AllergyIntolerance (PS-CA)
This version of the PS-CA Implementation Guide has been superseded by a newer version. Other releases of the PS-CA Implementation Guide may be found on a table on the Home Page of this Project.
Additional information on this profile (including the JSON & XML structure and detailed element descriptions) can be found at Allergy Intolerance (PS-CA)
Profile
AllergyIntolerance | I | AllergyIntolerance | There are no (further) constraints on this element Element IdAllergyIntolerance Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Alternate namesAllergy, Intolerance, Adverse Reaction DefinitionRisk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element IdAllergyIntolerance.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Constraints
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abatement-datetime | I | 0..1 | Extension(dateTime) | Element IdAllergyIntolerance.extension:abatement-datetime Extension for representing Abatement datetime Alternate namesextensions, user content DefinitionThe date or estimated date that the condition resolved or went into remission. 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. http://hl7.org/fhir/uv/ips/StructureDefinition/abatement-dateTime-uv-ips Constraints
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier External ids for this item DefinitionBusiness identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
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clinicalStatus | S Σ ?! I | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.clinicalStatus active | inactive | resolved DefinitionThe clinical status of the allergy or intolerance. The requirement from the base FHIR specification to provide a system and value from the bound value set supersedes the use of MS flags in the data type for this element. Systems will be expected to show they can conform by supplying both the code and the system from the required value set. The clinical status of the allergy or intolerance. AllergyIntoleranceClinicalStatusCodes (required)Constraints
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verificationStatus | Σ ?! I | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.verificationStatus unconfirmed | confirmed | refuted | entered-in-error DefinitionAssertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content. FHIR Base Note: This element is a modifier element with a required vocabulary binding in the base FHIR specification. IPS-UV Note: In the scope of the IPS-UV the entered-in-error concept is not allowed and so the modifier on this element has been removed. Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatusCodes (required)Constraints
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coding | Σ | 0..* | Coding | Element IdAllergyIntolerance.verificationStatus.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Many Canadian systems currently use the AllergyIntoleranceStatusCode value set comprised of SNOMED CT codes that can be mapped and provided as additional codings to the required FHIR allergyIntolerance-verification codes. The element is sliced to express the required population of at least one allergyIntolerance-verification coding Unordered, Open, by $this(Pattern) Constraints
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HL7VerificationStatus | Σ | 1..1 | CodingBinding | Element IdAllergyIntolerance.verificationStatus.coding:HL7VerificationStatus Required value set for AllergyIntolerance Verification Status. DefinitionCode for an allergy or intolerance statement. Represents whether an allergy/intolerance is active or resolved (indicating no longer active). Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. HL7 required value set for AllergyIntolerance Verification Status. AllergyIntoleranceVerificationStatusCodes (required)Constraints
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StatusCode | Σ | 0..1 | CodingBinding | Element IdAllergyIntolerance.verificationStatus.coding:StatusCode Code for allergy or intolerance status DefinitionCode for an allergy or intolerance statement. Represents whether an allergy/intolerance is active or resolved (indicating no longer active). Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.verificationStatus.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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type | Σ | 0..1 | codeBinding | Element IdAllergyIntolerance.type allergy | intolerance - Underlying mechanism (if known) Alternate namesCategory, Class DefinitionIdentification of the underlying physiological mechanism for the reaction risk. IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content. Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required)Constraints
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category | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.category food | medication | environment | biologic Alternate namesCategory, Type, Reaction Type, Class DefinitionCategory of the identified substance. This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. Category of an identified substance associated with allergies or intolerances. AllergyIntoleranceCategory (required)Constraints
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criticality | Σ | 0..1 | codeBinding | Element IdAllergyIntolerance.criticality low | high | unable-to-assess Alternate namesSeverity, Seriousness, Contra-indication, Risk DefinitionEstimate of the potential clinical harm, or seriousness, of the reaction to the identified substance. IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content. Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance. AllergyIntoleranceCriticality (required)Constraints
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code | S Σ | 1..1 | Data Type: Codeable Concept (PS-CA)Binding | Element IdAllergyIntolerance.code Concept - reference to a terminology or just text Alternate namesCode DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. IPS-UV allows the supply of coding, text, or both. Use of the IPS-UV ValueSet is currently marked as preferred, work is underway to determine the pan-Canadian terminology that will be preferred and/or socialized for this element. Until then, only the existing slices are put forward below. They are considered optional, meaning an implementer can still be conformant if they use another subset of codes from SNOMED CT, SNOMED CT CA or another Code System. Future releases of PS CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. Data Type: Codeable Concept (PS-CA) Sliced:Unordered, Open, by $this(Pattern) BindingType of the substance/product, allergy or intolerance condition. AllergyIntoleranceSubstanceConditionUvIps (preferred)Constraints
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allergyIntoleranceGPSCode | Σ | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.code:allergyIntoleranceGPSCode Optional slice for code for allergy or intolerance from the SNOMED CT GPS code set Alternate namesCode DefinitionCode for an allergy or intolerance statement that is selected from the SNOMED CT GPS code set. It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Codes for allergy or intolerance from the SNOMED CT GPS code set AllergyintolerancesubstanceconditionGPS (required)Constraints
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codeAllergyCA | Σ | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.code:codeAllergyCA Optional slice for codes for propensity to adverse reactions and allergic conditions from the SNOMED CT CA code set Alternate namesCode DefinitionCode for an propensity to adverse reaction and allergic condition that is selected from the SNOMED CT Canadian edition value set. It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Codes for allergic condition from the SNOMED CT Canadian edition value set SubstanceAndPharmaceuticalBiologicProductCode (required)Constraints
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absentOrUnknownAllergyIntolerance | S Σ | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.code:absentOrUnknownAllergyIntolerance Optional slice for code for absent or unknown allergy or intolerance Alternate namesCode DefinitionCode for an allergy or intolerance statement (either a positive or a negated/excluded statement). This describes a categorical negated statement (e.g., "No known allergy"). The use of Null values in v3 implementations and SNOMED CT 716186003 (No known allergy) code are common in Canadian implementations - given the semantic equivalence to the codes no-allergy-info and no-known-allergies, Canadian implementers are encouraged to map to the IPS-UV value set (and provide the original source code as an alternate coding) when noting this concept in patient summaries. negation/exclusion codes for reporting no known allergies or not available data. NoAllergiesInfoUvIps (required)Constraints
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patient | S Σ I | 1..1 | Reference(Patient (PS-CA)) | Element IdAllergyIntolerance.patient Who the sensitivity is for Alternate namesPatient DefinitionThe patient who has the allergy or intolerance. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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reference | S Σ I | 1..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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encounter | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter Encounter when the allergy or intolerance was asserted DefinitionThe encounter when the allergy or intolerance was asserted. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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onset[x] | 0..1 | There are no (further) constraints on this element Element IdAllergyIntolerance.onset[x] When allergy or intolerance was identified DefinitionEstimated or actual date, date-time, or age when allergy or intolerance was identified. Unordered, Open, by $this(Type) Constraints
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onsetAge | Age | There are no (further) constraints on this element Data Type | ||
onsetPeriod | Period | There are no (further) constraints on this element Data Type | ||
onsetRange | Range | There are no (further) constraints on this element Data Type | ||
onsetString | string | There are no (further) constraints on this element Data Type | ||
onsetDateTime | S | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.onset[x]:onsetDateTime When allergy or intolerance was identified DefinitionEstimated or actual date, date-time, or age when allergy or intolerance was identified.
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recordedDate | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.recordedDate Date first version of the resource instance was recorded DefinitionThe recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.
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recorder | I | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder Who recorded the sensitivity Alternate namesAuthor DefinitionIndividual who recorded the record and takes responsibility for its content. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Constraints
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asserter | Σ I | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Element IdAllergyIntolerance.asserter Source of the information about the allergy Alternate namesSource, Informant DefinitionThe source of the information about the allergy that is recorded. IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content. Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Constraints
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lastOccurrence | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.lastOccurrence Date(/time) of last known occurrence of a reaction DefinitionRepresents the date and/or time of the last known occurrence of a reaction event. This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdAllergyIntolerance.note Additional text not captured in other fields DefinitionAdditional narrative about the propensity for the Adverse Reaction, not captured in other fields. For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.
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reaction | S | 0..* | BackboneElement | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction Adverse Reaction Events linked to exposure to substance DefinitionDetails about each adverse reaction event linked to exposure to the identified substance.
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substance | 0..1 | CodeableConcept | Element IdAllergyIntolerance.reaction.substance Specific substance or pharmaceutical product considered to be responsible for event DefinitionIdentification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. The IPS-UV does not consider this element MS, however some Canadian systems may capture allergen substances separately from allergyIntolerance.code. Further investigation is required to determine what approaches are in use by participating jurisdictions. Codes defining the type of the substance (including pharmaceutical products). SubstanceCode (example)Constraints
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manifestation | S | 1..* | Data Type: Codeable Concept (PS-CA) | Element IdAllergyIntolerance.reaction.manifestation Concept - reference to a terminology or just text Alternate namesSymptoms, Signs DefinitionA concept that may be defined by a formal reference to a terminology or ontology or may be provided by text. Future releases of PS CA may require use of coded entries. In this release, however, implementors that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content. Data Type: Codeable Concept (PS-CA) Sliced:Unordered, Open, by $this(Pattern) BindingClinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. SNOMEDCTClinicalFindings (example)Constraints
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allergyIntoleranceReactionManifestationGPSCode | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.reaction.manifestation:allergyIntoleranceReactionManifestationGPSCode Optional slice for representing code for the allergy or intolerance reaction manifestation from the SNOMED CT GPS code set Alternate namesSymptoms, Signs DefinitionCode for an allergy or intolerance reaction manifestation statement that is selected from the SNOMED CT GPS code set. Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. AllergyReactionGpsUvIps (required)Constraints
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manifestationSCTCA | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.reaction.manifestation:manifestationSCTCA Optional slice for representing code for the allergy or intolerance reaction manifestation from the SNOMED CT Canadian edition value set. Alternate namesSymptoms, Signs DefinitionCode for an allergy or intolerance reaction manifestation statement that is selected from the SNOMED CT Canadian edition value set. Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. ClinicalFindingCode (required)Constraints
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description | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.description Description of the event as a whole Alternate namesNarrative, Text DefinitionText description about the reaction as a whole, including details of the manifestation if required. Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.
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onset | 0..1 | dateTime | Element IdAllergyIntolerance.reaction.onset Date(/time) when manifestations showed DefinitionRecord of the date and/or time of the onset of the Reaction. IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content.
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severity | 0..1 | codeBinding | Element IdAllergyIntolerance.reaction.severity mild | moderate | severe (of event as a whole) DefinitionClinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations. IPS-UV flags this as a MS element. It is not currently flagged as MS in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a MS requirement within the context of their own jurisdictional content. Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations. AllergyIntoleranceSeverity (required)Constraints
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exposureRoute | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.exposureRoute How the subject was exposed to the substance DefinitionIdentification of the route by which the subject was exposed to the substance. Coding of the route of exposure with a terminology should be used wherever possible. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMEDCTRouteCodes (example)Constraints
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note | 0..* | Annotation | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.note Text about event not captured in other fields DefinitionAdditional text about the adverse reaction event not captured in other fields. Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.
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Extensions
This profile uses the following extensions:
- AllergyIntolerance: abatement-dateTime
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
The following elements are considered "must support" in the IPS-UV specification that are relaxed in this version of the PS-CA profile:
AllergyIntolerance
AllergyIntolerance.extension abatement-datetime slice
AllergyIntolerance.verificationStatus
AllergyIntolerance.type
AllergyIntolerance.criticality
AllergyIntolerance.code
AllergyIntolerance.asserter
AllergyIntolerance.reaction.onset
Note: Systems that support these elements are encouraged to send them in patient summaries
Cardinality Differences:
- AllergyIntolerance.verificationStatus.coding:
- removed minimum cardinality constraints from system and code
Vocabulary Differences:
- AllergyIntolerance.verificationStatus: optional slice added for AllergyIntoleranceVerificationStatus
- AllergyIntolerance.code:
- comment added describing alternative value sets
- slice added for SNOMED CT Canadian Edition substance and pharmaceurtical biologic product codes
- AllergyIntolerance.reaction.manifestation:
- slice added for SNOMED CT Canadian Edition clinical findings
Other differences between the IPS and PS-CA Include:
- AllergyIntolerance.clinicalStatus:
- removed IPS datatype profile
- AllergyIntolerance.verificationStatus:
- removed IPS datatype profile
- AllergyIntolerance.patient:
- reference target changed to PS-CA patient
- AllergyIntolerance.reaction.manifestation:
- comment added about future potential use of coded elements