Implementation Guide for Portuguese Use Cases

AllergyIntolerance PT PS

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AllergyIntolerance	I		AllergyIntolerance	There are no (further) constraints on this element Element id AllergyIntolerance Short description Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Alternate names Allergy, Intolerance, Adverse Reaction 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.exists() and ('#'+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(uri) = '#').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.exists() and verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code='entered-in-error').exists().not()) implies 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').exists()) implies clinicalStatus.exists().not()` aitPtCore-01: Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'medication' é obrigatório o envio de um código ATC no elemento AllergyIntolerance.code. Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'food', 'environment', 'biologic' é obrigatório o envio, no elemento AllergyIntolerance.code, de um código pertencente ao value set Allergen No Drug. O desconhecimento de existência de alergias ou intolerância TERÁ de ser claramente documentado, enviando no elemento AllergyIntolerance.code, o código 716186003. Quando no elemento AllergyIntolerance.code é enviado o código 716186003, está dispensado o envio do elemento AllergyIntolerance.category e AllergyIntolerance.type. `(category.exists() and (code.id).exists() and code.id='drugAllergen' and category ='medication') or ( category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='food' )) or (category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='biologic' )) or ( (code.id).exists() and code.id='allergenNoDrug' and (category='environment' ) ) or ((code.id).exists() and code.id='absentOrUnknownAllergy' and (category.exists().not() or category .exists()))` Mappings rim: Entity. Role, or Act rim: Observation[classCode=OBS, moodCode=EVN] w5: clinical.general
id	Σ	1..1	id	There are no (further) constraints on this element Element id AllergyIntolerance.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id AllergyIntolerance.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id AllergyIntolerance.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding IETF language tag Common Languages (preferred) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id AllergyIntolerance.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A rim: Act.text?
contained	I	0..*	Resource	There are no (further) constraints on this element Element id AllergyIntolerance.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Constraints dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.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 resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
abatementDateTimePTExtension	I	0..1	Extension(dateTime)	There are no (further) constraints on this element Element id AllergyIntolerance.extension:abatementDateTimePTExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Indica a data ou a data estimada em que a condição foi resolvida ou entrou em remissão. 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(dateTime) Extension URL https://spms.min-saude.pt/fhir-r4B/iop/StructureDefinition/AbatementDateTimePTExtension Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
id		0..1	id	There are no (further) constraints on this element Element id AllergyIntolerance.extension:abatementDateTimePTExtension.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.extension:abatementDateTimePTExtension.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.extension:abatementDateTimePTExtension.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 uri Fixed value https://spms.min-saude.pt/fhir-r4B/iop/StructureDefinition/AbatementDateTimePTExtension Mappings rim: N/A
value[x]		0..1		There are no (further) constraints on this element Element id AllergyIntolerance.extension:abatementDateTimePTExtension.value[x] Short description Value of extension Definition Indicar a data e hora da resolução ou remissão. Uma data ou data parcial ou data e hora, sendo o formato definido pela ISO8601. Se a hora e minutos forem especificados, descrição da time zone (UTC) DEVE ser preenchida. Os segundos devem ser fornecidos devido a restrições de tipo de esquema, mas podem ser preenchidos com zero. O horário "24:00" não é permitido. Formatos possíveis: ano ano e mês ano, mês e dia YYYY-MM-DDThh:mm:ss+zz:zz - ano, mês, dia , hora, minutos , segundos e time zone. Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: N/A
valueDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
allergyIntoleranceTypePTExtension	I	0..1	Extension(CodeableConcept PT Core)	There are no (further) constraints on this element Element id AllergyIntolerance.extension:allergyIntoleranceTypePTExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Possibilita a distinção entre Alergia e Intolerância. 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 PT Core) Extension URL https://spms.min-saude.pt/fhir-r4B/iop/StructureDefinition/AllergyIntoleranceTypePTExtension Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..0	Extension Identifier PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.identifier Short description An identifier intended for computation Definition Utilizado para indicar o identificador local e/ou central. 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 Extension Identifier PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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	CodeableConcept PT CoreBinding	Element id AllergyIntolerance.clinicalStatus Short description Concept - reference to a terminology or just text Definition Identifica o estado clínico da Alergia ou Intolerância. Se ativa, implica que o utente não se encontra curado ou há risco de manifestar reação à substância identificada. Quando o utente se encontra em recuperação ou quando a alergia/intolerância persiste deverá ser utilizado o estado: “active”. Se inativa, o utente já não está em risco de desenvolver reação à substância identificada. Perante esta situação deve ser utilizado o estado: “inative”. Se resolvido, implica que o utente se encontra curado ou curado com sequelas. A reação à substância identificada foi clinicamente reavaliada por análise ou (re)exposição e é considerada como não presente, Perante esta situação deve ser utilizado o estado: “resolved”. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept PT Core Binding The clinical status of the allergy or intolerance. AllergyIntolerance Clinical Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
verificationStatus	Σ ?! I	0..1	CodeableConcept PT CoreBinding	Element id AllergyIntolerance.verificationStatus Short description Concept - reference to a terminology or just text Definition Identifica o estado de confirmação ou propensão da Intolerância ou Alergia. Se não confirmado, considera-se que o nível de certeza é baixo relativamente à propensão para uma reação à substância identificada. Neste sentido, é possível a ocorrência de uma futura reação. Perante esta situação deve ser utilizado o estado: “unconfirmed”. Se confirmado, considera-se que o nível de certeza é alto relativamente à propensão para uma reação à substância identificada. Neste sentido, é provável a ocorrência de uma futura reação. Perante esta situação deve ser utilizado o estado: “confirmed”. Se refutado, considera-se que a propensão para uma reação à substância identificada foi contestada ou refutada com um nível de certeza clínico suficiente para justificar a invalidação da informação. Perante esta situação deve ser utilizado o estado: “refuted”. O estado “entered-in-error” é utilizado em situações nas quais a instrução foi inserida com erro ou não é válida. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept PT Core Binding Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntolerance Verification Status Codes (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
type	Σ	0..0	codeBinding	Element id AllergyIntolerance.type Short description allergy \| intolerance - Underlying mechanism (if known) Alternate names Category, Class Definition Possibilita a distinção entre Alergia e Intolerância. Uma alergia corresponde à propensão para reações de hipersensibilidade a uma determinada substância. Perante esta situação deve ser utilizado o tipo: “allergy”. Uma intolerância corresponde a reações tipicamente (mas não necessariamente) não imunes. Perante esta situação deve ser utilizado o tipo: “intolerance”. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a w5: FiveWs.class v2: IAM-9 rim: code
category	Σ I	0..1	codeBinding	Element id AllergyIntolerance.category Short description food \| medication \| environment \| biologic Alternate names Category, Type, Reaction Type, Class Definition Identifica a categoria de Alergia ou Intolerância. “food”, deve ser utilizado para descrever qualquer substância que fornece suporte nutricional. “medication”, deve ser utilizado para descrever substâncias que são administradas para obtenção de um efeito fisiológico. “environment”, deve ser utilizado para descrever quaisquer substâncias encontradas no meio ambiente, não classificadas como alimento, medicamente ou biológico. “biologic”, deve ser utilizado para descrever preparações sintetizadas a partir de organismos vivos ou dos seus produtos. 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 Category of an identified substance associated with allergies or intolerances. AllergyIntoleranceCategory (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a w5: FiveWs.class v2: AL1-2 rim: value < IntoleranceValue (Agent)
criticality	Σ	0..0	codeBinding	Element id AllergyIntolerance.criticality Short description low \| high \| unable-to-assess Alternate names Severity, Seriousness, Contra-indication, Risk Definition Identifica a criticalidade associada a futuras exposições. “low” identifica que o pior resultado de uma futura exposição não é considerado como risco de vida ou com elevada probabilidade de falência dos sistemas do utente (morte). “high” identifica que o pior resultado de uma futura exposição é considerada como risco de vida ou com elevada probabilidade de falência dos sistemas do utente (morte). “unable-to-assess” identifica que não é possível avaliar qual o pior resultado decorrente de futuras exposições. 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 Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance. AllergyIntoleranceCriticality (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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)]
code	S Σ I	1..1	CodeableConcept PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code Short description Concept - reference to a terminology or just text Alternate names Code Definition Identifica o alergénio responsável pela alergia ou intolerância. Caso não seja conhecida nenhuma alergia, esta informação deverá ser comunicada. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept PT Core Sliced: Unordered, Open, by id(Value) Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. AllergyIntolerance Substance/Product, Condition and Negation Codes (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
absentOrUnknownAllergy	Σ I	0..1	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id AllergyIntolerance.code:absentOrUnknownAllergy Short description Concept - reference to a terminology or just text Alternate names Code Definition Identica quando se desconhece a existencia de alergias. Comments Value Set Name: AbsentOrUnknownAllergy Data type CodeableConcept PT Core Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:absentOrUnknownAllergy.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value absentOrUnknownAllergy Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:absentOrUnknownAllergy.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:absentOrUnknownAllergy.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:absentOrUnknownAllergy.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
allergenNoDrug	Σ I	0..1	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id AllergyIntolerance.code:allergenNoDrug Short description Concept - reference to a terminology or just text Alternate names Code Definition Identifica o alergénio não medicamentoso. Comments Value Set Name: AllergenNoDrug Data type CodeableConcept PT Core Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:allergenNoDrug.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value allergenNoDrug Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:allergenNoDrug.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:allergenNoDrug.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:allergenNoDrug.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
drugAllergen	Σ I	0..1	Codeable Concept MED Code PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen Short description Concept - reference to a terminology or just text Alternate names Code Definition Identifica o alergénio medicamentoso. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type Codeable Concept MED Code PT Core Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. AllergyIntolerance Substance/Product, Condition and Negation Codes (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value drugAllergen Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Sliced: Unordered, Open, by id(Value) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
EMA	Σ	0..0	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:EMA Short description A reference to a code defined by a terminology system Definition Número do Medicamento na Agência Europeia de Medicamentos Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
absentUnknownMedication	Σ	0..0	Coding PT CoreBinding	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:absentUnknownMedication Short description A reference to a code defined by a terminology system Definition Identifica quando não é conhecido o medicamento ou quando não há registos de relevantes de medicamentos. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Value set Name ID: AbsentOrUnknownMedication Data type Coding PT Core Binding https://www.ctc.min-saude.pt/catalogos/apoio-ao-registo-da-medicacao (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ATC	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC Short description A reference to a code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value ATC Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value http://www.whocc.no/atc Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:ATC.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
RN-PT	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT Short description A reference to a code defined by a terminology system Definition Número de Registo do Medicamento do INFARMED Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value RN-PT Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://www.infarmed.pt Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:RN-PT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
CHNM-PT	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT Short description A reference to a code defined by a terminology system Definition Código Hospitalar Nacional do Medicamento do INFARMED Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value CHNM-PT Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://www.infarmed.pt Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CHNM-PT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
CNPEM-PT	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT Short description A reference to a code defined by a terminology system Definition Código Nacional para a Prescrição Eletrónica de Medicamentos do INFARMED Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value CNPEM-PT Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://www.infarmed.pt Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNPEM-PT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
CNID-PT	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT Short description A reference to a code defined by a terminology system Definition Código Nacional para a Identificação Comercial do Medicamento do INFARMED (MED_ID) Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	idFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Fixed value CNID-PT Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://www.infarmed.pt Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:CNID-PT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
DCI-PT	Σ	0..*	Coding PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT Short description A reference to a code defined by a terminology system Definition Denominação Comum Internacional em Português das substâncias ativas dos medicamentos Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Data type Coding PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	id	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
system	Σ	1..1	uriFixed Value	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Data type uri Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Fixed value https://www.infarmed.pt Mappings rim: n/a v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..0	boolean	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.coding:DCI-PT.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	1..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.code:drugAllergen.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
patient	S Σ I	1..1	Reference(Patient PT PS)	Element id AllergyIntolerance.patient Short description Who the sensitivity is for Alternate names Patient Definition Identifica o Utente ao qual a Alergia ou Intolerância se encontra associada. 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 PT PS) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.subject[x] v2: (PID-3) rim: .participation[typeCode=SBJ].role[classCode=PAT] w5: FiveWs.subject
encounter	I	0..0	Reference(Encounter PT Core)	There are no (further) constraints on this element Element id AllergyIntolerance.encounter Short description Encounter when the allergy or intolerance was asserted Definition Identifica o Episódio no qual a Alergia ou Intolerância foi identificada. 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 PT Core) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.context rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
onset[x]	S	0..1		There are no (further) constraints on this element Element id AllergyIntolerance.onset[x] Short description When allergy or intolerance was identified Definition Identifica quando é que Alergia ou Intolerância foi identificada. Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a w5: FiveWs.init rim: effectiveTime.low
onsetDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
onsetAge			Age PT Core	There are no (further) constraints on this element Data type Age PT Core
onsetPeriod			Period PT Core	There are no (further) constraints on this element Data type Period PT Core
onsetRange			Range PT Core	There are no (further) constraints on this element Data type Range PT Core
onsetString			string	There are no (further) constraints on this element Data type string
recordedDate		0..0	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 Identifica a data associada ao primeiro registo. Uma data ou data parcial ou data e hora, sendo o formato definido pela ISO8601. Se a hora e minutos forem especificados, descrição da time zone (UTC) DEVE ser preenchida. Os segundos devem ser fornecidos devido a restrições de tipo de esquema, mas podem ser preenchidos com zero. O horário "24:00" não é permitido. Formatos possíveis: ano; ano e mês; ano, mês e dia; YYYY-MM-DDThh:mm:ss+zz:zz - ano, mês, dia , hora, minutos , segundos e time zone. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a w5: FiveWs.recorded v2: IAM-13 rim: .participation[typeCode=AUT].time
recorder	I	0..0	Reference(PractitionerRole PT Core \| Practitioner PT Core \| Patient PT Core \| Related Person PT Core)	There are no (further) constraints on this element Element id AllergyIntolerance.recorder Short description Who recorded the sensitivity Alternate names Author Definition Identifica o responsável pelo registo da Alergia ou Intolerância. 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(PractitionerRole PT Core \| Practitioner PT Core \| Patient PT Core \| Related Person PT Core) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.author rim: .participation[typeCode=AUT].role
asserter	Σ I	0..0	Reference(PractitionerRole PT Core \| Practitioner PT Core \| Patient PT Core \| Related Person PT Core)	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 Identifica a quem registou a alergia ou intolerância. Assim, a origem da informação pode ser o Profissional, Utente ou Pessoa Relacionad Comments The recorder takes responsibility for the content, but can reference the source from where they got it. Data type Reference(PractitionerRole PT Core \| Practitioner PT Core \| Patient PT Core \| Related Person PT Core) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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')) or (reference='#' and %rootResource!=%resource)` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.source v2: IAM-14 (if patient) / IAM-18 (if practitioner) rim: .participation[typeCode=INF].role
lastOccurrence		0..0	dateTime	Element id AllergyIntolerance.lastOccurrence Short description Date(/time) of last known occurrence of a reaction Definition A data de última ocorrência de reação. Uma data ou data parcial ou data e hora, sendo o formato definido pela ISO8601. Se a hora e minutos forem especificados, descrição da time zone (UTC) DEVE ser preenchida. Os segundos devem ser fornecidos devido a restrições de tipo de esquema, mas podem ser preenchidos com zero. O horário "24:00" não é permitido. Formatos possíveis: ano; ano e mês; ano, mês e dia; YYYY-MM-DDThh:mm:ss+zz:zz - ano, mês, dia , hora, minutos , segundos e time zone. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime
note		0..*	Annotation PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.note Short description Text node with attribution Definition Apresenta informação complementar, não descrita nos restantes atributos Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: N/A rim: Act rim: subjectOf.observationEvent[code="annotation"].value
reaction	S	0..*	BackboneElement	There are no (further) constraints on this element Element id AllergyIntolerance.reaction Short description Adverse Reaction Events linked to exposure to substance Definition Identifica eventos associados à exposição. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]
id		0..0	id	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type id Mappings rim: n/a
extension	S I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.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) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
severityReactionPTExtension	I	0..*	Extension(CodeableConcept PT Core)	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.extension:severityReactionPTExtension Short description Optional Extensions Element Alternate names extensions, user content Definition Identifica a severidade ou gravidade da reação. Comments Value Set Name: Severity Data type Extension(CodeableConcept PT Core) Extension URL https://spms.min-saude.pt/fhir-r4B/iop/StructureDefinition/SeverityReactionPTExtension Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
substance		0..0	CodeableConcept PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.substance Short description Concept - reference to a terminology or just text Definition Identifica o alergénio responsável pela alergia ou intolerância. Caso não seja conhecida nenhuma alergia, esta informação deverá ser comunicada. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept PT Core Binding Codes defining the type of the substance (including pharmaceutical products). Substance Code (example) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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]
manifestation	S	1..*	CodeableConcept PT CoreBinding	Element id AllergyIntolerance.reaction.manifestation Short description Concept - reference to a terminology or just text Alternate names Symptoms, Signs Definition Identifica os sintomas/sinais associados à reação. Esta informação encontra-se disponível no catálogo CPARA, Value Set “Reaction Manifestation” codificado de acordo com “http://snomed.info/sct". Comments Value Set Name: ReactionManifestation Data type CodeableConcept PT Core Binding Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AL1-5 rim: code
description		0..0	string	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.description Short description Description of the event as a whole Alternate names Narrative, Text Definition Apresenta descrição da reação. 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 unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: text
onset		0..0	dateTime	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.onset Short description Date(/time) when manifestations showed Definition A data da manifestação da reação. Uma data ou data parcial ou data e hora, sendo o formato definido pela ISO8601. Se a hora e minutos forem especificados, descrição da time zone (UTC) DEVE ser preenchida. Os segundos devem ser fornecidos devido a restrições de tipo de esquema, mas podem ser preenchidos com zero. O horário "24:00" não é permitido. Formatos possíveis: ano; ano e mês; ano, mês e dia; YYYY-MM-DDThh:mm:ss+zz:zz - ano, mês, dia , hora, minutos , segundos e time zone. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: AL1-6 rim: effectiveTime.low
severity		0..0	codeBinding	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.severity Short description mild \| moderate \| severe (of event as a whole) Definition Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations. 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 Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations. AllergyIntoleranceSeverity (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
exposureRoute		0..0	CodeableConcept PT CoreBinding	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.exposureRoute Short description Concept - reference to a terminology or just text Definition Identifica a via de exposição associada à reação. Comments Value Set Name: RouteofAdministration Data type CodeableConcept PT Core Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. https://www.ctc.min-saude.pt/catalogos/apoio-ao-registo-da-medicacao (required) Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` 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
note		0..*	Annotation PT Core	There are no (further) constraints on this element Element id AllergyIntolerance.reaction.note Short description Text node with attribution Definition Apresenta informação complementar, não descrita nos restantes atributos. Comments For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). Data type Annotation PT Core Constraints ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource `hasValue() or (children().count() > id.count()) or $this is Parameters` Mappings rim: n/a v2: N/A rim: Act rim: subjectOf.observationEvent[code="annotation"].value

Binding

Path	Strength	ValueSet	Comment
AllergyIntolerance.code absentOrUnknownAllergy	required	https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas	Value Set Name: AbsentOrUnknownAllergy
AllergyIntolerance.code allergenNoDrug	required	https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas	Value Set Name: AllergenNoDrug
AllergyIntolerance.reaction.manifestation	required	https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas	Value Set Name: ReactionManifestation
AllergyIntolerance.reaction.exposureRoute	required	https://www.ctc.min-saude.pt/catalogos/apoio-ao-registo-da-medicacao	Value Set Name: RouteofAdministration
Extension.value[x] AllergyIntoleranceType	required	https://www.ctc.min-saude.pt/catalogos/alergias-e-outras-reacoes-adversas	Value Set Name: AllergyIntoleranceType
Extension.value[x] SeverityReaction	required	https://www.ctc.min-saude.pt/catalogos/apoio-ao-registo-clinico	Value Set Name: Severity

Para mais informações sobre a utilização do elemento system consultar Systems.

Binding do FHIR Required

Path	strength	ValueSet
AllergyIntolerance.clinicalStatus	required	AllergyIntolerance Clinical Status Codes
AllergyIntolerance.verificationStatus	required	AllergyIntolerance Verification Status Codes
AllergyIntolerance.category	required	AllergyIntoleranceCategory

Identifiers Type

Estes Identificadores devem ser utilizados no elemento

identifier.type.coding[*]

Regras de implementação

Para além das constraints identificadas pelo FHIR para este recurso devem ser consideradas as constraints que identificamos na tabela infra.

Path Key Descricao

Path	Key	Descricao
AllergyIntolerance	aitPtCore-01	Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'medication' é obrigatório o envio de um código ATC no elemento AllergyIntolerance.code. Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'food', 'environment', 'biologic' é obrigatório o envio, no elemento AllergyIntolerance.code, de um código pertencente ao value set Allergen No Drug. O desconhecimento de existência de alergias ou intolerância TERÁ de ser claramente documentado, enviando no elemento AllergyIntolerance.code, o código 716186003. Quando no elemento AllergyIntolerance.code é enviado o código 716186003, está dispensado o envio do elemento AllergyIntolerance.category e AllergyIntolerance.type. `(category.exists() and (code.id).exists() and code.id='drugAllergen' and category ='medication') or ( category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='food' )) or (category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='biologic' )) or ( (code.id).exists() and code.id='allergenNoDrug' and (category='environment' ) ) or ((code.id).exists() and code.id='absentOrUnknownAllergy' and (category.exists().not() or category .exists()))`

AllergyIntolerance

aitPtCore-01

Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'medication' é obrigatório o envio de um código ATC no elemento AllergyIntolerance.code. Quando o código associado ao elemento AllergyIntolerance.category corresponde a 'food', 'environment', 'biologic' é obrigatório o envio, no elemento AllergyIntolerance.code, de um código pertencente ao value set Allergen No Drug. O desconhecimento de existência de alergias ou intolerância TERÁ de ser claramente documentado, enviando no elemento AllergyIntolerance.code, o código 716186003. Quando no elemento AllergyIntolerance.code é enviado o código 716186003, está dispensado o envio do elemento AllergyIntolerance.category e AllergyIntolerance.type.

(category.exists() and (code.id).exists() and code.id='drugAllergen' and category ='medication') or ( category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='food' )) or (category.exists() and (code.id).exists() and code.id='allergenNoDrug' and (category='biologic' )) or ( (code.id).exists() and code.id='allergenNoDrug' and (category='environment' ) ) or ((code.id).exists() and code.id='absentOrUnknownAllergy' and (category.exists().not() or category .exists()))

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