HdBe-AllergyIntolerance

Profile	Description	Status	URL
HdBe-AllergyIntolerance	An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction. The substances can be categorized as follows: Medicine Medicine category Ingredient/addition Nutrition Environmental factor Animal Plants Chemicals Inhaled allergenic	draft	https://fhir.healthdata.be/StructureDefinition/HdBe-AllergyIntolerance

Profile

Description

Status

URL

HdBe-AllergyIntolerance

An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction. The substances can be categorized as follows:

Medicine
Medicine category
Ingredient/addition
Nutrition
Environmental factor
Animal
Plants
Chemicals
Inhaled allergenic

draft

https://fhir.healthdata.be/StructureDefinition/HdBe-AllergyIntolerance

AllergyIntolerance	I		AllergyIntolerance	Element Id AllergyIntolerance Short description AllergyIntolerance Alternate names Allergy, Intolerance, Adverse Reaction, AllergieIntolerantie Definition Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. Comments Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings. Data Type AllergyIntolerance Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ait-1:AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()` ait-2:AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=OBS, moodCode=EVN] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.1 HdBe-AllergyIntolerance:AllergyIntolerance
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id AllergyIntolerance.identifier Short description External ids for this item Definition Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:IAM-7 rim:id
clinicalStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.clinicalStatus Short description AllergyStatus Alternate names AllergieStatus Definition Statement on the status of the patient’s hypersensitivity. Comments See the comment on the root element for guidance on mapping zib AllergyStatus to FHIR. Data Type CodeableConcept Binding Use ConceptMap AllergyStatusCodelist_to_AllergyIntoleranceClinicalStatusCodes to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceClinicalStatusCodes AllergyIntoleranceClinicalStatusCodes (required) Permitted Values AllergyStatus_to_AllergyIntoleranceClinicalStatusCodes Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyStatus
verificationStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.verificationStatus Short description AllergyStatus Alternate names AllergieStatus Definition Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). Comments The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Data Type CodeableConcept Binding Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatusCodes (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id AllergyIntolerance.type Short description allergy \| intolerance - Underlying mechanism (if known) Alternate names Category, Class Definition Identification of the underlying physiological mechanism for the reaction risk. Comments Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource. Data Type code Binding Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:IAM-9 rim:code
category	Σ	0..1	codeBinding	Element Id AllergyIntolerance.category Short description AllergyCategory Alternate names Category, Type, Reaction Type, Class, AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Comments This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. Data Type code Binding Use ConceptMap AllergyCategoryCodelist_to_AllergyIntoleranceCategory to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCategory AllergyIntoleranceCategory (required) Permitted Values AllergyCategory_to_AllergyIntoleranceCategory Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:AL1-2 rim:value < IntoleranceValue (Agent) zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
extension	I	0..*	Extension	Element Id AllergyIntolerance.category.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
allergyCategoryCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.value[x] Short description AllergyCategory Alternate names AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Binding AllergyCategory (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
criticality	Σ	0..1	codeBinding	Element Id AllergyIntolerance.criticality Short description Criticality Alternate names Severity, Seriousness, Contra-indication, Risk, MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Comments The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceCriticality to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCriticality AllergyIntoleranceCriticality (required) Permitted Values CriticalExtent_to_AllergyIntoleranceCriticality Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.grade v2:AL1-4 rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
extension	I	0..*	Extension	Element Id AllergyIntolerance.criticality.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
criticalExtentCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.value[x] Short description Criticality Alternate names MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Binding CriticalExtent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
code	Σ	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.code Short description CausativeAgent Alternate names Code, VeroorzakendeStof Definition Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive. Comments It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Data Type CodeableConcept Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] v2:AL1-3 / IAM-3 rim:substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.2 HdBe-AllergyIntolerance:AllergyIntolerance.CausativeAgent
patient	Σ I	1..1	Reference(Patient)	There are no (further) constraints on this element Element Id AllergyIntolerance.patient Short description Who the sensitivity is for Alternate names Patient Definition The patient who has the allergy or intolerance. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] v2:(PID-3) rim:.participation[typeCode=SBJ].role[classCode=PAT] w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id AllergyIntolerance.encounter Short description Encounter when the allergy or intolerance was asserted Definition The encounter when the allergy or intolerance was asserted. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
onset[x]		0..1		Element Id AllergyIntolerance.onset[x] Short description When allergy or intolerance was identified Definition Estimated or actual date, date-time, or age when allergy or intolerance was identified. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low
onsetAge			Age	There are no (further) constraints on this element Data Type Age
onsetPeriod			Period	There are no (further) constraints on this element Data Type Period
onsetRange			Range	There are no (further) constraints on this element Data Type Range
onsetString			string	There are no (further) constraints on this element Data Type string
onsetDateTime		0..1	dateTime	Element Id AllergyIntolerance.onset[x]:onsetDateTime Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the allergy or undesired reaction was determined. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.6 HdBe-AllergyIntolerance:AllergyIntolerance.StartDateTime
recordedDate		0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.recordedDate Short description Date first version of the resource instance was recorded Definition The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.recorded v2:IAM-13 rim:.participation[typeCode=AUT].time
recorder	I	0..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id AllergyIntolerance.recorder Short description Who recorded the sensitivity Alternate names Author Definition Individual who recorded the record and takes responsibility for its content. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role
asserter	Σ I	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id AllergyIntolerance.asserter Short description Source of the information about the allergy Alternate names Source, Informant Definition The source of the information about the allergy that is recorded. Comments The recorder takes responsibility for the content, but can reference the source from where they got it. Data Type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.source v2:IAM-14 (if patient) / IAM-18 (if practitioner) rim:.participation[typeCode=INF].role
lastOccurrence		0..1	dateTime	Element Id AllergyIntolerance.lastOccurrence Short description LastReactionDateTime Alternate names LaatsteReactieDatumTijd Definition Entry of the last time a hypersensitive reaction took place. Comments This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.8 HdBe-AllergyIntolerance:AllergyIntolerance.LastReactionDateTime
note		0..1	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.note Short description Additional text not captured in other fields Definition Additional narrative about the propensity for the Adverse Reaction, not captured in other fields. Comments For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id AllergyIntolerance.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id AllergyIntolerance.note.text Short description Comment Alternate names Toelichting Definition Textual explanation of the hypersensitivity which cannot be entered in any of the other fields. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.9 HdBe-AllergyIntolerance:AllergyIntolerance.Comment
reaction		0..*	BackboneElement	Element Id AllergyIntolerance.reaction Short description Reaction Alternate names Reactie Definition Details about each adverse reaction event linked to exposure to the identified substance. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.10 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction
substance		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.substance Short description SpecificSubstance Alternate names SpecifiekeStof Definition More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive. Comments Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'. Data Type CodeableConcept Binding Codes defining the type of the substance (including pharmaceutical products). CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.12 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.SpecificSubstance
manifestation		1..*	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.manifestation Short description Symptom Alternate names Symptoms, Signs, Symptoom Definition The content specifications of the reaction that takes place when the patient is exposed to the causative substance. Comments Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Data Type CodeableConcept Binding Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. Symptom (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:AL1-5 rim:code zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.11 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Symptom
description		0..1	string	Element Id AllergyIntolerance.reaction.description Short description ReactionDescription Alternate names Narrative, Text, ReactieBeschrijving Definition Textual description of the reaction as a whole. Comments Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.13 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionDescription
onset		0..1	dateTime	Element Id AllergyIntolerance.reaction.onset Short description ReactionTime Alternate names ReactieTijdstip Definition Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:AL1-6 rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.17 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionTime
severity		0..1	codeBinding	Element Id AllergyIntolerance.reaction.severity Short description Severity Alternate names Ernst Definition The severity of the reaction as a result of exposure to the causative substance. Comments It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceSeverity to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceSeverity AllergyIntoleranceSeverity (required) Permitted Values CriticalExtent_to_AllergyIntoleranceSeverity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.14 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Severity
exposureRoute		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.exposureRoute Short description RouteOfExposure Alternate names WijzeVanBlootstelling Definition Way in which the patient came into contact with the causative agent or the way in which the agent was administered. Comments Coding of the route of exposure with a terminology should be used wherever possible. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfExposure (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.15 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.RouteOfExposure
note		0..*	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.reaction.note Short description Text about event not captured in other fields Definition Additional text about the adverse reaction event not captured in other fields. Comments Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value

AllergyIntolerance	I		AllergyIntolerance	Element Id AllergyIntolerance Short description AllergyIntolerance Alternate names Allergy, Intolerance, Adverse Reaction, AllergieIntolerantie Definition Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. Comments Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings. Data Type AllergyIntolerance Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ait-1:AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()` ait-2:AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=OBS, moodCode=EVN] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.1 HdBe-AllergyIntolerance:AllergyIntolerance
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id AllergyIntolerance.identifier Short description External ids for this item Definition Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:IAM-7 rim:id
clinicalStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.clinicalStatus Short description AllergyStatus Alternate names AllergieStatus Definition Statement on the status of the patient’s hypersensitivity. Comments See the comment on the root element for guidance on mapping zib AllergyStatus to FHIR. Data Type CodeableConcept Binding Use ConceptMap AllergyStatusCodelist_to_AllergyIntoleranceClinicalStatusCodes to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceClinicalStatusCodes AllergyIntoleranceClinicalStatusCodes (required) Permitted Values AllergyStatus_to_AllergyIntoleranceClinicalStatusCodes Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyStatus
verificationStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.verificationStatus Short description AllergyStatus Alternate names AllergieStatus Definition Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). Comments The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Data Type CodeableConcept Binding Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatusCodes (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id AllergyIntolerance.type Short description allergy \| intolerance - Underlying mechanism (if known) Alternate names Category, Class Definition Identification of the underlying physiological mechanism for the reaction risk. Comments Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource. Data Type code Binding Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:IAM-9 rim:code
category	Σ	0..1	codeBinding	Element Id AllergyIntolerance.category Short description AllergyCategory Alternate names Category, Type, Reaction Type, Class, AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Comments This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. Data Type code Binding Use ConceptMap AllergyCategoryCodelist_to_AllergyIntoleranceCategory to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCategory AllergyIntoleranceCategory (required) Permitted Values AllergyCategory_to_AllergyIntoleranceCategory Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:AL1-2 rim:value < IntoleranceValue (Agent) zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
extension	I	0..*	Extension	Element Id AllergyIntolerance.category.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
allergyCategoryCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.value[x] Short description AllergyCategory Alternate names AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Binding AllergyCategory (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
criticality	Σ	0..1	codeBinding	Element Id AllergyIntolerance.criticality Short description Criticality Alternate names Severity, Seriousness, Contra-indication, Risk, MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Comments The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceCriticality to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCriticality AllergyIntoleranceCriticality (required) Permitted Values CriticalExtent_to_AllergyIntoleranceCriticality Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.grade v2:AL1-4 rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
extension	I	0..*	Extension	Element Id AllergyIntolerance.criticality.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
criticalExtentCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.value[x] Short description Criticality Alternate names MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Binding CriticalExtent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
code	Σ	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.code Short description CausativeAgent Alternate names Code, VeroorzakendeStof Definition Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive. Comments It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Data Type CodeableConcept Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] v2:AL1-3 / IAM-3 rim:substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.2 HdBe-AllergyIntolerance:AllergyIntolerance.CausativeAgent
patient	Σ I	1..1	Reference(Patient)	There are no (further) constraints on this element Element Id AllergyIntolerance.patient Short description Who the sensitivity is for Alternate names Patient Definition The patient who has the allergy or intolerance. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] v2:(PID-3) rim:.participation[typeCode=SBJ].role[classCode=PAT] w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id AllergyIntolerance.encounter Short description Encounter when the allergy or intolerance was asserted Definition The encounter when the allergy or intolerance was asserted. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
onset[x]		0..1		Element Id AllergyIntolerance.onset[x] Short description When allergy or intolerance was identified Definition Estimated or actual date, date-time, or age when allergy or intolerance was identified. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low
onsetAge			Age	There are no (further) constraints on this element Data Type Age
onsetPeriod			Period	There are no (further) constraints on this element Data Type Period
onsetRange			Range	There are no (further) constraints on this element Data Type Range
onsetString			string	There are no (further) constraints on this element Data Type string
onsetDateTime		0..1	dateTime	Element Id AllergyIntolerance.onset[x]:onsetDateTime Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the allergy or undesired reaction was determined. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.6 HdBe-AllergyIntolerance:AllergyIntolerance.StartDateTime
recordedDate		0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.recordedDate Short description Date first version of the resource instance was recorded Definition The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.recorded v2:IAM-13 rim:.participation[typeCode=AUT].time
recorder	I	0..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id AllergyIntolerance.recorder Short description Who recorded the sensitivity Alternate names Author Definition Individual who recorded the record and takes responsibility for its content. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role
asserter	Σ I	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id AllergyIntolerance.asserter Short description Source of the information about the allergy Alternate names Source, Informant Definition The source of the information about the allergy that is recorded. Comments The recorder takes responsibility for the content, but can reference the source from where they got it. Data Type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.source v2:IAM-14 (if patient) / IAM-18 (if practitioner) rim:.participation[typeCode=INF].role
lastOccurrence		0..1	dateTime	Element Id AllergyIntolerance.lastOccurrence Short description LastReactionDateTime Alternate names LaatsteReactieDatumTijd Definition Entry of the last time a hypersensitive reaction took place. Comments This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.8 HdBe-AllergyIntolerance:AllergyIntolerance.LastReactionDateTime
note		0..1	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.note Short description Additional text not captured in other fields Definition Additional narrative about the propensity for the Adverse Reaction, not captured in other fields. Comments For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id AllergyIntolerance.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id AllergyIntolerance.note.text Short description Comment Alternate names Toelichting Definition Textual explanation of the hypersensitivity which cannot be entered in any of the other fields. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.9 HdBe-AllergyIntolerance:AllergyIntolerance.Comment
reaction		0..*	BackboneElement	Element Id AllergyIntolerance.reaction Short description Reaction Alternate names Reactie Definition Details about each adverse reaction event linked to exposure to the identified substance. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.10 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction
substance		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.substance Short description SpecificSubstance Alternate names SpecifiekeStof Definition More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive. Comments Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'. Data Type CodeableConcept Binding Codes defining the type of the substance (including pharmaceutical products). CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.12 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.SpecificSubstance
manifestation		1..*	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.manifestation Short description Symptom Alternate names Symptoms, Signs, Symptoom Definition The content specifications of the reaction that takes place when the patient is exposed to the causative substance. Comments Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Data Type CodeableConcept Binding Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. Symptom (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:AL1-5 rim:code zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.11 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Symptom
description		0..1	string	Element Id AllergyIntolerance.reaction.description Short description ReactionDescription Alternate names Narrative, Text, ReactieBeschrijving Definition Textual description of the reaction as a whole. Comments Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.13 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionDescription
onset		0..1	dateTime	Element Id AllergyIntolerance.reaction.onset Short description ReactionTime Alternate names ReactieTijdstip Definition Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:AL1-6 rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.17 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionTime
severity		0..1	codeBinding	Element Id AllergyIntolerance.reaction.severity Short description Severity Alternate names Ernst Definition The severity of the reaction as a result of exposure to the causative substance. Comments It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceSeverity to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceSeverity AllergyIntoleranceSeverity (required) Permitted Values CriticalExtent_to_AllergyIntoleranceSeverity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.14 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Severity
exposureRoute		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.exposureRoute Short description RouteOfExposure Alternate names WijzeVanBlootstelling Definition Way in which the patient came into contact with the causative agent or the way in which the agent was administered. Comments Coding of the route of exposure with a terminology should be used wherever possible. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfExposure (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.15 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.RouteOfExposure
note		0..*	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.reaction.note Short description Text about event not captured in other fields Definition Additional text about the adverse reaction event not captured in other fields. Comments Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value

AllergyIntolerance	I		AllergyIntolerance	Element Id AllergyIntolerance Short description AllergyIntolerance Alternate names Allergy, Intolerance, Adverse Reaction, AllergieIntolerantie Definition Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. Comments Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings. Data Type AllergyIntolerance Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ait-1:AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()` ait-2:AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=OBS, moodCode=EVN] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.1 HdBe-AllergyIntolerance:AllergyIntolerance
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id AllergyIntolerance.identifier Short description External ids for this item Definition Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier v2:IAM-7 rim:id
clinicalStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.clinicalStatus Short description AllergyStatus Alternate names AllergieStatus Definition Statement on the status of the patient’s hypersensitivity. Comments See the comment on the root element for guidance on mapping zib AllergyStatus to FHIR. Data Type CodeableConcept Binding Use ConceptMap AllergyStatusCodelist_to_AllergyIntoleranceClinicalStatusCodes to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceClinicalStatusCodes AllergyIntoleranceClinicalStatusCodes (required) Permitted Values AllergyStatus_to_AllergyIntoleranceClinicalStatusCodes Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyStatus
verificationStatus	Σ ?! I	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.verificationStatus Short description AllergyStatus Alternate names AllergieStatus Definition Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). Comments The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Data Type CodeableConcept Binding Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatusCodes (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.status rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.5
type	Σ	0..1	codeBinding	There are no (further) constraints on this element Element Id AllergyIntolerance.type Short description allergy \| intolerance - Underlying mechanism (if known) Alternate names Category, Class Definition Identification of the underlying physiological mechanism for the reaction risk. Comments Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource. Data Type code Binding Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:IAM-9 rim:code
category	Σ	0..1	codeBinding	Element Id AllergyIntolerance.category Short description AllergyCategory Alternate names Category, Type, Reaction Type, Class, AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Comments This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. Data Type code Binding Use ConceptMap AllergyCategoryCodelist_to_AllergyIntoleranceCategory to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCategory AllergyIntoleranceCategory (required) Permitted Values AllergyCategory_to_AllergyIntoleranceCategory Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.class v2:AL1-2 rim:value < IntoleranceValue (Agent) zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
extension	I	0..*	Extension	Element Id AllergyIntolerance.category.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
allergyCategoryCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.category.extension:allergyCategoryCodelist.value[x] Short description AllergyCategory Alternate names AllergieCategorie Definition Identifies the allergy category such as medication, food or environment. Binding AllergyCategory (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.4 HdBe-AllergyIntolerance:AllergyIntolerance.AllergyCategory
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
criticality	Σ	0..1	codeBinding	Element Id AllergyIntolerance.criticality Short description Criticality Alternate names Severity, Seriousness, Contra-indication, Risk, MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Comments The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceCriticality to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCriticality AllergyIntoleranceCriticality (required) Permitted Values CriticalExtent_to_AllergyIntoleranceCriticality Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.grade v2:AL1-4 rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
extension	I	0..*	Extension	Element Id AllergyIntolerance.criticality.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
criticalExtentCodelist	I	0..1	Extension(CodeableConcept)	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(CodeableConcept) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-CodeSpecification Mappings rim:N/A
value[x]		0..1	Binding	Element Id AllergyIntolerance.criticality.extension:criticalExtentCodelist.value[x] Short description Criticality Alternate names MateVanKritiekZijn Definition Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself. Binding CriticalExtent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.7 HdBe-AllergyIntolerance:AllergyIntolerance.Criticality
valueCodeableConcept			CodeableConcept	There are no (further) constraints on this element Data Type CodeableConcept
code	Σ	0..1	CodeableConceptBinding	Element Id AllergyIntolerance.code Short description CausativeAgent Alternate names Code, VeroorzakendeStof Definition Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive. Comments It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Data Type CodeableConcept Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] v2:AL1-3 / IAM-3 rim:substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.2 HdBe-AllergyIntolerance:AllergyIntolerance.CausativeAgent
patient	Σ I	1..1	Reference(Patient)	There are no (further) constraints on this element Element Id AllergyIntolerance.patient Short description Who the sensitivity is for Alternate names Patient Definition The patient who has the allergy or intolerance. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] v2:(PID-3) rim:.participation[typeCode=SBJ].role[classCode=PAT] w5:FiveWs.subject
encounter	I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id AllergyIntolerance.encounter Short description Encounter when the allergy or intolerance was asserted Definition The encounter when the allergy or intolerance was asserted. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
onset[x]		0..1		Element Id AllergyIntolerance.onset[x] Short description When allergy or intolerance was identified Definition Estimated or actual date, date-time, or age when allergy or intolerance was identified. Sliced: Unordered, Open, by $this(Type) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low
onsetAge			Age	There are no (further) constraints on this element Data Type Age
onsetPeriod			Period	There are no (further) constraints on this element Data Type Period
onsetRange			Range	There are no (further) constraints on this element Data Type Range
onsetString			string	There are no (further) constraints on this element Data Type string
onsetDateTime		0..1	dateTime	Element Id AllergyIntolerance.onset[x]:onsetDateTime Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the allergy or undesired reaction was determined. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.init rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.6 HdBe-AllergyIntolerance:AllergyIntolerance.StartDateTime
recordedDate		0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.recordedDate Short description Date first version of the resource instance was recorded Definition The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.recorded v2:IAM-13 rim:.participation[typeCode=AUT].time
recorder	I	0..1	Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson)	There are no (further) constraints on this element Element Id AllergyIntolerance.recorder Short description Who recorded the sensitivity Alternate names Author Definition Individual who recorded the record and takes responsibility for its content. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Practitioner \| PractitionerRole \| Patient \| RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role
asserter	Σ I	0..1	Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id AllergyIntolerance.asserter Short description Source of the information about the allergy Alternate names Source, Informant Definition The source of the information about the allergy that is recorded. Comments The recorder takes responsibility for the content, but can reference the source from where they got it. Data Type Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.source v2:IAM-14 (if patient) / IAM-18 (if practitioner) rim:.participation[typeCode=INF].role
lastOccurrence		0..1	dateTime	Element Id AllergyIntolerance.lastOccurrence Short description LastReactionDateTime Alternate names LaatsteReactieDatumTijd Definition Entry of the last time a hypersensitive reaction took place. Comments This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.8 HdBe-AllergyIntolerance:AllergyIntolerance.LastReactionDateTime
note		0..1	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.note Short description Additional text not captured in other fields Definition Additional narrative about the propensity for the Adverse Reaction, not captured in other fields. Comments For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value
author[x]	Σ	0..1		There are no (further) constraints on this element Element Id AllergyIntolerance.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation. Comments Organization is used when there's no need for specific attribution as to who made the comment. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.participant[typeCode=AUT].role
authorString			string	There are no (further) constraints on this element Data Type string
authorReference			Reference(Practitioner \| Patient \| RelatedPerson \| Organization)	There are no (further) constraints on this element Data Type Reference(Practitioner \| Patient \| RelatedPerson \| Organization)
time	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id AllergyIntolerance.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.effectiveTime
text	Σ	1..1	markdown	Element Id AllergyIntolerance.note.text Short description Comment Alternate names Toelichting Definition Textual explanation of the hypersensitivity which cannot be entered in any of the other fields. Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/ Data Type markdown Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act.text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.9 HdBe-AllergyIntolerance:AllergyIntolerance.Comment
reaction		0..*	BackboneElement	Element Id AllergyIntolerance.reaction Short description Reaction Alternate names Reactie Definition Details about each adverse reaction event linked to exposure to the identified substance. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.10 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction
substance		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.substance Short description SpecificSubstance Alternate names SpecifiekeStof Definition More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive. Comments Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'. Data Type CodeableConcept Binding Codes defining the type of the substance (including pharmaceutical products). CausativeAgent (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.12 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.SpecificSubstance
manifestation		1..*	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.manifestation Short description Symptom Alternate names Symptoms, Signs, Symptoom Definition The content specifications of the reaction that takes place when the patient is exposed to the causative substance. Comments Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Data Type CodeableConcept Binding Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. Symptom (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:AL1-5 rim:code zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.11 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Symptom
description		0..1	string	Element Id AllergyIntolerance.reaction.description Short description ReactionDescription Alternate names Narrative, Text, ReactieBeschrijving Definition Textual description of the reaction as a whole. Comments Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:text zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.13 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionDescription
onset		0..1	dateTime	Element Id AllergyIntolerance.reaction.onset Short description ReactionTime Alternate names ReactieTijdstip Definition Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:AL1-6 rim:effectiveTime.low zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.17 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.ReactionTime
severity		0..1	codeBinding	Element Id AllergyIntolerance.reaction.severity Short description Severity Alternate names Ernst Definition The severity of the reaction as a result of exposure to the causative substance. Comments It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions. Data Type code Binding Use ConceptMap CriticalExtentCodelist_to_AllergyIntoleranceSeverity to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceSeverity AllergyIntoleranceSeverity (required) Permitted Values CriticalExtent_to_AllergyIntoleranceSeverity Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)] zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.14 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.Severity
exposureRoute		0..1	CodeableConceptBinding	Element Id AllergyIntolerance.reaction.exposureRoute Short description RouteOfExposure Alternate names WijzeVanBlootstelling Definition Way in which the patient came into contact with the causative agent or the way in which the agent was administered. Comments Coding of the route of exposure with a terminology should be used wherever possible. Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. RouteOfExposure (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode zib-allergyintolerance-v3.3-2020EN:NL-CM:8.2.15 HdBe-AllergyIntolerance:AllergyIntolerance.Reaction.RouteOfExposure
note		0..*	Annotation	There are no (further) constraints on this element Element Id AllergyIntolerance.reaction.note Short description Text about event not captured in other fields Definition Additional text about the adverse reaction event not captured in other fields. Comments Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased. Data Type Annotation Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:N/A rim:Act rim:subjectOf.observationEvent[code="annotation"].value

Mapping FHIR profile to CBB

Path	map	CBB
AllergyIntolerance	AllergyIntolerance	HdBe-AllergyIntolerance
AllergyIntolerance.clinicalStatus	AllergyIntolerance.AllergyStatus	HdBe-AllergyIntolerance
AllergyIntolerance.category	AllergyIntolerance.AllergyCategory	HdBe-AllergyIntolerance
AllergyIntolerance.category.extension:allergyCategoryCodelist.value[x]	AllergyIntolerance.AllergyCategory	HdBe-AllergyIntolerance
AllergyIntolerance.criticality	AllergyIntolerance.Criticality	HdBe-AllergyIntolerance
AllergyIntolerance.criticality.extension:criticalExtentCodelist.value[x]	AllergyIntolerance.Criticality	HdBe-AllergyIntolerance
AllergyIntolerance.code	AllergyIntolerance.CausativeAgent	HdBe-AllergyIntolerance
AllergyIntolerance.onset[x]:onsetDateTime	AllergyIntolerance.StartDateTime	HdBe-AllergyIntolerance
AllergyIntolerance.lastOccurrence	AllergyIntolerance.LastReactionDateTime	HdBe-AllergyIntolerance
AllergyIntolerance.note.text	AllergyIntolerance.Comment	HdBe-AllergyIntolerance
AllergyIntolerance.reaction	AllergyIntolerance.Reaction	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.substance	AllergyIntolerance.Reaction.SpecificSubstance	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.manifestation	AllergyIntolerance.Reaction.Symptom	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.description	AllergyIntolerance.Reaction.ReactionDescription	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.onset	AllergyIntolerance.Reaction.ReactionTime	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.severity	AllergyIntolerance.Reaction.Severity	HdBe-AllergyIntolerance
AllergyIntolerance.reaction.exposureRoute	AllergyIntolerance.Reaction.RouteOfExposure	HdBe-AllergyIntolerance

HdBe-AllergyIntolerance-01

zib [zib-profile name] difference

Concept	Category	Description
`AllergyIntolerance (root)`	textual	Removed comment regarding clinicalStatus and AllergyStatus ConceptMap.
`clinicalStatus`	terminology	Replaced AllergyStatus valueSet values with SNOMED CT codes of active and inactive, which are equal to the values in the AllergyIntolerance-v4.0 2021 pre-adopt version.
`clinicalStatus`	terminology	Adapted ConceptMap AllergyStatus-to-AllergyIntoleranceClinicalStatusCodes to match with the AllergyStatus values.
`verificationStatus`	mapping	Deviated from the mapping as the AllergyStatus ValueSet does not represent the verificationStatus valueSet.
`category`	terminology	Added SNOMED CT code for unknown to AllergyCategory valueSet and replaced Other value with SNOMED CT code.
`category`	terminology	Adapted ConceptMap AllergyCategory-to-AllergyIntoleranceCategory to match with the AllergyCategory values.
`code`	terminology	Replaced existing Codelists in ValueSet with Belgium SNOMED refset with code: 751000172100.
`reaction.substance`	terminology	Replaced existing Codelists with valueSet CausativeAgent which contains Belgium SNOMED refset with code: 751000172100.
`reaction.manifestation`	terminology	Added SNOMED CT code for unknown to Symptom valueSet and replaced Other value with SNOMED CT code.
`reaction.severity`	terminology	Replaced valueSet with CriticalExtent valueSet, which is also used at the `criticality` element.
`reaction.severity`	terminology	Added a ConceptMap CriticalExtent-to-AllergyIntoleranceSeverity to map the CriticalExtent valueSet with the AllergyIntolerance values.

Terminology Bindings

Path	Name	Strength	URL	ConceptMap
AllergyIntolerance.clinicalStatus	allergyintolerance-clinical\|4.0.1	required	http://hl7.org/fhir/ValueSet/allergyintolerance-clinical\|4.0.1	https://fhir.healthdata.be/ConceptMap/AllergyStatus-to-AllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.category	allergy-intolerance-category\|4.0.1	required	http://hl7.org/fhir/ValueSet/allergy-intolerance-category\|4.0.1	https://fhir.healthdata.be/ConceptMap/AllergyCategory-to-AllergyIntoleranceCategory
AllergyIntolerance.category.extension.value[x]	AllergyCategory	required	https://fhir.healthdata.be/ValueSet/AllergyCategory	No bound ConceptMap
AllergyIntolerance.criticality	allergy-intolerance-criticality\|4.0.1	required	http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality\|4.0.1	https://fhir.healthdata.be/ConceptMap/CriticalExtent-to-AllergyIntoleranceCriticality
AllergyIntolerance.criticality.extension.value[x]	CriticalExtent	required	https://fhir.healthdata.be/ValueSet/CriticalExtent	No bound ConceptMap
AllergyIntolerance.code	CausativeAgent	required	https://fhir.healthdata.be/ValueSet/CausativeAgent	No bound ConceptMap
AllergyIntolerance.reaction.substance	CausativeAgent	required	https://fhir.healthdata.be/ValueSet/CausativeAgent	No bound ConceptMap
AllergyIntolerance.reaction.manifestation	Symptom	extensible	https://fhir.healthdata.be/ValueSet/Symptom	No bound ConceptMap
AllergyIntolerance.reaction.severity	reaction-event-severity\|4.0.1	required	http://hl7.org/fhir/ValueSet/reaction-event-severity\|4.0.1	https://fhir.healthdata.be/ConceptMap/CriticalExtent-to-AllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoute	RouteOfExposure	required	https://fhir.healthdata.be/ValueSet/RouteOfExposure	No bound ConceptMap