AllergyIntolerance | I | | AllergyIntolerance | There are no (further) constraints on this element Element IdShort 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 in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() - dom-6:A resource should have narrative for robust management
text.`div`.exists() - dom-5:If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty() - ait-1:AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() - ait-2:AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
Mappings- rim:Entity. Role, or Act
- rim:Observation[classCode=OBS, moodCode=EVN]
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extension | I | 0..* | Extension | Element IdAllergyIntolerance.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) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
allergyIntoleranceEnd | I | 0..1 | Extension(Complex) | Element IdAllergyIntolerance.extension:allergyIntoleranceEnd Short description Supports the date when the allergy or intolerance was no longer valid, and/or, the reason why the allergy or intolerance is no longer valid. Alternate names extensions, user content Definition Supports the date when the allergy or intolerance was no longer valid, and/or, the reason why the allergy or intolerance is no longer valid.
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(Complex) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AllergyIntoleranceEnd Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
evidence | I | 0..* | Extension(Reference(UK Core DiagnosticReport)) | Element IdAllergyIntolerance.extension:evidence Short description A reference to results of investigations that confirmed the certainty of the diagnosis. Alternate names extensions, user content Definition A reference to results of investigations that confirmed the certainty of the diagnosis.
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(Reference(UK Core DiagnosticReport)) Extension URL https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Evidence Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ext-1:Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier Short description External ids for this item Definition Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Requirements Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.
Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- w5:FiveWs.identifier
- v2:IAM-7
- rim:id
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data Type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:CX.5
- rim:Role.code or implied by context
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim:n/a
- v2:CX.1 / EI.1
- rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd:./Value
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdAllergyIntolerance.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data Type Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim:n/a
- v2:DR
- rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2:CX.7 + CX.8
- rim:Role.effectiveTime or implied by context
- servd:./StartDate and ./EndDate
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdAllergyIntolerance.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data Type Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:CX.4 / (CX.4,CX.9,CX.10)
- rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd:./IdentifierIssuingAuthority
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clinicalStatus | Σ ?! I | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.clinicalStatus Short description active | inactive | resolved Definition The clinical status of the allergy or intolerance.
Comments Refer to discussion if clincalStatus is missing data.
The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.
Data Type CodeableConcept Binding The clinical status of the allergy or intolerance. AllergyIntoleranceClinicalStatusCodes (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5:FiveWs.status
- rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
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verificationStatus | Σ ?! I | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.verificationStatus Short description unconfirmed | confirmed | refuted | entered-in-error Definition Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).
Comments The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.
Data Type CodeableConcept Binding Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatusCodes (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- w5:FiveWs.status
- rim:Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdShort description allergy | intolerance - Underlying mechanism (if known) Alternate names Category, Class Definition Identification of the underlying physiological mechanism for the reaction risk.
Comments Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.
Data Type code Binding Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- w5:FiveWs.class
- v2:IAM-9
- rim:code
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category | Σ | 0..* | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.category Short description food | medication | environment | biologic Alternate names Category, Type, Reaction Type, Class Definition Category of the identified substance.
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
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- w5:FiveWs.class
- v2:AL1-2
- rim:value < IntoleranceValue (Agent)
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criticality | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.criticality Short description low | high | unable-to-assess Alternate names Severity, Seriousness, Contra-indication, Risk Definition Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
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
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- w5:FiveWs.grade
- v2:AL1-4
- rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
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code | Σ | 1..1 | CodeableConceptBinding | Element IdShort description Code that identifies the allergy or intolerance Alternate names Code Definition Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.
Comments It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.
When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.
The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.
Data Type CodeableConcept Binding Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. UKCoreAllergyCode (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- 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
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patient | Σ I | 1..1 | Reference(UK Core Patient) | Element IdAllergyIntolerance.patient Short description Who the sensitivity is for Alternate names Patient Definition The patient who has the allergy or intolerance.
Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data Type Reference(UK Core Patient) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5:FiveWs.subject[x]
- v2:(PID-3)
- rim:.participation[typeCode=SBJ].role[classCode=PAT]
- w5:FiveWs.subject
|
reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.type Short description Type the reference refers to (e.g. "Patient") Definition The 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).
Comments 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.
Data Type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier Short description Logical reference, when literal reference is not known Definition An 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.
Comments 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).
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data Type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:CX.5
- rim:Role.code or implied by context
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
|
value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim:n/a
- v2:CX.1 / EI.1
- rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd:./Value
|
period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data Type Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim:n/a
- v2:DR
- rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2:CX.7 + CX.8
- rim:Role.effectiveTime or implied by context
- servd:./StartDate and ./EndDate
|
assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdAllergyIntolerance.patient.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data Type Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:CX.4 / (CX.4,CX.9,CX.10)
- rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd:./IdentifierIssuingAuthority
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.patient.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
encounter | I | 0..1 | Reference(UK Core Encounter) | Element IdAllergyIntolerance.encounter Short description Encounter when the allergy or intolerance was asserted Definition The encounter when the allergy or intolerance was asserted.
Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data Type Reference(UK Core Encounter) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5:FiveWs.context
- rim:.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
|
reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.type Short description Type the reference refers to (e.g. "Patient") Definition The 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).
Comments 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.
Data Type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier Short description Logical reference, when literal reference is not known Definition An 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.
Comments 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).
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data Type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:CX.5
- rim:Role.code or implied by context
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
|
value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim:n/a
- v2:CX.1 / EI.1
- rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd:./Value
|
period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data Type Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim:n/a
- v2:DR
- rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2:CX.7 + CX.8
- rim:Role.effectiveTime or implied by context
- servd:./StartDate and ./EndDate
|
assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdAllergyIntolerance.encounter.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data Type Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:CX.4 / (CX.4,CX.9,CX.10)
- rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd:./IdentifierIssuingAuthority
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.encounter.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
onset[x] | | 0..1 | | There are no (further) constraints on this element Element IdAllergyIntolerance.onset[x] Short description When allergy or intolerance was identified Definition Estimated or actual date, date-time, or age when allergy or intolerance was identified.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- w5:FiveWs.init
- rim:effectiveTime.low
|
onsetDateTime | | | dateTime | There are no (further) constraints on this element Data Type dateTime |
onsetAge | | | Age | There are no (further) constraints on this element Data Type Age |
onsetPeriod | | | Period | There are no (further) constraints on this element Data Type Period |
onsetRange | | | Range | There are no (further) constraints on this element Data Type Range |
onsetString | | | string | There are no (further) constraints on this element Data Type string |
recordedDate | | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.recordedDate Short description Date first version of the resource instance was recorded Definition The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- w5:FiveWs.recorded
- v2:IAM-13
- rim:.participation[typeCode=AUT].time
|
recorder | I | 0..1 | Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Patient | UK Core RelatedPerson) | Element IdAllergyIntolerance.recorder Short description Who recorded the sensitivity Alternate names Author Definition Individual who recorded the record and takes responsibility for its content.
Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
Data Type Reference(UK Core Practitioner | UK Core PractitionerRole | UK Core Patient | UK Core RelatedPerson) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5:FiveWs.author
- rim:.participation[typeCode=AUT].role
|
reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.type Short description Type the reference refers to (e.g. "Patient") Definition The 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).
Comments 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.
Data Type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier Short description Logical reference, when literal reference is not known Definition An 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.
Comments 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).
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
|
use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data Type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
|
type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:CX.5
- rim:Role.code or implied by context
|
system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
|
value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim:n/a
- v2:CX.1 / EI.1
- rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd:./Value
|
period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data Type Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim:n/a
- v2:DR
- rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2:CX.7 + CX.8
- rim:Role.effectiveTime or implied by context
- servd:./StartDate and ./EndDate
|
assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdAllergyIntolerance.recorder.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data Type Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:CX.4 / (CX.4,CX.9,CX.10)
- rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd:./IdentifierIssuingAuthority
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.recorder.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
asserter | Σ I | 0..1 | Reference(UK Core Patient | UK Core RelatedPerson | UK Core Practitioner | UK Core PractitionerRole) | Element IdAllergyIntolerance.asserter Short description Source of the information about the allergy Alternate names Source, Informant Definition The source of the information about the allergy that is recorded.
Comments The recorder takes responsibility for the content, but can reference the source from where they got it.
Data Type Reference(UK Core Patient | UK Core RelatedPerson | UK Core Practitioner | UK Core PractitionerRole) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- w5:FiveWs.source
- v2:IAM-14 (if patient) / IAM-18 (if practitioner)
- rim:.participation[typeCode=INF].role
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.reference Short description Literal reference, Relative, internal or absolute URL Definition A 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.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.type Short description Type the reference refers to (e.g. "Patient") Definition The 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).
Comments 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.
Data Type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier Short description Logical reference, when literal reference is not known Definition An 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.
Comments 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).
Data Type Identifier Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CX / EI (occasionally, more often EI maps to a resource id or a URL)
- rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
- servd:Identifier
- rim:.identifier
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier.use Short description usual | official | temp | secondary | old (If known) Definition The purpose of this identifier.
Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Data Type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Role.code or implied by context
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Requirements Allows users to make use of identifiers when the identifier system is not known.
Comments This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Data Type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:CX.5
- rim:Role.code or implied by context
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments Identifier.system is always case sensitive.
Data Type uri Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Generalhttp://www.acme.com/identifiers/patient Mappings- rim:n/a
- v2:CX.4 / EI-2-4
- rim:II.root or Role.id.root
- servd:./IdentifierType
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Examples Mappings- rim:n/a
- v2:CX.1 / EI.1
- rim:II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
- servd:./Value
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use.
Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration.
Data Type Period Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - per-1:If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)
Mappings- rim:n/a
- v2:DR
- rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
- v2:CX.7 + CX.8
- rim:Role.effectiveTime or implied by context
- servd:./StartDate and ./EndDate
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assigner | Σ I | 0..1 | Reference(UK Core Organization) | Element IdAllergyIntolerance.asserter.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier.
Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Data Type Reference(UK Core Organization) Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count()) - ref-1:SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings- rim:n/a
- rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
- v2:CX.4 / (CX.4,CX.9,CX.10)
- rim:II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
- servd:./IdentifierIssuingAuthority
|
display | Σ | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.asserter.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference.
Comments 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.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
lastOccurrence | | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.lastOccurrence Short description Date(/time) of last known occurrence of a reaction Definition Represents the date and/or time of the last known occurrence of a reaction event.
Comments This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime
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note | | 0..* | Annotation | There are no (further) constraints on this element Element IdShort description Additional text not captured in other fields Definition Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.
Comments For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.
Data Type Annotation Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act
- rim:subjectOf.observationEvent[code="annotation"].value
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author[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdAllergyIntolerance.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation.
Comments Organization is used when there's no need for specific attribution as to who made the comment.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.participant[typeCode=AUT].role
|
authorString | | | string | Data Type string |
authorReference | | | Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization) | Data Type Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization) |
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.effectiveTime
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text | Σ | 1..1 | markdown | There are no (further) constraints on this element Element IdAllergyIntolerance.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format.
Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Data Type markdown Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.text
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reaction | | 0..* | BackboneElement | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction Short description Adverse Reaction Events linked to exposure to substance Definition Details about each adverse reaction event linked to exposure to the identified substance.
Data Type BackboneElement Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]
|
substance | | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.reaction.substance Short description Specific substance or pharmaceutical product considered to be responsible for event Definition Identification 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.
Comments Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.
Data Type CodeableConcept Binding Codes defining the type of the substance (including pharmaceutical products). UKCoreAllergySubstance (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
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manifestation | | 1..* | CodeableConceptBinding | Element IdAllergyIntolerance.reaction.manifestation Short description Clinical symptoms/signs associated with the Event Alternate names Symptoms, Signs Definition Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.
Comments Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.
Data Type CodeableConcept Binding Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. UKCoreAllergyManifestation (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- v2:AL1-5
- rim:code
|
description | | 0..1 | string | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.description Short description Description of the event as a whole Alternate names Narrative, Text Definition Text description about the reaction as a whole, including details of the manifestation if required.
Comments Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.
Data Type string Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings |
onset | | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.onset Short description Date(/time) when manifestations showed Definition Record of the date and/or time of the onset of the Reaction.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:AL1-6
- rim:effectiveTime.low
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severity | | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAllergyIntolerance.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
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- rim:inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
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exposureRoute | | 0..1 | CodeableConceptBinding | Element IdAllergyIntolerance.reaction.exposureRoute Short description How the subject was exposed to the substance Definition Identification of the route by which the subject was exposed to the substance.
Comments Coding of the route of exposure with a terminology should be used wherever possible.
Data Type CodeableConcept Binding A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. UKCoreSubstanceOrProductAdministrationRoute (extensible)Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:CE/CNE/CWE
- rim:CD
- orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
- rim:outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode
|
note | | 0..* | Annotation | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.note Short description Text about event not captured in other fields Definition Additional text about the adverse reaction event not captured in other fields.
Comments Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.
Data Type Annotation Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act
- rim:subjectOf.observationEvent[code="annotation"].value
|
author[x] | Σ | 0..1 | | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.note.author[x] Short description Individual responsible for the annotation Definition The individual responsible for making the annotation.
Comments Organization is used when there's no need for specific attribution as to who made the comment.
Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.participant[typeCode=AUT].role
|
authorString | | | string | Data Type string |
authorReference | | | Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization) | Data Type Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization) |
time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.note.time Short description When the annotation was made Definition Indicates when this particular annotation was made.
Data Type dateTime Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.effectiveTime
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text | Σ | 1..1 | markdown | There are no (further) constraints on this element Element IdAllergyIntolerance.reaction.note.text Short description The annotation - text content (as markdown) Definition The text of the annotation in markdown format.
Comments Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
Data Type markdown Constraints- ele-1:All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Mappings- rim:n/a
- v2:N/A
- rim:Act.text
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