIntolerance Profile
... code Binding: SHR AllergenIrritantVS ValueSet (required)
... patient Reference(SHR Patient Profile)
... onset[x] dateTime, SHR Age Profile, SHR GestationalAge Profile, Period
... assertedDate 1..1
... recorder Reference(SHR Patient Profile)
... asserter Reference(SHR Patient Profile), Reference(SHR RelatedPerson Profile)
... reaction
.... substance Binding: SHR AllergenIrritantVS ValueSet (required)
.... manifestation Binding: SHR ManifestationVS ValueSet (required)
.... exposureRoute Binding: SNOMED CT Route Codes (required)
... shr-base-RelatedEncounter-extension 0..1Reference(SHR EncounterPerformed Profile)SHR RelatedEncounter Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-FindingMethod-extension 0..1CodeableConceptSHR FindingMethod Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension
... shr-finding-FindingStatus-extension 0..1CodeableConceptSHR FindingStatus Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension
Binding: ObservationStatus (required)
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-condition-Abatement-extension 0..1(Complex)SHR Abatement Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-condition-Abatement-extension

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance I0..*SHR AllergyIntolerance Profile
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... shr-base-RelatedEncounter-extension 0..1Reference(SHR EncounterPerformed Profile)SHR RelatedEncounter Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension
... shr-finding-FocalSubject-extension 0..1CodeableConceptSHR FocalSubject Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension
... shr-finding-FocalSubjectReference-extension 0..1(Complex)SHR FocalSubjectReference Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension
... shr-finding-FindingMethod-extension 0..1CodeableConceptSHR FindingMethod Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension
... shr-finding-FindingStatus-extension 0..1CodeableConceptSHR FindingStatus Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension
Binding: ObservationStatus (required)
... shr-finding-Evidence-extension 0..*(Complex)SHR Evidence Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension
... shr-condition-Abatement-extension 0..1(Complex)SHR Abatement Extension
URL: http://standardhealthrecord.org/fhir/StructureDefinition/shr-condition-Abatement-extension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!SΣI0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required)
... verificationStatus ?!SΣI1..1codeunconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatus (required)
... type Σ0..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required)
... category Σ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required)
... criticality Σ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required)
... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: SHR AllergenIrritantVS ValueSet (required)
... patient SΣ1..1Reference(SHR Patient Profile)Who the sensitivity is for
... onset[x] 0..1dateTime, SHR Age Profile, SHR GestationalAge Profile, PeriodWhen allergy or intolerance was identified
... assertedDate 1..1dateTimeDate record was believed accurate
... recorder 0..1Reference(SHR Patient Profile)Who recorded the sensitivity
... asserter Σ0..1Reference(SHR Patient Profile), Reference(SHR RelatedPerson Profile)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 I0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: SHR AllergenIrritantVS ValueSet (required)
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: SHR ManifestationVS ValueSet (required)
.... description 0..1stringDescription of the event as a whole
.... onset 0..1dateTimeDate(/time) when manifestations showed
.... severity 0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: SNOMED CT Route Codes (required)
.... note 0..*AnnotationText about event not captured in other fields

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron

 

Terminology Bindings

PathNameConformanceValueSet
AllergyIntolerance.languageCommon LanguagesextensibleCommon Languages
AllergyIntolerance.clinicalStatusAllergyIntoleranceClinicalStatusrequiredAllergyIntoleranceClinicalStatus
AllergyIntolerance.verificationStatusAllergyIntoleranceVerificationStatusrequiredAllergyIntoleranceVerificationStatus
AllergyIntolerance.typeAllergyIntoleranceTyperequiredAllergyIntoleranceType
AllergyIntolerance.categoryAllergyIntoleranceCategoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityAllergyIntoleranceCriticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codeSHR AllergenIrritantVS ValueSetrequiredSHR AllergenIrritantVS ValueSet
AllergyIntolerance.reaction.substanceSHR AllergenIrritantVS ValueSetrequiredSHR AllergenIrritantVS ValueSet
AllergyIntolerance.reaction.manifestationSHR ManifestationVS ValueSetrequiredSHR ManifestationVS ValueSet
AllergyIntolerance.reaction.severityAllergyIntoleranceSeverityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRouteSNOMED CT Route CodesrequiredSNOMED CT Route Codes

 

Constraints

IdPathDetailsRequirements
dom-2AllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1AllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.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-3AllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ait-1AllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus='entered-in-error' or clinicalStatus.exists()
ait-2AllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus!='entered-in-error' or clinicalStatus.empty()
ele-1AllergyIntolerance.reactionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())