UK Core Implementation Guide 1.0.0 - STU1 Pre-release

StructureDefinition-UKCore-AllergyIntolerance

This UK Core profile is a restraint on the International FHIR resource AllergyIntolerance, and defines the constraints, extensions, and minimal set of data to query and retrieve allergy information.

Profile Purpose

This profile allows a record of a clinical assessment of an allergy or intolerance; a propensity, or a potential risk to an individual, to have an adverse reaction on future exposure to the specified substance, or class of substance.

Where a propensity is identified, to record information or evidence about a reaction event that is characterised by any harmful or undesirable physiological response that is specific to the individual and triggered by exposure of an individual to the identified substance or class of substance.

Substances include but are not limited to a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

This resource is used to record physical conditions. It SHALL NOT be used to record preferences for or against types of treatment, for example on religious grounds. For such use cases consider the use of the FHIR Consent resource.

Snapshot View

evidenceI0..*Extension(Reference(UK Core DiagnosticReport))
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
allergyIntoleranceEndI0..1Extension(Complex)
codingΣ0..*Coding
textΣ0..1string
verificationStatusΣ ?! I0..1CodeableConceptBinding
typeΣ0..1codeBinding
categoryΣ0..*codeBinding
criticalityΣ0..1codeBinding
codeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
onsetDateTimedateTime
onsetAgeAge
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
recordedDate0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lastOccurrence0..1dateTime
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
substance0..1CodeableConceptBinding
manifestation1..*CodeableConceptBinding
description0..1string
onset0..1dateTime
severity0..1codeBinding
exposureRoute0..1CodeableConceptBinding
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown

Differential View

evidenceI0..*Extension(Reference(UK Core DiagnosticReport))
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
allergyIntoleranceEndI0..1Extension(Complex)
codingΣ0..*Coding
textΣ0..1string
verificationStatusΣ ?! I0..1CodeableConceptBinding
typeΣ0..1codeBinding
categoryΣ0..*codeBinding
criticalityΣ0..1codeBinding
codeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
onsetDateTimedateTime
onsetAgeAge
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
recordedDate0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lastOccurrence0..1dateTime
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
substance0..1CodeableConceptBinding
manifestation1..*CodeableConceptBinding
description0..1string
onset0..1dateTime
severity0..1codeBinding
exposureRoute0..1CodeableConceptBinding
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown

Hybrid View

evidenceI0..*Extension(Reference(UK Core DiagnosticReport))
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
allergyIntoleranceEndI0..1Extension(Complex)
codingΣ0..*Coding
textΣ0..1string
verificationStatusΣ ?! I0..1CodeableConceptBinding
typeΣ0..1codeBinding
categoryΣ0..*codeBinding
criticalityΣ0..1codeBinding
codeΣ1..1CodeableConceptBinding
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
onsetDateTimedateTime
onsetAgeAge
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
recordedDate0..1dateTime
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
referenceΣ I0..1string
typeΣ0..1uriBinding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(UK Core Organization)
displayΣ0..1string
lastOccurrence0..1dateTime
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown
substance0..1CodeableConceptBinding
manifestation1..*CodeableConceptBinding
description0..1string
onset0..1dateTime
severity0..1codeBinding
exposureRoute0..1CodeableConceptBinding
authorStringstring
authorReferenceReference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization)
timeΣ0..1dateTime
textΣ1..1markdown

Table View

AllergyIntolerance..
AllergyIntolerance.extension0..
AllergyIntolerance.extensionExtension0..
AllergyIntolerance.identifier..
AllergyIntolerance.identifier.assignerReference(UK Core Organization)..
AllergyIntolerance.clinicalStatus..
AllergyIntolerance.clinicalStatus.extension0..
AllergyIntolerance.clinicalStatus.extensionExtension0..1
AllergyIntolerance.code1..
AllergyIntolerance.patientReference(UK Core Patient)..
AllergyIntolerance.patient.identifier..
AllergyIntolerance.patient.identifier.assignerReference(UK Core Organization)..
AllergyIntolerance.encounterReference(UK Core Encounter)..
AllergyIntolerance.encounter.identifier..
AllergyIntolerance.encounter.identifier.assignerReference(UK Core Organization)..
AllergyIntolerance.recorderReference(UK Core Practitioner | UK Core PractitionerRole | UK Core Patient | UK Core RelatedPerson)..
AllergyIntolerance.recorder.identifier..
AllergyIntolerance.recorder.identifier.assignerReference(UK Core Organization)..
AllergyIntolerance.asserterReference(UK Core Patient | UK Core RelatedPerson | UK Core Practitioner | UK Core PractitionerRole)..
AllergyIntolerance.asserter.identifier..
AllergyIntolerance.asserter.identifier.assignerReference(UK Core Organization)..
AllergyIntolerance.note..
AllergyIntolerance.note.author[x]Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization), string..
AllergyIntolerance.reaction..
AllergyIntolerance.reaction.substance..
AllergyIntolerance.reaction.manifestation..
AllergyIntolerance.reaction.exposureRoute..
AllergyIntolerance.reaction.note..
AllergyIntolerance.reaction.note.author[x]Reference(UK Core Practitioner | UK Core Patient | UK Core RelatedPerson | UK Core Organization), string..


XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-AllergyIntolerance" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
    <version value="2.3.0" />
    <name value="UKCoreAllergyIntolerance" />
    <title value="UK Core AllergyIntolerance" />
    <status value="active" />
    <date value="2022-08-26" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="secretariat@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <contact>
        <name value="NHS Digital" />
        <telecom>
            <system value="email" />
            <value value="interoperabilityteam@nhs.net" />
            <use value="work" />
            <rank value="2" />
        </telecom>
    </contact>
    <description value="Defines the UK Core constraints and extensions on the AllergyIntolerance resource for the minimal set of data to query and retrieve allergy information." />
    <purpose value="This profile allows a record of a clinical assessment of an allergy or intolerance; a propensity, or a potential risk to an individual, to have an adverse reaction on future exposure to the specified substance, or class of substance. \nWhere a propensity is identified, to record information or evidence about a reaction event that is characterised by any harmful or undesirable physiological response that is specific to the individual and triggered by exposure of an individual to the identified substance or class of substance. \nSubstances 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." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="AllergyIntolerance" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/AllergyIntolerance" />
    <derivation value="constraint" />
    <differential>
        <element id="AllergyIntolerance.extension">
            <path value="AllergyIntolerance.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="0" />
        </element>
        <element id="AllergyIntolerance.extension:evidence">
            <path value="AllergyIntolerance.extension" />
            <sliceName value="evidence" />
            <short value="A reference to results of investigations that confirmed the certainty of the diagnosis." />
            <min value="0" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Evidence" />
            </type>
        </element>
        <element id="AllergyIntolerance.identifier.assigner">
            <path value="AllergyIntolerance.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="AllergyIntolerance.clinicalStatus.extension">
            <path value="AllergyIntolerance.clinicalStatus.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <rules value="open" />
            </slicing>
            <min value="0" />
        </element>
        <element id="AllergyIntolerance.clinicalStatus.extension:allergyIntoleranceEnd">
            <path value="AllergyIntolerance.clinicalStatus.extension" />
            <sliceName value="allergyIntoleranceEnd" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AllergyIntoleranceEnd" />
            </type>
            <isModifier value="false" />
        </element>
        <element id="AllergyIntolerance.code">
            <path value="AllergyIntolerance.code" />
            <min value="1" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-AllergyCode" />
            </binding>
        </element>
        <element id="AllergyIntolerance.patient">
            <path value="AllergyIntolerance.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
            </type>
        </element>
        <element id="AllergyIntolerance.patient.identifier.assigner">
            <path value="AllergyIntolerance.patient.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="AllergyIntolerance.encounter">
            <path value="AllergyIntolerance.encounter" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" />
            </type>
        </element>
        <element id="AllergyIntolerance.encounter.identifier.assigner">
            <path value="AllergyIntolerance.encounter.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="AllergyIntolerance.recorder">
            <path value="AllergyIntolerance.recorder" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
        </element>
        <element id="AllergyIntolerance.recorder.identifier.assigner">
            <path value="AllergyIntolerance.recorder.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="AllergyIntolerance.asserter">
            <path value="AllergyIntolerance.asserter" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
            </type>
        </element>
        <element id="AllergyIntolerance.asserter.identifier.assigner">
            <path value="AllergyIntolerance.asserter.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="AllergyIntolerance.note.author[x]">
            <path value="AllergyIntolerance.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
            <type>
                <code value="string" />
            </type>
        </element>
        <element id="AllergyIntolerance.reaction.substance">
            <path value="AllergyIntolerance.reaction.substance" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-AllergySubstance" />
            </binding>
        </element>
        <element id="AllergyIntolerance.reaction.manifestation">
            <path value="AllergyIntolerance.reaction.manifestation" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-AllergyManifestation" />
            </binding>
        </element>
        <element id="AllergyIntolerance.reaction.exposureRoute">
            <path value="AllergyIntolerance.reaction.exposureRoute" />
            <binding>
                <strength value="extensible" />
                <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute" />
            </binding>
        </element>
        <element id="AllergyIntolerance.reaction.note.author[x]">
            <path value="AllergyIntolerance.reaction.note.author[x]" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
            <type>
                <code value="string" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-AllergyIntolerance",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance",
    "version": "2.3.0",
    "name": "UKCoreAllergyIntolerance",
    "title": "UK Core AllergyIntolerance",
    "status": "active",
    "date": "2022-08-26",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "secretariat@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        },
        {
            "name": "NHS Digital",
            "telecom":  [
                {
                    "system": "email",
                    "value": "interoperabilityteam@nhs.net",
                    "use": "work",
                    "rank": 2
                }
            ]
        }
    ],
    "description": "Defines the UK Core constraints and extensions on the AllergyIntolerance resource for the minimal set of data to query and retrieve allergy information.",
    "purpose": "This profile allows a record of a clinical assessment of an allergy or intolerance; a propensity, or a potential risk to an individual, to have an adverse reaction on future exposure to the specified substance, or class of substance. \nWhere a propensity is identified, to record information or evidence about a reaction event that is characterised by any harmful or undesirable physiological response that is specific to the individual and triggered by exposure of an individual to the identified substance or class of substance. \nSubstances 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.",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "AllergyIntolerance",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "AllergyIntolerance.extension",
                "path": "AllergyIntolerance.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 0
            },
            {
                "id": "AllergyIntolerance.extension:evidence",
                "path": "AllergyIntolerance.extension",
                "sliceName": "evidence",
                "short": "A reference to results of investigations that confirmed the certainty of the diagnosis.",
                "min": 0,
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Evidence"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.identifier.assigner",
                "path": "AllergyIntolerance.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.clinicalStatus.extension",
                "path": "AllergyIntolerance.clinicalStatus.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "rules": "open"
                },
                "min": 0
            },
            {
                "id": "AllergyIntolerance.clinicalStatus.extension:allergyIntoleranceEnd",
                "path": "AllergyIntolerance.clinicalStatus.extension",
                "sliceName": "allergyIntoleranceEnd",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AllergyIntoleranceEnd"
                        ]
                    }
                ],
                "isModifier": false
            },
            {
                "id": "AllergyIntolerance.code",
                "path": "AllergyIntolerance.code",
                "min": 1,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-AllergyCode"
                }
            },
            {
                "id": "AllergyIntolerance.patient",
                "path": "AllergyIntolerance.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.patient.identifier.assigner",
                "path": "AllergyIntolerance.patient.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.encounter",
                "path": "AllergyIntolerance.encounter",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.encounter.identifier.assigner",
                "path": "AllergyIntolerance.encounter.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.recorder",
                "path": "AllergyIntolerance.recorder",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.recorder.identifier.assigner",
                "path": "AllergyIntolerance.recorder.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.asserter",
                "path": "AllergyIntolerance.asserter",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.asserter.identifier.assigner",
                "path": "AllergyIntolerance.asserter.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.note.author[x]",
                "path": "AllergyIntolerance.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    },
                    {
                        "code": "string"
                    }
                ]
            },
            {
                "id": "AllergyIntolerance.reaction.substance",
                "path": "AllergyIntolerance.reaction.substance",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-AllergySubstance"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.manifestation",
                "path": "AllergyIntolerance.reaction.manifestation",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-AllergyManifestation"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.exposureRoute",
                "path": "AllergyIntolerance.reaction.exposureRoute",
                "binding": {
                    "strength": "extensible",
                    "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SubstanceOrProductAdministrationRoute"
                }
            },
            {
                "id": "AllergyIntolerance.reaction.note.author[x]",
                "path": "AllergyIntolerance.reaction.note.author[x]",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    },
                    {
                        "code": "string"
                    }
                ]
            }
        ]
    }
}

Examples

Allergy - An example to illustrate an allergy to medication.
Example UKCore-AllergyIntolerance

Allergy entered in error - An example to illustrate an allergy which was entered in error and has been marked as ended.
Example UKCore-AllergyIntolerance-EnteredInError

Allergy evidence - An example to illustrate a reference to results of investigations that confirmed the certainty of the diagnosis for an allergy or intolerance.
Example UKCore-AllergyIntolerance-Extension-Evidence

Allergy List - An example to illustrate a list of allergies contained in a Bundle resource.
Example UKCore-Bundle-BundledAllergyList

Example Usage Scenarios

The following are feasible use cases for the UK Core AllergyIntolerance profile:

  • Query for patient allergy information
  • Exchange patient allergy information within a FHIR Document or FHIR Message
  • Migration of allergies data between systems.

Profile Specific Implementation Guidance:

Use Case: Query

The query against a clinical system or shared record to return recorded allergies as AllergyIntolerance resources.

Returned results could be ordered by recordedDate and/or lastOccurence.

Returned results MAY include multiple instances of the same allergy, as per the causative agent (code), but with different clinicalStatus values. The newer of such records either by recordedDate or lastOccurence SHOULD be deemed the latest or current record of the allergy.

Use Case: Exchange

For when systems need to exchange allergy information within a point-to-point message. The AllergyIntolerance resources can be included within a FHIR Message (within the Bundle), or within a FHIR Document alongside other structured resources and text-based data.

Allergy information SHOULD NOT be duplicated between systems (and, in England, this aligns with the NHS Data Strategy). When exchanging allergies data between systems be mindful of whether the receiving system plans to persist the data. If persisted, processes SHALL be put in place to ensure the data is updated if/when the source record is updated.

Use Case: Migration

When allergy records are migrated between systems, the AllergyIntolerance resource could be used as a data migration standard.

Where migrated data is not coded, uses retired / invalidated codes, or coded with a terminology which cannot be mapped to SNOMED CT, then refer to the guidance on using degraded drug / non-drug allergy codes.


Extensions

More information about the extensions can be found using the links below.

Extension Context Link Comment
allergyIntoleranceEnd AllergyIntolerance.clinicalStatus Extension UKCore-AllergyIntoleranceEnd For the date when the allergy or intolerance clinicalStatus is updated to inactive or resolved.
evidence AllergyIntolerance Extension UKCore-Evidence To reference a DiagnosticReport resource for investigations that confirm the certainty of the allergy or intolerance diagnosis.

verificationStatus

An optional value from a required terminology binding containing the values;

  • unconfirmed
  • confirmed
  • refuted
  • entered-in-error.

Note: The use of entered-in-error dictates the population of the clinicalStatus element.


code

Identifies the causative agent for the allergy or intolerance.

When recording an allergy to a medication substance, the provider system SHOULD use a dm+d concept class or alternatively, when the allergy is not recorded against a medication substance, the relevant set of SNOMED CT. These can be found within the ValueSet UKCore-AllergyCode.

Using transfer degraded drug / non-drug allergy codes

Degraded drug allergy codes can be used in three scenarios, with examples.

  1. If only a text representation of the allergy is known.

Table View

AllergyIntolerance.id[0]UKCore-AllergyIntolerance-Sn-NonDrugAllergy-Example
AllergyIntolerance.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.clinicalStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus[0].coding[0].code[0]active
AllergyIntolerance.clinicalStatus[0].coding[0].display[0]Active
AllergyIntolerance.verificationStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus[0].coding[0].code[0]confirmed
AllergyIntolerance.verificationStatus[0].coding[0].display[0]Confirmed
AllergyIntolerance.code[0].coding[0].system[0]http://snomed.info/sct
AllergyIntolerance.code[0].coding[0].code[0]196471000000108
AllergyIntolerance.code[0].coding[0].display[0]Transfer-degraded non-drug allergy (record artifact)
AllergyIntolerance.code[0].text[0]Latex
AllergyIntolerance.patient[0].reference[0]Patient/UKCore-RichardSmith-Patient-Example

Tree View

AllergyIntolerance

XML View

<AllergyIntolerance xmlns="http://hl7.org/fhir">
    <id value="UKCore-AllergyIntolerance-Sn-NonDrugAllergy-Example" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
    </meta>
    <clinicalStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical" />
            <code value="active" />
            <display value="Active" />
        </coding>
    </clinicalStatus>
    <verificationStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification" />
            <code value="confirmed" />
            <display value="Confirmed" />
        </coding>
    </verificationStatus>
    <!--  **************Snippet start**************  -->
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="196471000000108" />
            <display value="Transfer-degraded non-drug allergy (record artifact)" />
        </coding>
        <text value="Latex" />
    </code>
    <!--  **************Snippet end**************  -->
    <patient>
        <reference value="Patient/UKCore-RichardSmith-Patient-Example" />
    </patient>
</AllergyIntolerance>

JSON View

{
    "resourceType": "AllergyIntolerance",
    "id": "UKCore-AllergyIntolerance-Sn-NonDrugAllergy-Example",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance"
        ]
    },
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                "code": "confirmed",
                "display": "Confirmed"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "196471000000108",
                "display": "Transfer-degraded non-drug allergy (record artifact)"
            }
        ],
        "text": "Latex"
    },
    "patient": {
        "reference": "Patient/UKCore-RichardSmith-Patient-Example"
    }
}


2. If a text representation of the allergy is known but any associated coding is not recognised by the system.

Table View

AllergyIntolerance.id[0]UKCore-AllergyIntolerance-Sn-DrugAllergy-Example
AllergyIntolerance.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.clinicalStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus[0].coding[0].code[0]active
AllergyIntolerance.clinicalStatus[0].coding[0].display[0]Active
AllergyIntolerance.verificationStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus[0].coding[0].code[0]confirmed
AllergyIntolerance.verificationStatus[0].coding[0].display[0]Confirmed
AllergyIntolerance.code[0].coding[0].system[0]http://snomed.info/sct
AllergyIntolerance.code[0].coding[0].code[0]196461000000101
AllergyIntolerance.code[0].coding[0].display[0]Transfer-degraded drug allergy (record artifact)
AllergyIntolerance.code[0].text[0]9339101000001105 | Septrin
AllergyIntolerance.patient[0].reference[0]Patient/UKCore-RichardSmith-Patient-Example

Tree View

AllergyIntolerance

XML View

<AllergyIntolerance xmlns="http://hl7.org/fhir">
    <id value="UKCore-AllergyIntolerance-Sn-DrugAllergy-Example" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
    </meta>
    <clinicalStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical" />
            <code value="active" />
            <display value="Active" />
        </coding>
    </clinicalStatus>
    <verificationStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification" />
            <code value="confirmed" />
            <display value="Confirmed" />
        </coding>
    </verificationStatus>
    <!--  **************Snippet start**************  -->
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="196461000000101" />
            <display value="Transfer-degraded drug allergy (record artifact)" />
        </coding>
        <text value="9339101000001105 | Septrin" />
    </code>
    <!--  **************Snippet end**************  -->
    <patient>
        <reference value="Patient/UKCore-RichardSmith-Patient-Example" />
    </patient>
</AllergyIntolerance>

JSON View

{
    "resourceType": "AllergyIntolerance",
    "id": "UKCore-AllergyIntolerance-Sn-DrugAllergy-Example",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance"
        ]
    },
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                "code": "confirmed",
                "display": "Confirmed"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "196461000000101",
                "display": "Transfer-degraded drug allergy (record artifact)"
            }
        ],
        "text": "9339101000001105 | Septrin"
    },
    "patient": {
        "reference": "Patient/UKCore-RichardSmith-Patient-Example"
    }
}

Note: “Septrin” is a long discontinued brand name of an antibiotic.


3. If a pre-coordinated allergy code is known which this is not part of the permitted value set for causative agent defined above.

Table View

AllergyIntolerance.id[0]UKCore-AllergyIntolerance-Sn-DrugAllergyToEggProtein-Example
AllergyIntolerance.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.clinicalStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus[0].coding[0].code[0]active
AllergyIntolerance.clinicalStatus[0].coding[0].display[0]Active
AllergyIntolerance.verificationStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus[0].coding[0].code[0]confirmed
AllergyIntolerance.verificationStatus[0].coding[0].display[0]Confirmed
AllergyIntolerance.code[0].coding[0].system[0]http://snomed.info/sct
AllergyIntolerance.code[0].coding[0].code[0]196461000000101
AllergyIntolerance.code[0].coding[0].display[0]Transfer-degraded drug allergy (record artifact)
AllergyIntolerance.code[0].text[0]213020009 | Allergy to egg protein
AllergyIntolerance.patient[0].reference[0]Patient/UKCore-RichardSmith-Patient-Example

Tree View

AllergyIntolerance

XML View

<AllergyIntolerance xmlns="http://hl7.org/fhir">
    <id value="UKCore-AllergyIntolerance-Sn-DrugAllergyToEggProtein-Example" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
    </meta>
    <clinicalStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical" />
            <code value="active" />
            <display value="Active" />
        </coding>
    </clinicalStatus>
    <verificationStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification" />
            <code value="confirmed" />
            <display value="Confirmed" />
        </coding>
    </verificationStatus>
    <!--  **************Snippet start**************  -->
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="196461000000101" />
            <display value="Transfer-degraded drug allergy (record artifact)" />
        </coding>
        <text value="213020009 | Allergy to egg protein" />
    </code>
    <!--  **************Snippet end**************  -->
    <patient>
        <reference value="Patient/UKCore-RichardSmith-Patient-Example" />
    </patient>
</AllergyIntolerance>

JSON View

{
    "resourceType": "AllergyIntolerance",
    "id": "UKCore-AllergyIntolerance-Sn-DrugAllergyToEggProtein-Example",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance"
        ]
    },
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                "code": "confirmed",
                "display": "Confirmed"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "196461000000101",
                "display": "Transfer-degraded drug allergy (record artifact)"
            }
        ],
        "text": "213020009 | Allergy to egg protein"
    },
    "patient": {
        "reference": "Patient/UKCore-RichardSmith-Patient-Example"
    }
}

Handling of 'No known allergies'

There can be an explicit assertion of ‘No Known Allergies’ using the SNOMED CT 'No known allergy' hierarchy 716186003 | No known allergy. The parent concept, or any child concept MAY be used.-

Table View

AllergyIntolerance.id[0]UKCore-AllergyIntolerance-Sn-NegHandlNoKnownAllergies-Example
AllergyIntolerance.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.clinicalStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus[0].coding[0].code[0]active
AllergyIntolerance.clinicalStatus[0].coding[0].display[0]Active
AllergyIntolerance.verificationStatus[0].coding[0].system[0]http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus[0].coding[0].code[0]confirmed
AllergyIntolerance.verificationStatus[0].coding[0].display[0]Confirmed
AllergyIntolerance.code[0].coding[0].system[0]http://snomed.info/sct
AllergyIntolerance.code[0].coding[0].code[0]409137002
AllergyIntolerance.code[0].coding[0].display[0]No known drug allergy (situation)
AllergyIntolerance.patient[0].reference[0]Patient/UKCore-RichardSmith-Patient-Example

Tree View

AllergyIntolerance

XML View

<AllergyIntolerance xmlns="http://hl7.org/fhir">
    <id value="UKCore-AllergyIntolerance-Sn-NegHandlNoKnownAllergies-Example" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance" />
    </meta>
    <clinicalStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical" />
            <code value="active" />
            <display value="Active" />
        </coding>
    </clinicalStatus>
    <verificationStatus>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification" />
            <code value="confirmed" />
            <display value="Confirmed" />
        </coding>
    </verificationStatus>
    <!--  **************Snippet start**************  -->
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="409137002" />
            <display value="No known drug allergy (situation)" />
        </coding>
    </code>
    <!--  **************Snippet end**************  -->
    <patient>
        <reference value="Patient/UKCore-RichardSmith-Patient-Example" />
    </patient>
</AllergyIntolerance>

JSON View

{
    "resourceType": "AllergyIntolerance",
    "id": "UKCore-AllergyIntolerance-Sn-NegHandlNoKnownAllergies-Example",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance"
        ]
    },
    "clinicalStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
                "code": "active",
                "display": "Active"
            }
        ]
    },
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
                "code": "confirmed",
                "display": "Confirmed"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "409137002",
                "display": "No known drug allergy (situation)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/UKCore-RichardSmith-Patient-Example"
    }
}

If other `AllergyIntolerance` resources exist in the patient record with a `clinicalStatus` of `active` then the system SHALL ignore the 'No Known Allergies' resource instance. The existence of recorded and active allergies takes precedence over instances of 'No Known Allergies' records.

Use of plain text only

The representation of the causative agent as text is supported within the FHIR standard but this SHOULD only be used as a last resort if a suitable coded term does not exist within the SNOMED CT terminology or if using a degraded allergy code is not appropriate.

Use of nullFlavor

The UK Core recommendation is that the nullFlavor is not used for the causative agent, even though it is permitted within the FHIR standard.


patient

A reference to the patient resource which SHOULD conform to Profile UKCore-Patient.


encounter

A reference to the encounter resource which SHOULD conform to Profile UKCore-Encounter.


onset[x]

Record of the date and/or time of the onset of the reaction caused by the allergy or intolerance which can be recorded in one of five ways;

  • onsetDateTime
  • onsetAge
  • onsetPeriod
  • onsetRange
  • onsetString.

Provider Systems

Provider systems are recommended to support at least onsetDateTime and onsetAge where this date is available.

It is recommended not to record the onset using an onsetPeriod or onsetRange as these data types are complex and less useful. If the exact onset date is not known, but was between two known dates, e.g. 2018 and 2019, then use the lower/older date as the onsetDateTime instead of using an onsetPeriod.

It is recommended not to record the onset using an onsetString as this data will not be machine processable.

Consumer Systems

Consumer systems SHALL be able to handle any of the onset data types.


recordedDate

The date the first version of the resource instance was recorded.

The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.

If the instance of the resource is updated via an operation like a RESTful PATCH or PUT then the recordedDate is not updated and remains the date the resource instance was recorded.

Provider Systems

Provider systems SHALL provide this data.

Consumer Systems

Consumer systems SHALL consume this data.


recorder

A reference to the individual who recorded the record and takes responsibility for its content. The resource being referenced SHOULD conform to one of the following:

Provider Systems

Provider systems SHOULD provide this data.

Consumer Systems

Consumer systems SHOULD consume this data.


asserter

A reference to the source of the information about the allergy. The resource being referenced SHOULD conform to one of the following:

Provider Systems

Provider systems SHOULD provide at least the following minimum data within the referenced resource.

practioner

  • identifier
  • name

practionerRole

  • identifier
  • practitioner (as above) OR organisation.identifier OR healthcareService.identifier

patient

  • identifier:nhsNumber
  • name

relatedPerson

  • identifier
  • name
  • patient

Where a human asserter is not captured or cannot be confirmed, i.e. a practitioner, patient or relatedPerson, the provider systems SHOULD reference an Organisation and/or healthcareService within a PractitionerRole, using the associated ODS code.

For example, asserted by "MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST".

Table View

PractitionerRole.id[0]UKCore-PractitionerRole-Sn-Organization-Code-Example
PractitionerRole.meta[0].profile[0]https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole
PractitionerRole.identifier[0].system[0]https://fhir.nhs.uk/Id/sds-role-profile-id
PractitionerRole.identifier[0].value[0]100334993514
PractitionerRole.organization[0].identifier[0].system[0]https://fhir.nhs.uk/Id/ods-organization-code
PractitionerRole.organization[0].identifier[0].value[0]RD8
PractitionerRole.organization[0].display[0]MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST

Tree View

PractitionerRole

XML View

<PractitionerRole xmlns="http://hl7.org/fhir">
    <id value="UKCore-PractitionerRole-Sn-Organization-Code-Example" />
    <meta>
        <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
    </meta>
    <!--  **************snippet start**************  -->
    <identifier>
        <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
        <value value="100334993514" />
    </identifier>
    <organization>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
            <value value="RD8" />
        </identifier>
        <display value="MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST" />
    </organization>
    <!--  **************snippet end**************  -->
</PractitionerRole>

JSON View

{
    "resourceType": "PractitionerRole",
    "id": "UKCore-PractitionerRole-Sn-Organization-Code-Example",
    "meta": {
        "profile":  [
            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole"
        ]
    },
    "identifier":  [
        {
            "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
            "value": "100334993514"
        }
    ],
    "organization": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "RD8"
        },
        "display": "MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST"
    }
}

Consumer Systems

Consumer systems SHALL consume this data.

lastOccurence

Represents the date and/or time of the last known occurrence of a reaction event.

Provider Systems

Provider systems SHOULD populate with the date or date/time of the last known occurrence of a reaction to the allergy, if known.

Consumer Systems

Consumer systems MAY choose to consume this data.


note

An optional element for when the clinical user wishes to provide supporting textual information for the allergy record that cannot be conveyed within other elements of the resource.

Provider Systems

Where a provider system only has the capability to record a note at one level it SHOULD populate the AllergyIntolerance.note elements with any notes data captured within the system, irrespective of the data level that the system uses to capture that data.

Where a provider system has the capability to record a note at both the AllergyIntolerance and at the AllergyIntolerance.reaction level it SHOULD populate both with the relevant notes applicable to each level.

Consumer Systems

Consumer systems SHALL be able to handle both multiple AllergyIntolerance.note and multiple AllergyIntolerance.reaction.note elements.


reaction

Details about each adverse reaction event linked to exposure to the identified substance.

The AllergyIntolerance.reaction is optional, but where a severity is available in the provider system it SHALL be included to convey severity even if no other reaction details are explicitly available. If this is the case the AllergyIntolerance.reaction.manifestation SHALL be coded as the nullFlavor NI.

Element: reaction.substance

An element to record the specific substance or pharmaceutical product considered to be responsible for event using the ValueSet UKCore-AllergySubstance

Element: reaction.manifestation

A mandatory element if a reaction is recorded for the clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

Use nullFlavour NI for the case when a reaction.severity needs to be shared but where a manifestation is not known.

Element: reaction.severity

An optional value from a required terminology binding containing the values;

  • mild
  • moderate
  • severe

Provider Systems

Where a severity is available in the provider system it SHALL be included to convey severity even if no other reaction details are explicitly available.

Where the severity is not known, this element SHOULD be omitted.

Consumer Systems

Use of this element when populated as severe MAY be used to express life threatening allergies, used in conjunction with the AllergyIntolerance.criticality element.

An omitted severity will either mean severity data is not available within the provider system or the severity is not known by the provider system.

Element: reaction.exposureRoute

An optional element to identify the route by which the patient was exposed to the substance.

Provider Systems

If this data is available the binding SHOULD be to the ValueSet UKCore-SubstanceOrProductAdministrationRoute.

Consumer Systems

Consumer systems are recommended not to include this coded information within automated clinical decision support. This is because it could either mean two quite different things;

  1. The reaction only occurs if the substance enters the body via the specified route, implying the use of other routes is safe.

OR

  1. The reaction was identified when the substance entered the body via the specified route, but could also react when using other routes.

Element: reaction.note

An optional element for when the clinical user wishes to provide supporting textual information for the reaction that cannot be conveyed within other elements of the backbone element.

See the related guidance above for AllergyIntolerance.note.


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