AllergyIntolerance Guidance
The recording of allergy and intolerance information in patient records is a major component of communicating the effects of external substances and compounds on patient health.
Introduction
General Overview of Resource
Note: Guidance replicated from that published for GPConnect.
The allergy and intolerance concept is broad and multi-dimensional:
- the causation of allergy and intolerance may be linked to specific medications or pharmaceuticals or substances (biological or chemical) in the environment
- the weight and significance that may be attached to recorded allergy or intolerance is affected by a number of factors including the certainty, the severity of the reaction and the likelihood of occurrence
- allergies and intolerances may be linked to other clinical events, such as diagnostic tests that confirm the presence of the allergy or intolerance or linked to instances of illness caused by the allergy or intolerance
- allergies and intolerances may be dynamic and evolving, increasing in severity over time, recurrent or perhaps only active and observed within defined periods.
The recording and handling of allergy and intolerance information has an important role to play in patient safety, not only with regard to clinical decision making, but also in the realm of prescribing decision support, where the presence of allergy information linked to causative agents can trigger automated alerts and restrictions when prescribing.
Given the complexity and depth of the allergy and intolerance domain there are significant differences and variations in the implementation of the allergy and intolerance concept across participating systems in terms of structure, terminology and the linkages between terminology and decision support. These differences limit the current interoperability of allergies and intolerances.
The AllergyIntolerance
resource aims to improve the interoperability of allergies and intolerances through convergence towards a standardised structure and common terminology.
The clinical importance of allergy and intolerance information coupled with the variability of implementations across participating systems means that there is a need for clear guidance on the utilisation of the AllergyIntolerance
resource by both providers and consumers.
Transformation Overview
The following sections provide details on the properties that differ when comparing
Base AllergyIntolerance Diff Table
Source: https://www.hl7.org/fhir/R4/allergyintolerance.html#tabs-diff
Element | Changes |
---|---|
AllergyIntolerance.clinicalStatus | Type changed from code to CodeableConcept. Change value set from http://hl7.org/fhir/ValueSet/allergy-clinical-status to http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1 |
AllergyIntolerance.verificationStatus | Min Cardinality changed from 1 to 0. Type changed from code to CodeableConcept. Change value set from http://hl7.org/fhir/ValueSet/allergy-verification-status to http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1 |
AllergyIntolerance.type | Change value set from http://hl7.org/fhir/ValueSet/allergy-intolerance-type to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1 |
AllergyIntolerance.category | Change value set from http://hl7.org/fhir/ValueSet/allergy-intolerance-category to http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1 |
AllergyIntolerance.criticality | Change value set from http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality to http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1 |
AllergyIntolerance.encounter | Added Element |
AllergyIntolerance.recordedDate | Renamed from assertedDate to recordedDate |
AllergyIntolerance.recorder | Type Reference: Added Target Types PractitionerRole, RelatedPerson |
AllergyIntolerance.asserter | Type Reference: Added Target Type PractitionerRole |
AllergyIntolerance.reaction.severity | Change value set from http://hl7.org/fhir/ValueSet/reaction-event-severity to http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1 |
CareConnect to UKCore AllergyIntolerance Diff table
Element | Changes |
---|---|
AllergyIntolerance.extension:encounter | Moved to new resource element AllergyIntolerance.encounter |
AllergyIntolerance.extension:allergyEnd | Renamed from AllergyIntolerance.extension.allergyEnd to AllergyIntolerance.extension.allergyIntoleranceEnd Change profle from Extension-CareConnect-AllergyIntoleranceEnd-1 to Extension-UKCore-AllergyIntoleranceEnd |
AllergyIntolerance.extension:evidence | Change profle from Extension-CareConnect-Evidence-1 to Extension-UKCore-Evidence |
AllergyIntolerance.identifier.system | Min cardinality changed from 0 to 1 |
AllergyIntolerance.identifier.value | Min cardinality changed from 0 to 1 |
AllergyIntolerance.identifier.assigner | Change profile from CareConnect-Organization-1 to UKCore-Organization |
AllergyIntolerance.verificationStatus | Change profile from CareConnect-AllergyVerificationStatus-1 to (base) http://hl7.org/fhir/ValueSet/allergyintolerance-verification |
AllergyIntolerance.code.coding | Slicing removed |
AllergyIntolerance.code.coding:snomedCT | Removed. Not required. (Covered by AllergyIntolerance.code, and cardinalify was 0..*) |
AllergyIntolerance.code | Min cardinality changed from 0 to 1ValueSet changed from to 'Care Connect Allergy Code' to UKCoreAllergyCode. |
AllergyIntolerance.patient | Change profile from CareConnect-Patient-1 to UKCore-Patient |
AllergyIntolerance.onset[x] | Remove mustSupport = true |
AllergyIntolerance.assertedDate | Min cardinality changed from 0 to 1 |
AllergyIntolerance.patient.identifier.assigner | Change profile from Orgnanization to UKCore-Organization |
AllergyIntolerance.recorder | Change profile from {CareConnect-Patient-1, CareConnect-Practitioner-1} to {UKCore-Practitioner, UKCore-PractitionerRole, UKCore-Patient, UKCore-RelatedPerson} |
AllergyIntolerance.recorder.identifier.assigner | Change profile from Orgnanization to UKCore-Organization |
AllergyIntolerance.asserter | Change profile from {RelatedPerson, CareConnect-Patient-1, CareConnect-Practitioner-1} to {UKCore-Patient, UKCore-RelatedPerson, UKCore-Practitioner, UKCore-PractitionerRole} |
AllergyIntolerance.asserter.identifier.assigner | Change profile from Orgnanization to UKCore-Organization |
AllergyIntolerance.note.author[x] | Change profile from {RelatedPerson, CareConnect-Patient-1, CareConnect-Practitioner-1} to {UKCore-Practitioner, UKCore-Organization, UKCore-Patient, UKCore-RelatedPerson} |
AllergyIntolerance.reaction.substance.coding | Slicing removed |
AllergyIntolerance.reaction.substance.coding:snomedCT | Removed. Not required. (Covered by AllergyIntolerance.reaction.substance, and cardinalify was 0..*) |
AllergyIntolerance.reaction.substance | Change profile from (base) http://hl7.org/fhir/ValueSet/substance-code to UKCore-AllergySubstance |
AllergyIntolerance.reaction.manifestation | Change profile from CareConnect-AllergyManifestation-1 to UKCore-AllergyManifestation |
AllergyIntolerance.reaction.manifestation.coding | Slicing removed |
AllergyIntolerance.reaction.manifestation.coding:snomedCT | Removed. Not required. (Covered by AllergyIntolerance.reaction.manifestation, and cardinalify was 0..*) |
AllergyIntolerance.reaction.severity | Change profile from CareConnect-ReactionEventSeverit to (base) http://hl7.org/fhir/ValueSet/reaction-event-severity |
AllergyIntolerance.reaction.exposureRoute | Slicing removed |
AllergyIntolerance.reaction.exposureRoute.coding | Removed. Not required. (Covered by AllergyIntolerance.reaction.exposureRoute, and cardinalify was 0..*) |
AllergyIntolerance.reaction.note.author[x] | Change profile from {RelatedPerson, CareConnect-Patient-1, CareConnect-Practitioner-1} to {UKCore-Practitioner, UKCore-Organization, UKCore-Patient, UKCore-RelatedPerson} |
Extensions
TODO
Element position changes
TODO
Element type changes
TODO
Element slices
TODO
Element binding changes
TODO
Element target profile changes
TODO