Copy of 'GP Connect Data Model | FHIR STU3 Representation'

Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Profile: CareConnect-GPC-AllergyIntolerance-1

idΣ0..1id
id0..1string
extensionC0..*Extension
versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileΣ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
encounterS C0..1Extension(Reference(Encounter))
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueDateTimedateTime
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
evidenceC0..1Extension(Reference(DiagnosticReport))
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ1..1uri
valueΣ1..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(Organization)
clinicalStatusΣ ?! C1..1CodeableConceptBinding
verificationStatusΣ ?! C0..1CodeableConceptBindingFixed Value
typeΣ0..1codeBinding
categoryΣ1..*codeBinding
criticalityΣ0..1codeBinding
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uri
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
patientΣ C1..1Reference(CareConnect-GPC-Patient-1)
encounterC0..1Reference(Encounter)
onsetAgeAge
onsetDateTimedateTime
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
recordedDate0..1dateTime
recorderC1..1Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
asserterS Σ C0..1Reference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
lastOccurrence0..1dateTime
id0..1string
extensionC0..*Extension
authorReferenceReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
description0..1string
onset0..1dateTime
severityS0..1codeBinding
id0..1string
extensionC0..*Extension
id0..1string
id0..1string
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueIdid
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueStringstring
url1..1uriFixed Value
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionC0..*Extension
authorReferenceReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown
assertedDate1..
AllergyIntoleranceC
ShortAllergy or Intolerance (generally: Risk of adverse reaction to a substance)
Definition

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

Cardinality0..*
AliasAllergy, Intolerance, Adverse Reaction
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.

Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • 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()
Mappings
  • rim: Entity. Role, or Act
  • rim: Observation[classCode=OBS, moodCode=EVN]
AllergyIntolerance.idΣ
ShortLogical id of this artifact
Definition

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

Cardinality0..1
Typeid
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.metaΣ
ShortMetadata about the resource
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.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.meta.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.meta.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.meta.versionIdΣ
ShortVersion specific identifier
Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Cardinality0..1
Typeid
SummaryTrue
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.lastUpdatedΣ
ShortWhen the resource version last changed
Definition

When the resource last changed - e.g. when the version changed.

Cardinality0..1
Typeinstant
SummaryTrue
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.sourceΣ
ShortIdentifies where the resource comes from
Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Cardinality0..1
Typeuri
SummaryTrue
Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.profileΣ
ShortProfiles this resource claims to conform to
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Cardinality1..*
Typecanonical(StructureDefinition)
SummaryTrue
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.meta.securityΣ
ShortSecurity Labels applied to this resource
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Cardinality0..*
TypeCoding
Binding

Security Labels from the Healthcare Privacy and Security Classification System.

AllSecurityLabels (extensible)

SummaryTrue
Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
AllergyIntolerance.meta.tagΣ
ShortTags applied to this resource
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Cardinality0..*
TypeCoding
Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

SummaryTrue
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
AllergyIntolerance.implicitRulesΣ ?!
ShortA set of rules under which this content was created
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.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
MaxValueSetAllLanguages
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).

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
AllergyIntolerance.text
ShortText summary of the resource, for human interpretation
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.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
AllergyIntolerance.contained
ShortContained, inline Resources
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.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained 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.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
AllergyIntolerance.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:encounterS C
ShortAn associated encounter reference
Definition

An associated encounter reference.

Cardinality0..1
TypeExtension(Reference(Encounter))
Must SupportTrue
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEndS C
ShortSupports the date and reason that the allergy was no longer valid
Definition

Supports the date and reason that the allergy was no longer valid.

Cardinality0..1
TypeExtension(Complex)
Must SupportTrue
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.extension:allergyEnd.extensionC
ShortAdditional content defined by implementations
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.

Cardinality2..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:endDateC
ShortThe date the allergy or intolerance was recorded as no longer valid.
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:endDate.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.extension:allergyEnd.extension:endDate.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:endDate.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
endDate
Mappings
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:endDate.value[x]
ShortThe date the allergy was recorded as no longer valid
Definition

The date the allergy was recorded as no longer valid.

Cardinality0..1
TypedateTime
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:reasonEndedC
ShortThe reason why the allergy or intolerance has been resolved.
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:reasonEnded.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.extension:allergyEnd.extension:reasonEnded.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:reasonEnded.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
reasonEnded
Mappings
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.extension:reasonEnded.value[x]
ShortThe reason why the allergy or intolerance has been resolved
Definition

The reason why the allergy or intolerance has been resolved.

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1
Mappings
  • rim: N/A
AllergyIntolerance.extension:allergyEnd.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.extension:evidenceC
ShortA reference to results of investigations that confirmed the certainty of the diagnosis
Definition

A reference to results of investigations that confirmed the certainty of the diagnosis.

Cardinality0..1
TypeExtension(Reference(DiagnosticReport))
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.modifierExtension?! C
ShortExtensions that cannot be ignored
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).

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
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.

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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.identifierΣ
ShortExternal ids for this item
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.

Cardinality1..*
TypeIdentifier
SummaryTrue
Requirements

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

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • v2: IAM-7
  • rim: id
AllergyIntolerance.identifier.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.identifier.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.identifier.useΣ ?!
Shortusual | official | temp | secondary | old (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
AllergyIntolerance.identifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

IdentifierTypeCodes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
AllergyIntolerance.identifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
AllergyIntolerance.identifier.valueΣ
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality1..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
AllergyIntolerance.identifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

Period is not used for a duration (a measure of elapsed time). See Duration.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
AllergyIntolerance.identifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(Organization)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
AllergyIntolerance.clinicalStatusΣ ?! C
Shortactive | inactive | resolved
Definition

The clinical status of the allergy or intolerance.

Cardinality1..1
TypeCodeableConcept
Binding

The clinical status of the allergy or intolerance.

AllergyIntoleranceClinicalStatusCodes (required)

ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ait-1, ait-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.status
  • rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
AllergyIntolerance.verificationStatusΣ ?! C
Shortunconfirmed | confirmed
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

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

AllergyIntoleranceVerificationStatusCodes (required)

ModifierTrue
SummaryTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, ait-1, ait-2
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
unconfirmed
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.status
  • rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
AllergyIntolerance.typeΣ
Shortallergy | intolerance - Underlying mechanism (if known)
Definition

Identification of the underlying physiological mechanism for the reaction risk.

Cardinality0..1
Typecode
Binding

Identification of the underlying physiological mechanism for a Reaction Risk.

AllergyIntoleranceType (required)

SummaryTrue
AliasCategory, Class
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.class
  • v2: IAM-9
  • rim: code
AllergyIntolerance.categoryΣ
Shortfood | medication | environment | biologic
Definition

Category of the identified substance.

Cardinality1..*
Typecode
Binding

Category of an identified substance associated with allergies or intolerances.

AllergyIntoleranceCategory (required)

SummaryTrue
AliasCategory, Type, Reaction Type, Class
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.class
  • v2: AL1-2
  • rim: value < IntoleranceValue (Agent)
AllergyIntolerance.criticalityΣ
Shortlow | high | unable-to-assess
Definition

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

Cardinality0..1
Typecode
Binding

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

AllergyIntoleranceCriticality (required)

SummaryTrue
AliasSeverity, Seriousness, Contra-indication, Risk
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.grade
  • v2: AL1-4
  • rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
AllergyIntolerance.codeΣ
ShortCode that identifies the allergy or intolerance
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.

Cardinality1..1
TypeCodeableConcept
Binding

Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

SubstanceProductAndConditionAndNegationCodes (example)

SummaryTrue
AliasCode
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • v2: AL1-3 / IAM-3
  • rim: substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value
AllergyIntolerance.code.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.code.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.code.coding.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.code.coding.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
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.

Cardinality1..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
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.

Cardinality0..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.code.coding.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.code.coding.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.code.coding.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.code.coding.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.code.coding.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.code.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.patientΣ C
ShortWho the sensitivity is for
Definition

The patient who has the allergy or intolerance.

Cardinality1..1
TypeReference(CareConnect-GPC-Patient-1)
SummaryTrue
AliasPatient
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.subject[x]
  • v2: (PID-3)
  • rim: .participation[typeCode=SBJ].role[classCode=PAT]
  • w5: FiveWs.subject
AllergyIntolerance.encounterC
ShortEncounter when the allergy or intolerance was asserted
Definition

The encounter when the allergy or intolerance was asserted.

Cardinality0..1
TypeReference(Encounter)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.context
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
AllergyIntolerance.onset[x]S
ShortWhen allergy or intolerance was identified
Definition

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

Cardinality0..1
TypeAge | dateTime | Period | Range | string
Must SupportTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.init
  • rim: effectiveTime.low
AllergyIntolerance.recordedDate
ShortDate first version of the resource instance was recorded
Definition

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

Cardinality0..1
TypedateTime
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.recorded
  • v2: IAM-13
  • rim: .participation[typeCode=AUT].time
AllergyIntolerance.recorderC
ShortWho recorded the sensitivity
Definition

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

Cardinality1..1
TypeReference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
AliasAuthor
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.author
  • rim: .participation[typeCode=AUT].role
AllergyIntolerance.asserterS Σ C
ShortSource of the information about the allergy
Definition

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

Cardinality0..1
TypeReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1)
Must SupportTrue
SummaryTrue
AliasSource, Informant
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.source
  • v2: IAM-14 (if patient) / IAM-18 (if practitioner)
  • rim: .participation[typeCode=INF].role
AllergyIntolerance.lastOccurrence
ShortDate(/time) of last known occurrence of a reaction
Definition

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

Cardinality0..1
TypedateTime
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime
AllergyIntolerance.noteS
ShortAdditional text not captured in other fields
Definition

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

Cardinality0..*
TypeAnnotation
Must SupportTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • rim: subjectOf.observationEvent[code="annotation"].value
AllergyIntolerance.note.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.note.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.note.author[x]Σ
ShortIndividual responsible for the annotation
Definition

The individual responsible for making the annotation.

Cardinality0..1
TypeReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1) | string
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
AllergyIntolerance.note.timeΣ
ShortWhen the annotation was made
Definition

Indicates when this particular annotation was made.

Cardinality0..1
TypedateTime
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
AllergyIntolerance.note.textΣ
ShortThe annotation - text content (as markdown)
Definition

The text of the annotation in markdown format.

Cardinality1..1
Typemarkdown
SummaryTrue
Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
AllergyIntolerance.reaction
ShortAdverse Reaction Events linked to exposure to substance
Definition

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

Cardinality0..*
TypeBackboneElement
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]
AllergyIntolerance.reaction.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored even if unrecognized
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).

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance
ShortSpecific substance or pharmaceutical product considered to be responsible for event
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.

Cardinality0..1
TypeCodeableConcept
Binding

Codes defining the type of the substance (including pharmaceutical products).

SubstanceCode (example)

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'.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
AllergyIntolerance.reaction.substance.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.substance.coding:snomedCTΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.substance.coding:snomedCT.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.coding:snomedCT.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
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.

Cardinality1..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
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.

Cardinality0..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.substance.coding:snomedCT.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.substance.coding:snomedCT.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.substance.coding:snomedCT.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.substance.coding:snomedCT.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.substance.coding:snomedCT.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.substance.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.manifestation
ShortClinical symptoms/signs associated with the Event
Definition

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

Cardinality1..*
TypeCodeableConcept
Binding

Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.

SNOMEDCTClinicalFindings (extensible)

AliasSymptoms, Signs
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: AL1-5
  • rim: code
AllergyIntolerance.reaction.manifestation.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.manifestation.coding:snomedCTΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.manifestation.coding:snomedCT.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
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.

Cardinality1..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
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.

Cardinality0..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.manifestation.coding:snomedCT.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.manifestation.coding:snomedCT.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.manifestation.coding:snomedCT.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.manifestation.coding:snomedCT.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.manifestation.coding:snomedCT.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.manifestation.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.description
ShortDescription of the event as a whole
Definition

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

Cardinality0..1
Typestring
AliasNarrative, Text
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: text
AllergyIntolerance.reaction.onset
ShortDate(/time) when manifestations showed
Definition

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

Cardinality0..1
TypedateTime
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: AL1-6
  • rim: effectiveTime.low
AllergyIntolerance.reaction.severityS
Shortmild | moderate | severe (of event as a whole)
Definition

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

Cardinality0..1
Typecode
Binding

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

AllergyIntoleranceSeverity (required)

Must SupportTrue
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
AllergyIntolerance.reaction.exposureRoute
ShortHow the subject was exposed to the substance
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

SNOMEDCTRouteCodes (example)

Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode
AllergyIntolerance.reaction.exposureRoute.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.codingΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Slicing

Unordered, Open, by system(Value)

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.exposureRoute.coding:snomedCTΣ
ShortCode defined by a terminology system
Definition

A reference to a code defined by a terminology system.

Cardinality0..1
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionIDC
ShortThe SNOMED CT Description ID for the display
Definition

The SNOMED CT Description ID for the display.

Cardinality0..1
TypeExtension(Complex)
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extensionC
ShortAdditional content defined by implementations
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.

Cardinality1..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionIdC
ShortThe SNOMED CT Description ID
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.

Cardinality1..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionId
Mappings
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionId.value[x]
ShortThe SNOMED CT Description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typeid
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplayC
ShortThe SNOMED CT display for the description ID
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.

Cardinality0..1
TypeExtension
Aliasextensions, user content
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..0
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
descriptionDisplay
Mappings
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension:descriptionDisplay.value[x]
ShortThe SNOMED CT display for the description ID
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..1
Typestring
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.url
Shortidentifies the meaning of the extension
Definition

Source of the definition for the extension code - a logical name or a URL.

Cardinality1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Value
https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid
Mappings
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.value[x]
ShortValue of extension
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Cardinality0..0
TypeAddress | Age | Annotation | Attachment | base64Binary | boolean | code | CodeableConcept | Coding | ContactPoint | Count | date | dateTime | decimal | Distance | Duration | HumanName | id | Identifier | instant | integer | markdown | Money | oid | Period | positiveInt | Quantity | Range | Ratio | Reference | SampledData | Signature | string | time | Timing | unsignedInt | uri
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.systemΣ
ShortIdentity of the terminology system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Cardinality1..1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Fixed Value
http://snomed.info/sct
Mappings
  • rim: n/a
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.versionΣ
ShortVersion of the system - if relevant
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Cardinality0..0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.codeΣ
ShortSymbol in syntax defined by the system
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Cardinality1..1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.displayΣ
ShortRepresentation defined by the system
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Cardinality0..1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.userSelectedΣ
ShortIf this coding was chosen directly by the user
Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Cardinality0..1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
AllergyIntolerance.reaction.exposureRoute.textΣ
ShortPlain text representation of the concept
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Cardinality0..1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
AllergyIntolerance.reaction.note
ShortText about event not captured in other fields
Definition

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

Cardinality0..*
TypeAnnotation
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.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act
  • rim: subjectOf.observationEvent[code="annotation"].value
AllergyIntolerance.reaction.note.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
AllergyIntolerance.reaction.note.extensionC
ShortAdditional content defined by implementations
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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
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.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-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()
Mappings
  • rim: n/a
  • rim: N/A
AllergyIntolerance.reaction.note.author[x]Σ
ShortIndividual responsible for the annotation
Definition

The individual responsible for making the annotation.

Cardinality0..1
TypeReference(RelatedPerson) | Reference(CareConnect-GPC-Patient-1) | Reference(CareConnect-GPC-Practitioner-1) | string
SummaryTrue
Comments

Organization is used when there's no need for specific attribution as to who made the comment.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.participant[typeCode=AUT].role
AllergyIntolerance.reaction.note.timeΣ
ShortWhen the annotation was made
Definition

Indicates when this particular annotation was made.

Cardinality0..1
TypedateTime
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.effectiveTime
AllergyIntolerance.reaction.note.textΣ
ShortThe annotation - text content (as markdown)
Definition

The text of the annotation in markdown format.

Cardinality1..1
Typemarkdown
SummaryTrue
Comments

Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Act.text
AllergyIntolerance.assertedDate
Cardinality1
<StructureDefinition xmlns="http://hl7.org/fhir">
<lastUpdated value="2026-10-29T16:51:33.5195126+00:00" />
</meta>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="pc" />
</extension>
<url value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1" />
<version value="1.7.0" />
<name value="CareConnect-GPC-AllergyIntolerance-1" />
<status value="active" />
<date value="2020-02-17" />
<publisher value="HL7 UK" />
<description value="This AllergyIntolerance Resource records Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance." />
<copyright value="Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html" />
<fhirVersion value="3.0.2" />
<kind value="resource" />
<abstract value="false" />
<type value="AllergyIntolerance" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance" />
<derivation value="constraint" />
<element id="AllergyIntolerance.meta">
<path value="AllergyIntolerance.meta" />
</element>
<element id="AllergyIntolerance.meta.profile">
<path value="AllergyIntolerance.meta.profile" />
<min value="1" />
</element>
<element id="AllergyIntolerance.extension:encounter">
<path value="AllergyIntolerance.extension" />
<sliceName value="encounter" />
<max value="1" />
<code value="Extension" />
<profile value="http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter" />
</type>
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.extension:allergyEnd">
<path value="AllergyIntolerance.extension" />
<sliceName value="allergyEnd" />
<max value="1" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1" />
</type>
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.extension:allergyEnd.extension">
<path value="AllergyIntolerance.extension.extension" />
<min value="2" />
</element>
<element id="AllergyIntolerance.extension:evidence">
<path value="AllergyIntolerance.extension" />
<sliceName value="evidence" />
<max value="1" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1" />
</type>
</element>
<element id="AllergyIntolerance.identifier">
<path value="AllergyIntolerance.identifier" />
<min value="1" />
</element>
<element id="AllergyIntolerance.identifier.system">
<path value="AllergyIntolerance.identifier.system" />
<min value="1" />
</element>
<element id="AllergyIntolerance.identifier.value">
<path value="AllergyIntolerance.identifier.value" />
<min value="1" />
</element>
<element id="AllergyIntolerance.clinicalStatus">
<path value="AllergyIntolerance.clinicalStatus" />
<min value="1" />
</element>
<element id="AllergyIntolerance.verificationStatus">
<path value="AllergyIntolerance.verificationStatus" />
<short value="unconfirmed | confirmed" />
<fixedCode value="unconfirmed" />
</element>
<element id="AllergyIntolerance.category">
<path value="AllergyIntolerance.category" />
<min value="1" />
</element>
<element id="AllergyIntolerance.code">
<path value="AllergyIntolerance.code" />
<min value="1" />
<strength value="example" />
</binding>
</element>
<element id="AllergyIntolerance.code.coding.extension:snomedCTDescriptionID">
<path value="AllergyIntolerance.code.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension">
<path value="AllergyIntolerance.code.coding.extension.extension" />
<min value="1" />
</element>
<element id="AllergyIntolerance.code.coding.system">
<path value="AllergyIntolerance.code.coding.system" />
<min value="1" />
</element>
<element id="AllergyIntolerance.code.coding.version">
<path value="AllergyIntolerance.code.coding.version" />
<max value="0" />
</element>
<element id="AllergyIntolerance.code.coding.code">
<path value="AllergyIntolerance.code.coding.code" />
<min value="1" />
</element>
<element id="AllergyIntolerance.patient">
<path value="AllergyIntolerance.patient" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
</element>
<element id="AllergyIntolerance.onset[x]">
<path value="AllergyIntolerance.onset[x]" />
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.assertedDate">
<path value="AllergyIntolerance.assertedDate" />
<min value="1" />
</element>
<element id="AllergyIntolerance.recorder">
<path value="AllergyIntolerance.recorder" />
<min value="1" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="AllergyIntolerance.asserter">
<path value="AllergyIntolerance.asserter" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.note">
<path value="AllergyIntolerance.note" />
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.note.author[x]">
<path value="AllergyIntolerance.note.author[x]" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="string" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
<element id="AllergyIntolerance.reaction.substance.coding">
<path value="AllergyIntolerance.reaction.substance.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT">
<path value="AllergyIntolerance.reaction.substance.coding" />
<sliceName value="snomedCT" />
<max value="1" />
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="AllergyIntolerance.reaction.substance.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="AllergyIntolerance.reaction.substance.coding.extension.extension" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT.system">
<path value="AllergyIntolerance.reaction.substance.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT.version">
<path value="AllergyIntolerance.reaction.substance.coding.version" />
<max value="0" />
</element>
<element id="AllergyIntolerance.reaction.substance.coding:snomedCT.code">
<path value="AllergyIntolerance.reaction.substance.coding.code" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.manifestation">
<path value="AllergyIntolerance.reaction.manifestation" />
<strength value="extensible" />
</binding>
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding">
<path value="AllergyIntolerance.reaction.manifestation.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT">
<path value="AllergyIntolerance.reaction.manifestation.coding" />
<sliceName value="snomedCT" />
<max value="1" />
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="AllergyIntolerance.reaction.manifestation.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="AllergyIntolerance.reaction.manifestation.coding.extension.extension" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.system">
<path value="AllergyIntolerance.reaction.manifestation.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.version">
<path value="AllergyIntolerance.reaction.manifestation.coding.version" />
<max value="0" />
</element>
<element id="AllergyIntolerance.reaction.manifestation.coding:snomedCT.code">
<path value="AllergyIntolerance.reaction.manifestation.coding.code" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.severity">
<path value="AllergyIntolerance.reaction.severity" />
<mustSupport value="true" />
</element>
<element id="AllergyIntolerance.reaction.exposureRoute">
<path value="AllergyIntolerance.reaction.exposureRoute" />
<strength value="example" />
</binding>
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding">
<path value="AllergyIntolerance.reaction.exposureRoute.coding" />
<type value="value" />
<path value="system" />
</discriminator>
<ordered value="false" />
<rules value="open" />
</slicing>
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT">
<path value="AllergyIntolerance.reaction.exposureRoute.coding" />
<sliceName value="snomedCT" />
<max value="1" />
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID">
<path value="AllergyIntolerance.reaction.exposureRoute.coding.extension" />
<sliceName value="snomedCTDescriptionID" />
<code value="Extension" />
<profile value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
</type>
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension">
<path value="AllergyIntolerance.reaction.exposureRoute.coding.extension.extension" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system">
<path value="AllergyIntolerance.reaction.exposureRoute.coding.system" />
<min value="1" />
<fixedUri value="http://snomed.info/sct" />
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version">
<path value="AllergyIntolerance.reaction.exposureRoute.coding.version" />
<max value="0" />
</element>
<element id="AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code">
<path value="AllergyIntolerance.reaction.exposureRoute.coding.code" />
<min value="1" />
</element>
<element id="AllergyIntolerance.reaction.note.author[x]">
<path value="AllergyIntolerance.reaction.note.author[x]" />
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
</type>
<code value="string" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1" />
</type>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1" />
</type>
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"meta": {
"lastUpdated": "2026-10-29T16:51:33.5195126+00:00"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "pc"
}
],
"url": "https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1",
"version": "1.7.0",
"name": "CareConnect-GPC-AllergyIntolerance-1",
"status": "active",
"date": "2020-02-17",
"publisher": "HL7 UK",
"description": "This AllergyIntolerance Resource records Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.",
"copyright": "Copyright © 2020 HL7 UK\n\nLicensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n\nhttp://www.apache.org/licenses/LICENSE-2.0\n\nUnless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n\nHL7® FHIR® standard Copyright © 2011+ HL7\n\nThe HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n\nhttps://www.hl7.org/fhir/license.html",
"fhirVersion": "3.0.2",
"kind": "resource",
"abstract": false,
"type": "AllergyIntolerance",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance",
"derivation": "constraint",
"element": [
{
"id": "AllergyIntolerance.meta",
"path": "AllergyIntolerance.meta"
},
{
"id": "AllergyIntolerance.meta.profile",
"path": "AllergyIntolerance.meta.profile",
"min": 1
},
{
"id": "AllergyIntolerance.extension:encounter",
"path": "AllergyIntolerance.extension",
"sliceName": "encounter",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter"
]
}
],
"mustSupport": true
},
{
"id": "AllergyIntolerance.extension:allergyEnd",
"path": "AllergyIntolerance.extension",
"sliceName": "allergyEnd",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1"
]
}
],
"mustSupport": true
},
{
"id": "AllergyIntolerance.extension:allergyEnd.extension",
"path": "AllergyIntolerance.extension.extension",
"min": 2
},
{
"id": "AllergyIntolerance.extension:evidence",
"path": "AllergyIntolerance.extension",
"sliceName": "evidence",
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-Evidence-1"
]
}
]
},
{
"id": "AllergyIntolerance.identifier",
"path": "AllergyIntolerance.identifier",
"min": 1
},
{
"id": "AllergyIntolerance.identifier.system",
"path": "AllergyIntolerance.identifier.system",
"min": 1
},
{
"id": "AllergyIntolerance.identifier.value",
"path": "AllergyIntolerance.identifier.value",
"min": 1
},
{
"id": "AllergyIntolerance.clinicalStatus",
"path": "AllergyIntolerance.clinicalStatus",
"min": 1
},
{
"id": "AllergyIntolerance.verificationStatus",
"path": "AllergyIntolerance.verificationStatus",
"short": "unconfirmed | confirmed",
"fixedCode": "unconfirmed"
},
{
"id": "AllergyIntolerance.category",
"path": "AllergyIntolerance.category",
"min": 1
},
{
"id": "AllergyIntolerance.code",
"path": "AllergyIntolerance.code",
"min": 1,
"binding": {
"reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyCode-1"
},
"strength": "example"
}
},
{
"id": "AllergyIntolerance.code.coding.extension:snomedCTDescriptionID",
"path": "AllergyIntolerance.code.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "AllergyIntolerance.code.coding.extension:snomedCTDescriptionID.extension",
"path": "AllergyIntolerance.code.coding.extension.extension",
"min": 1
},
{
"id": "AllergyIntolerance.code.coding.system",
"path": "AllergyIntolerance.code.coding.system",
"min": 1
},
{
"id": "AllergyIntolerance.code.coding.version",
"path": "AllergyIntolerance.code.coding.version",
"max": "0"
},
{
"id": "AllergyIntolerance.code.coding.code",
"path": "AllergyIntolerance.code.coding.code",
"min": 1
},
{
"id": "AllergyIntolerance.patient",
"path": "AllergyIntolerance.patient",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
}
]
},
{
"id": "AllergyIntolerance.onset[x]",
"path": "AllergyIntolerance.onset[x]",
"mustSupport": true
},
{
"id": "AllergyIntolerance.assertedDate",
"path": "AllergyIntolerance.assertedDate",
"min": 1
},
{
"id": "AllergyIntolerance.recorder",
"path": "AllergyIntolerance.recorder",
"min": 1,
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "AllergyIntolerance.asserter",
"path": "AllergyIntolerance.asserter",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
],
"mustSupport": true
},
{
"id": "AllergyIntolerance.note",
"path": "AllergyIntolerance.note",
"mustSupport": true
},
{
"id": "AllergyIntolerance.note.author[x]",
"path": "AllergyIntolerance.note.author[x]",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "string"
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
},
{
"id": "AllergyIntolerance.reaction.substance.coding",
"path": "AllergyIntolerance.reaction.substance.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT",
"path": "AllergyIntolerance.reaction.substance.coding",
"sliceName": "snomedCT",
"max": "1"
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "AllergyIntolerance.reaction.substance.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "AllergyIntolerance.reaction.substance.coding.extension.extension",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT.system",
"path": "AllergyIntolerance.reaction.substance.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT.version",
"path": "AllergyIntolerance.reaction.substance.coding.version",
"max": "0"
},
{
"id": "AllergyIntolerance.reaction.substance.coding:snomedCT.code",
"path": "AllergyIntolerance.reaction.substance.coding.code",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.manifestation",
"path": "AllergyIntolerance.reaction.manifestation",
"binding": {
"reference": "https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-AllergyManifestation-1"
},
"strength": "extensible"
}
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding",
"path": "AllergyIntolerance.reaction.manifestation.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT",
"path": "AllergyIntolerance.reaction.manifestation.coding",
"sliceName": "snomedCT",
"max": "1"
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "AllergyIntolerance.reaction.manifestation.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "AllergyIntolerance.reaction.manifestation.coding.extension.extension",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.system",
"path": "AllergyIntolerance.reaction.manifestation.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.version",
"path": "AllergyIntolerance.reaction.manifestation.coding.version",
"max": "0"
},
{
"id": "AllergyIntolerance.reaction.manifestation.coding:snomedCT.code",
"path": "AllergyIntolerance.reaction.manifestation.coding.code",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.severity",
"path": "AllergyIntolerance.reaction.severity",
"mustSupport": true
},
{
"id": "AllergyIntolerance.reaction.exposureRoute",
"path": "AllergyIntolerance.reaction.exposureRoute",
"binding": {
"reference": "https://fhir.nhs.uk/STU3/ValueSet/CareConnect-AllergyExposureRoute-1"
},
"strength": "example"
}
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding",
"path": "AllergyIntolerance.reaction.exposureRoute.coding",
"slicing": {
{
"type": "value",
"path": "system"
}
],
"ordered": false,
"rules": "open"
}
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT",
"path": "AllergyIntolerance.reaction.exposureRoute.coding",
"sliceName": "snomedCT",
"max": "1"
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID",
"path": "AllergyIntolerance.reaction.exposureRoute.coding.extension",
"sliceName": "snomedCTDescriptionID",
"type": [
{
"code": "Extension",
"profile": [
"https://fhir.nhs.uk/STU3/StructureDefinition/Extension-coding-sctdescid"
]
}
]
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.extension:snomedCTDescriptionID.extension",
"path": "AllergyIntolerance.reaction.exposureRoute.coding.extension.extension",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.system",
"path": "AllergyIntolerance.reaction.exposureRoute.coding.system",
"min": 1,
"fixedUri": "http://snomed.info/sct"
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.version",
"path": "AllergyIntolerance.reaction.exposureRoute.coding.version",
"max": "0"
},
{
"id": "AllergyIntolerance.reaction.exposureRoute.coding:snomedCT.code",
"path": "AllergyIntolerance.reaction.exposureRoute.coding.code",
"min": 1
},
{
"id": "AllergyIntolerance.reaction.note.author[x]",
"path": "AllergyIntolerance.reaction.note.author[x]",
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
},
{
"code": "string"
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Patient-1"
]
},
{
"code": "Reference",
"https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-Practitioner-1"
]
}
]
}
]
}
}
Command 'details' could not render: There is no placeholder called 'details'


Reference

Canonical URI: https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1

The canonical URI is the stable FHIR identifier for this profile and is not currently available as a browsable web page.

Data model element usage

Element Use CareConnect (STU3) UK Core (R4)
id
meta.versionId
meta.lastUpdated
meta.profile
meta.security
meta.tag
extension(encounter)
extension(allergyEnd)
extension(evidence)
identifier
clinicalStatus
verificationStatus
type
category
criticality
code
patient
onset.onsetDateTime
assertedDate
recorder
asserter
lastOccurrence
note
reaction.substance
reaction.manifestation
reaction.description
reaction.onset[x]
reaction.severity
reaction.exposureRoute
reaction.note

id

Usage

Optional

Guidance

The id is the logical identifier for the CareConnect-GPC-AllergyIntolerance-1 profile.

Example
<id value="4095fcc9-c0ae-4f05-b5db-1fb648fe7bda" />


meta.profile

Usage

Mandatory

Guidance

The meta.profile contains a fixed value of the URL for the CareConnect-GPC-AllergyIntolerance-1 profile.

Example
<meta>
    <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-AllergyIntolerance-1" />
</meta>


meta.security

Usage

Optional

Guidance

The security label(s) applicable to the resource.

See Resources not to be disclosed to a patient for more details on how to populate the element.

Example
<meta>
    <security>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="NOPAT"/>
        <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/>
    </security>
</meta>


meta.tag

Usage

Optional

Guidance

A use-case for the meta.tag element within GP Connect has not been defined.

Example
<meta>
    <tag>
        <coding>
            <system value="http://hl7.org/fhir/common-tags" />
            <code value="actionable" />
            <display value="Actionable" />
        </coding>
    </tag>
</meta>


extension(encounter)

Usage

Required

Guidance
Note: The encounter is part of the base resource in FHIR R4 / UK CORE.

Providing it is known, the extension.encounter should be populated with a reference to the consultation where the allergy was first recorded.

Example
<extension>
    <url value="http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter" />
    <valueReference value="urn:uuid:85acc1ae-6b9d-4a9f-9840-60d6cac081cd" />
</extension>


extension(allergyEnd)

Usage

Required

Guidance

The extension.allergyEnd contains the endDate and endReason for when the allergy or intolerance was recorded as resolved.

It MUST be populated if the clinicalStatus has the value of resolved.

  • The endDate element is the date that the allergy or intolerance was recorded as resolved.
  • The reasonEnded element is the reason that the allergy or intolerance was resolved.
Note: The value "No information available" can be used in exception circumstances where a reason has not been recorded. For example, legacy data may not contain the reason.
Example
<extension>
    <url value="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-CareConnect-GPC-AllergyIntoleranceEnd-1" />
    <extension>
        <endDate>
            <valueDateTime value="2022-07-07T14:07:48+00:00" />
        </endDate>
        <reasonEnded>
            <valueString  value="No information available" />
        </reasonEnded>
    </extension>
</extension>


identifier

Usage

Mandatory

Guidance

The identifier element MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.

Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.

Example
<identifier>
    <system value="https://tools.ietf.org/html/rfc4122" />
    <value value="653c0790-a509-4eed-99f3-f42f3683cf2e" />
</identifier>


clinicalStatus

Usage

Mandatory

Guidance

GP systems which support the concept of resolved/ended allergies MUST reflect the status and end date within this profile.

  • active for all active allergies
  • resolved for all resolved allergies
Example
<clinicalStatus value="active" />


verificationStatus

Usage

Mandatory

Guidance
Note: This value is mandatory in the base FHIR resource so cannot be removed. It is not a concept in GP systems and as such meaning MUST NOT be attributed to this field in consuming systems.

The verificationStatus MUST contain a fixed value of unconfirmed.

Example
<verificationStatus value="unconfirmed" />


type

Usage

Optional

Guidance
Note: This value is mandatory in the base FHIR resource so cannot be removed. It is not a concept in GP systems and as such meaning MUST NOT be attributed to this field in consuming systems.

The type MUST be set to allergy for reactions which are allergenic in nature (immunological), a value of intolerance MAY be used to indicate adverse reactions (not immunologic in nature).

Where the type is unknown the type element may be omitted.

Example
<type value="intolerance" />


category

Usage

Mandatory

Guidance

Use medication for all drug allergy types, environment for all non-drug allergies. The other values in the AllergyIntoleranceCategory ValueSet (food and biologic) MUST NOT be used.

It is expected that it will always be possible to assign a category of medication for drug allergies or environment for all other types of allergy/intolerance. If it is not possible to distinguish between a drug and non-drug allergy, medication MUST be used. Generally, the choice in a given system is explicit. The GP suppliers MUST follow the categorisation already in use in populating the GP2GP message.

In some cases, the type of allergy/intolerance may be more general - for example, a system designated type of Other or equivalent. In such cases, if the allergy/intolerance entry interacts with prescribing decision support it MUST be assigned a category of medication. Otherwise, the category of environment MUST be used.

Example
<category value="medication" />


criticality

Usage

Required

Guidance

Distinguishes between life-threatening (high) and non-life-threatening (low) potential as well as unable-to-assess. It MAY be used in addition to severity within the reaction element to express severity - for example, systems that support a severity of life-threatening MAY set criticality to high.

It MAY be used in conjunction with reaction / severity by systems which support a severity of life-threatening or equivalent.

Example
<criticality value="high" />


code

Usage

Mandatory

Guidance

The causative agent such as food, drug or substances that has caused or may cause an allergy, intolerance or adverse reaction in this patient.

Systems will evolve to use the specified vocabulary of SNOMED CT concepts from the specified subset. The subset includes products and concepts from the substance and product hierarchies and allows medication concepts from the dm+d SNOMED CT extension.

In the interim this coded element will hold the primary code for the AllergyIntolerance which may in the case of drug allergies be a medication code or a pre-coordinated code which triggers decision support on the system.

Where the AllergyIntolerance has no coded representation in the source system, but is identified as such in the source record then the appropriate degrade code may be used and the text of the AllergyIntolerance placed in the text of the code.

Example
<code>
    <coding>
        <display value="Transfer-degraded drug allergy" />
        <code value="196461000000101" />
        <system value="http://snomed.info/sct" />
        <snomedCT>
            <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            <extension>
            <valueId value="294801000000114" />
                <descriptionId value="294801000000114" />
                <descriptionDisplay value="Transfer-degraded drug allergy (record artifact)" />
            </extesion>
        </snomedCT>
    </coding>
    <text value="Allergy to paracetemol" />
</code>



patient

Usage

Mandatory

Guidance

A reference to the patient who the allergy / intolerance relates to.

Command 'pagelink' could not render: Page not found.

Example
<patient>
    <reference value="patient-9929alp" />
</patient>


onset.onsetDateTime

Usage

Required

Guidance

Date when the allergy / intolerance first manifested. Currently restricted to values of dateTime for GP Connect.

This field MUST be populated where the GP system records an explicit onset date for an allergy.

Example
<onset>
    <onsetDateTime value="2011-05-07T00:00:00+00:00" />
</onset>


assertedDate

Usage

Mandatory

Guidance

The datetime the record was believed to be true.

The asserted date is when the allergy related to the patient was asserted. In many cases, this will be when the allergy is recorded onto the system however there are situations where they can differ. For example, if an allergy is asserted during a home visit that is recorded on the clinical system the following day, the asserted date is the date the consultation took place, not the date it was recorded.

Where no asserted date is available, the recorded date is used.

Example
<assertedDate value="2022-07-22T13:24:00+00:00" />


recorder

Usage

Mandatory

Guidance

A reference to the person that recorded the allergy / intolerance.

Example
<recorder>
    <reference value="practitioner-3239exck" />
</recorder>


asserter

Usage

Required

Guidance

Source of the information about the allergy.

Example
<asserter>
    <reference value="practitioner-3239exck" />
</asserter>


lastOccurrence

Usage

Optional

Guidance

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

This data item may not currently be available from providing systems and in this circumstance MAY be omitted. Omission SHOULD NOT prejudice the ability of providers and consumers to process this element if and when it is available.

Example
<lastOccurrence value="2022-07-22T13:28:00+00:00" />


note

Usage

Required

Guidance

All text associated with the AllergyIntolerance including user-entered notes and qualifiers is grouped together and expressed in this field, which ensures unmapped coded values or qualifiers are not lost.

Must be used to contain any textual data relevant to the allergy.

Example
<note>
    <author>
        <reference value="practitioner-948392" />
    </author>
    <time value="2022-10-13T16:59:00Z" />
    <text>
        Free text... R4 of the FHIR standard supports GitHub Flavoured Markdown (GFM).
    </text>
</note>


reaction.manifestation

Usage

Optional

Guidance

Conveys the reaction resulting from the allergy / intolerance as a code.

This element is mandatory in the FHIR base profile and so if no data is present please use the nullFlavour as outlined here.

Where no code is available, but a textual description of the reaction is available, then the nullFlavor UNC MAY be used and the textual description conveyed via reaction/description.

If no reaction has explicitly been recorded, but the reaction element is present to convey severity, then reaction/manifestation SHOULD be coded as the nullFlavor NI.

If the patient has been asked, but is unable to specify a reaction the nullFlavor, ASKU SHOULD be used.

Example
<reaction>
    <manifestation>
        <coding>
            <display value="Peanut-induced anaphylaxis" />
            <code value="241933001" />
            <system value="http://snomed.info/sct" />
            <snomedCT>
                <extension>
                  <descriptionId value="362151013" />
                  <descriptionDisplay value="Peanut-induced anaphylaxis (disorder)" />
                </extension>
                <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" />
            </snomedCT>
        </coding>
        <text value="Anaphalactic shock" />
    </manifestation>
</reaction>


reaction.description

Usage

Optional

Guidance

Conveys the textual description of the manifestation where no code is available.

A consuming system MAY concatenate the contents (appropriately labelled) with text in AllergyIntolerance.note if a textual description of the manifestation is not supported in the receiving system record structure.

Example
<reaction>
    <description value="Vivamus rhoncus mi id urna mattis, a fringilla quam congue." />
</reaction>


reaction.exposureRoute

Usage

Optional

Guidance

The route by which exposure to the substance causing the reaction occurred. Utilise the dm+d route codes.

Example
<reaction>
    <exposureRoute>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="26643006" />
            <display value="Oral" />
        </coding>
    </exposureRoute>
</reaction>


reaction.severity

Usage

Required

Guidance

Severities of Mild, Moderate, Severe are mapped directly to the ValueSet. Map life threatening to Severe and populate criticality with high.

Example
<severity value="Moderate" />


AllergyIntolerance Elements not in use

The following elements SHALL NOT be populated:

extension[evidence]

meta.versionId

meta.lastUpdated

reaction.note

AllergyIntolerance.note should contain all the consolidated text from the Allergy/Intelerance.

reaction.onset[x]

Onset explicitly supplied via AllergyIntolerance.onset[dateTime].

reaction.substance

The causative is explicitly and specifically coded via AllergyIntolerance.

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