DwAllergyIntolerance
Purpose
The purpose of this resource to provide a record of allergies and intolerances documented for a specific patient.
| DwAllergyIntolerance (AllergyIntolerance) | I | AllergyIntolerance | There are no (further) constraints on this element Element idAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Alternate namesAllergy, Intolerance, Adverse Reaction DefinitionRisk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. 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.
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| id | S Σ | 0..1 | string | Element idAllergyIntolerance.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. UUID The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAllergyIntolerance.meta Metadata about the resource DefinitionThe 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.meta.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.meta.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| versionId | Σ | 0..1 | id | There are no (further) constraints on this element Element idAllergyIntolerance.meta.versionId Version specific identifier DefinitionThe version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. 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.
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| lastUpdated | S Σ | 0..1 | instant | There are no (further) constraints on this element Element idAllergyIntolerance.meta.lastUpdated When the resource version last changed DefinitionWhen the resource last changed - e.g. when the version changed. 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.
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| source | Σ | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.meta.source Identifies where the resource comes from DefinitionA 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. 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.
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| profile | Σ | 0..* | canonical(StructureDefinition) | There are no (further) constraints on this element Element idAllergyIntolerance.meta.profile Profiles this resource claims to conform to DefinitionA list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. 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. canonical(StructureDefinition) Constraints
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| security | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idAllergyIntolerance.meta.security Security Labels applied to this resource DefinitionSecurity labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. 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. Security Labels from the Healthcare Privacy and Security Classification System.
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| tag | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.meta.tag Tags applied to this resource DefinitionTags 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. 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. Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idAllergyIntolerance.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idAllergyIntolerance.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idAllergyIntolerance.identifier External ids for this item DefinitionBusiness 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. Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. 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.
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| clinicalStatus | S Σ ?! I | 0..1 | CodeableConceptBinding | Element idAllergyIntolerance.clinicalStatus active | inactive | resolved DefinitionThe clinical status of the allergy or intolerance. The clinical status must be empty when the verification status is "entered-in-error" PS if allergy present in CPP status = active MA Allergy Active = active Refuted = inactive 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. The clinical status of the allergy or intolerance.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | S Σ | 1..* | Coding | Element idAllergyIntolerance.clinicalStatus.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Type) Constraints
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| HL7AllergyIntoleranceClinicalStatus | S Σ | 0..1 | CodingBinding | Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. AllergyIntoleranceClinicalStatusCodes (required) Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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| version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.version Version of the system - if relevant DefinitionThe 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. 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.
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| translation | I | 0..1 | Extension(Complex) | Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation Language Translation (Localization) Alternate namesextensions, user content DefinitionLanguage translation from base language of resource to another language. 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. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/translation Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 2..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| lang | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:lang Code for Language Alternate namesextensions, user content DefinitionCode for Language. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:lang.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:lang.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:lang.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. lang
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| value[x] | 1..1 | Binding | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:lang.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list). A human language.
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| valueCode | code | There are no (further) constraints on this element Data type | ||
| content | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:content Content in other Language Alternate namesextensions, user content DefinitionContent in other Language. The type (string or markdown) must match the context in which it is used.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:content.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:content.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:content.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. content
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| value[x] | 1..1 | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension:content.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| valueString | string | There are no (further) constraints on this element Data type | ||
| valueMarkdown | markdown | There are no (further) constraints on this element Data type | ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/translation
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| value[x] | 0..0 | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| value | 0..1 | System.String | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.value Primitive value for string DefinitionPrimitive value for string System.String Maximum string length1048576 | |
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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| statusCodeSCTCA | S Σ | 0..* | CodingBinding | Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Usage note: One of active; inactive; resolved. In PSS this is active; inactive; 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. https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (required) Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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| version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.version Version of the system - if relevant DefinitionThe 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. 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.
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| translation | I | 0..1 | Extension(Complex) | Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation Language Translation (Localization) Alternate namesextensions, user content DefinitionLanguage translation from base language of resource to another language. 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. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/translation Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 2..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| lang | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:lang Code for Language Alternate namesextensions, user content DefinitionCode for Language. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:lang.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:lang.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:lang.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. lang
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| value[x] | 1..1 | Binding | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:lang.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list). A human language.
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| valueCode | code | There are no (further) constraints on this element Data type | ||
| content | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:content Content in other Language Alternate namesextensions, user content DefinitionContent in other Language. The type (string or markdown) must match the context in which it is used.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:content.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:content.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:content.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. content
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| value[x] | 1..1 | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension:content.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| valueString | string | There are no (further) constraints on this element Data type | ||
| valueMarkdown | markdown | There are no (further) constraints on this element Data type | ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/translation
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| value[x] | 0..0 | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| value | 0..1 | System.String | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.value Primitive value for string DefinitionPrimitive value for string System.String Maximum string length1048576 | |
| userSelected | S Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.clinicalStatus.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| verificationStatus | S Σ ?! I | 0..1 | CodeableConceptBinding | Element idAllergyIntolerance.verificationStatus unconfirmed | confirmed | refuted | entered-in-error DefinitionAssertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). PSS->FHIR - Suspected = unconfirmed Confirmed = confirmed Refuted = Refuted deleted or Refuted status of entered in error or Incorrect = entered-in-error MA ->FHIR Confirmed = confirmed Suspected = unconfirmed Unconfimred = unconfirmed Refuted = Refuted Deleted = entered-in-error 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. Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | Element idAllergyIntolerance.verificationStatus.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Type) Constraints
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| HL7VerificationStatus | S Σ | 0..* | CodingBinding | Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus Code defined by a terminology system DefinitionA 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). One of unconfirmed | presumed | confirmed | refuted | entered in error Allows for alternative encodings within a code system, and translations to other code systems. 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. AllergyIntoleranceVerificationStatusCodes (required) Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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| version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.version Version of the system - if relevant DefinitionThe 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. 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.
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| userSelected | S Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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| text | S Σ | 0..1 | string | Element idAllergyIntolerance.verificationStatus.text Plain text representation of the concept DefinitionA 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. 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. Display the text as it is shown in the EMR Very often the text is the same as a displayName of one of the codings.
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| type | S Σ | 0..1 | codeBinding | Element idAllergyIntolerance.type allergy | intolerance - Underlying mechanism (if known) Alternate namesCategory, Class DefinitionIdentification of the underlying physiological mechanism for the reaction risk. FHIR->PSS -
allergy->allergy 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. Identification of the underlying physiological mechanism for a Reaction Risk.
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| category | S Σ | 0..* | codeBinding | Element idAllergyIntolerance.category food | medication | environment | biologic Alternate namesCategory, Type, Reaction Type, Class DefinitionCategory of the identified substance. PSS - FHIR Medication and Allergy group = medication Food = food Stinging insect and Pollen & Dander = environment MA->FHIR Drug Allergy and Drug Intolerance = medication 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. Category of an identified substance associated with allergies or intolerances.
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| criticality | S Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.criticality low | high | unable-to-assess Alternate namesSeverity, Seriousness, Contra-indication, Risk DefinitionEstimate of the potential clinical harm, or seriousness, of the reaction to the identified substance. 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. Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
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| code | S Σ | 1..1 | CodeableConcept | Element idAllergyIntolerance.code Code that identifies the allergy or intolerance Alternate namesCode DefinitionCode 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. 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. Unordered, Open, by coding.system(Value) BindingType of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.
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| absentOrUnknownAllergyIntolerance | S Σ | 0..1 | CodeableConceptBinding | Element idAllergyIntolerance.code:absentOrUnknownAllergyIntolerance Code that identifies the allergy or intolerance Alternate namesCode DefinitionCode 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. 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. Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.
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| codeAllergyCA | S Σ | 0..1 | CodeableConceptBinding | Element idAllergyIntolerance.code:codeAllergyCA Code that identifies the allergy or intolerance Alternate namesCode DefinitionCode 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. 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. Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.
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| codeAllergyICD10CA | Σ | 0..1 | CodeableConceptBinding | Element idAllergyIntolerance.code:codeAllergyICD10CA Code that identifies the allergy or intolerance Alternate namesCode DefinitionCode 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. Usage Note: For future consideration 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. Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code:codeAllergyICD10CA.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.code:codeAllergyICD10CA.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.code:codeAllergyICD10CA.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code:codeAllergyICD10CA.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| patient | S Σ I | 1..1 | Reference(Patient) | There are no (further) constraints on this element Element idAllergyIntolerance.patient Who the sensitivity is for Alternate namesPatient DefinitionThe patient who has the allergy or intolerance. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.patient.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.patient.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| reference | S Σ I | 1..1 | string | Element idAllergyIntolerance.patient.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Internal reference to a patient: urn:telus:emr:<emrType>:<emrInstanceId>:<patientId> Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAllergyIntolerance.patient.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAllergyIntolerance.patient.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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| encounter | S I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idAllergyIntolerance.encounter Encounter when the allergy or intolerance was asserted DefinitionThe encounter when the allergy or intolerance was asserted. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.encounter.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.encounter.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| reference | Σ I | 0..1 | string | Element idAllergyIntolerance.encounter.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Internal Encounter Reference: urn:telus:emr:pss:5197:encounter:112~20040823~DRAA
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| type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAllergyIntolerance.encounter.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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| identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAllergyIntolerance.encounter.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.encounter.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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| onset[x] | S | 0..1 | There are no (further) constraints on this element Element idAllergyIntolerance.onset[x] When allergy or intolerance was identified DefinitionEstimated or actual date, date-time, or age when allergy or intolerance was identified.
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| onsetDateTime | dateTime | There are no (further) constraints on this element Data type | ||
| onsetAge | Age | There are no (further) constraints on this element Data type | ||
| onsetPeriod | Period | There are no (further) constraints on this element Data type | ||
| onsetRange | Range | There are no (further) constraints on this element Data type | ||
| onsetString | string | There are no (further) constraints on this element Data type | ||
| recordedDate | S | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.recordedDate Date first version of the resource instance was recorded DefinitionThe recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.
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| recorder | S I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | There are no (further) constraints on this element Element idAllergyIntolerance.recorder Who recorded the sensitivity Alternate namesAuthor DefinitionIndividual who recorded the record and takes responsibility for its content. 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. Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Constraints
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| asserter | Σ I | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | There are no (further) constraints on this element Element idAllergyIntolerance.asserter Source of the information about the allergy Alternate namesSource, Informant DefinitionThe source of the information about the allergy that is recorded. The recorder takes responsibility for the content, but can reference the source from where they got it. Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Constraints
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| lastOccurrence | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.lastOccurrence Date(/time) of last known occurrence of a reaction DefinitionRepresents the date and/or time of the last known occurrence of a reaction event. 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.
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| note | S | 0..* | Annotation | Element idAllergyIntolerance.note Additional text not captured in other fields DefinitionAdditional narrative about the propensity for the Adverse Reaction, not captured in other fields. Usage Note: This is the current value of the notes on the allergy record, which includes the latest manifestation/reaction notes. EMRs who capture notes on a per reaction basis may include them here. Notes MA, PSS and MS and CHR support this. 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.
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| reaction | 0..* | BackboneElement | There are no (further) constraints on this element Element idAllergyIntolerance.reaction Adverse Reaction Events linked to exposure to substance DefinitionDetails about each adverse reaction event linked to exposure to the identified substance.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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| substance | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance Specific substance or pharmaceutical product considered to be responsible for event DefinitionIdentification 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. 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'. Codes defining the type of the substance (including pharmaceutical products).
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| manifestation | S | 1..* | CodeableConceptBinding | Element idAllergyIntolerance.reaction.manifestation Clinical symptoms/signs associated with the Event Alternate namesSymptoms, Signs DefinitionClinical symptoms and/or signs that are observed or associated with the adverse reaction event. 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. Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | Element idAllergyIntolerance.reaction.manifestation.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. Unordered, Open, by $this(Type) Constraints
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| manifestationSCTCA | S Σ | 0..* | CodingBinding | Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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. https://fhir.infoway-inforoute.ca/ValueSet/clinicalfindingcode (required) Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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.
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| version | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.version Version of the system - if relevant DefinitionThe 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. 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.
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| code | S Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| display | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| translation | I | 0..1 | Extension(Complex) | Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation Language Translation (Localization) Alternate namesextensions, user content DefinitionLanguage translation from base language of resource to another language. 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. Extension(Complex) Extension URLhttp://hl7.org/fhir/StructureDefinition/translation Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 2..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| lang | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:lang Code for Language Alternate namesextensions, user content DefinitionCode for Language. 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.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:lang.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:lang.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:lang.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. lang
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| value[x] | 1..1 | Binding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:lang.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list). A human language.
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| valueCode | code | There are no (further) constraints on this element Data type | ||
| content | I | 1..1 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:content Content in other Language Alternate namesextensions, user content DefinitionContent in other Language. The type (string or markdown) must match the context in which it is used.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:content.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..0 | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:content.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:content.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. content
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| value[x] | 1..1 | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension:content.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| valueString | string | There are no (further) constraints on this element Data type | ||
| valueMarkdown | markdown | There are no (further) constraints on this element Data type | ||
| url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. 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. http://hl7.org/fhir/StructureDefinition/translation
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| value[x] | 0..0 | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.value[x] Value of extension DefinitionValue of extension - must be one of a constrained set of the data types (see Extensibility for a list).
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| value | 0..1 | System.String | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.value Primitive value for string DefinitionPrimitive value for string System.String Maximum string length1048576 | |
| userSelected | S Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). 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. 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.
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| description | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.description Description of the event as a whole Alternate namesNarrative, Text DefinitionText description about the reaction as a whole, including details of the manifestation if required. 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.
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| onset | S | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.onset Date(/time) when manifestations showed DefinitionRecord of the date and/or time of the onset of the Reaction.
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| severity | S | 0..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.severity mild | moderate | severe (of event as a whole) DefinitionClinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations. 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. Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
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| exposureRoute | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute How the subject was exposed to the substance DefinitionIdentification of the route by which the subject was exposed to the substance. Coding of the route of exposure with a terminology should be used wherever possible. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
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| id | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. 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.
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| text | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute.text Plain text representation of the concept DefinitionA 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. 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. Very often the text is the same as a displayName of one of the codings.
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| note | 0..* | Annotation | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.note Text about event not captured in other fields DefinitionAdditional text about the adverse reaction event not captured in other fields. 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.
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Usage note
clinicalStatus - When allergy is present in CPP status is active and refuted allergies will have status of inactive
FHIR MA PSS CHR Active Confirmed, Unconfirmed, Suspect, Pending, Doubt raised, Reclassified Inactive Inactive, Refuted Resolved Resolved verificationStatus
FHIR MA PSS CHR Unconfirmed Unconfirmed, Suspected, Pending, Doubt raised Suspected Confirmed Confirmed Confirmed Refuted Refuted Refuted, RefuteReasonNoSubsequentReaction, RefuteReasonPatientDenies,RefuteReasonReclassified, RefuteReasonIdNoLongerFound Entered in Error Deleted, Erroneous deleted or Refuted status of entered in error, RefuteReasonIncorrectInfo, RefuteReasonEnteredInError, RefuteReasonDuplicate type - Identification of the underlying physiological mechanism for the reaction risk.
FHIR MA PSS CHR Allergy allergy drug allergy, non-drug allergy Allergy Intolerance side-effect, exagerated effect, other drug intollerance, non-drug intollerance Intolerance code
- absentOrUnknownAllergyIntolerance - When no allergy or no known allergy is documented this slice is provided.
- codeAllergyCA - Allergies documented in the EMR using the standard checkboxes will be mapped to https://tgateway.infoway-inforoute.ca/vs/pharmaceuticalbiologicproductandsubstancecode system. Allergies documented as free text will be provided as code.text
encounter - An encounter reference pertaining to a specific visit will be provided if the allergy was documented as part of that visit's encounter. In cases where allergies are documented outside the context of a visit, they will be provided without an associated encounter reference.
reaction.manifestation - Reaction to the allergen is provided as reaction.manifestation.coding when documented as standard reaction. If documented as free text then it will be provided as reaction.manifestation.text. PSS allows provider to add multiple reaction to the allergy, if documented it will be included as 0..* in the JSON message.
Bundle
Example
{
"resourceType":"AllergyIntolerance",
"id":"pss-CDK5-AllergyIntolerance-147.2",
"meta":{
"source":"urn:telus:emr:pss:CDK5",
"lastUpdated":"2022-12-20T13:19:37.000Z",
"security":[{
"system":"http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code":"N",
"display":"normal"
}
]
},
"identifier":[{
"system":"urn:telus:emr:pss:CDK5:AllergyIntolerance",
"use":"official",
"value":"147.2"
}
],
"clinicalStatus":{
"coding":[{
"system":"https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode",
"code":"active",
"display":"Active"
}
],
"text":"Confirmed"
},
"verificationStatus":{
"coding":[{
"system":"http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code":"confirmed",
"display":"Confirmed"
}
],
"text":"Confirmed"
},
"type":"allergy",
"category":["environment"],
"criticality":"high",
"code":{
"coding":[{
"system":"https://tgateway.infoway-inforoute.ca/vs/pharmaceuticalbiologicproductandsubstancecode",
"code":"256277009",
"display":"Grass pollen"
},{
"system":"https://tgateway.infoway-inforoute.ca/vs/pharmaceuticalbiologicproductandsubstancecode",
"code":"703927007",
"display":"Guinea pig dander"
},{
"system":"https://tgateway.infoway-inforoute.ca/vs/pharmaceuticalbiologicproductandsubstancecode",
"code":"710943006",
"display":"Cockroach protein"
}],
"text":"Unrecognized Imported Allergy 2"
},
"patient":{
"reference":"Patient/pss-CDK5-Patient-pss-CDK5-Patient-147",
"type":"Patient"
},
"encounter":{
"reference":"Encounter/pss-CDK5-Encounter-pss-CDK5-Encounter-2294",
"type":"Encounter"
},
"recordedDate":"2012-08-21T00:00:00.000Z",
"recorder":{
"reference":"Practitioner/pss-CDK5-Practitioner-9",
"display":"Dr. Marcus Welby",
"type":"Practitioner"
},
"note":[{
"text":"No special notes"
}
],
"reaction":[{
"manifestation":[{
"coding":[{
"system":"https://fhir.infoway-inforoute.ca/CodeSystem/snomedctcaextension",
"code":"403608009",
"display":"Serum sickness due to drug"
}
],
"text":"Moderate reaction : Serum sickness"
}
],
"severity":"moderate"
}
]
}