Allergy Intolerance

$10 / year

This resource includes 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. 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.

Complexity

This resource is used to provide a single place within the health record to document a range of clinical statements about adverse reactions to substances/products, including:
– Record a clinical assessment of the individual’s propensity to a potential future reaction upon re-exposure
– Record cumulative information about the reaction to each exposure, including ‘no reaction’ if appropriate

Use to record information about the positive presence of the risk of an adverse reaction:
– To support direct clinical care of an individual
– As part of a managed adverse reaction or allergy/intolerance list
– To support exchange of information about the propensity and events related to adverse reactions
– To inform adverse reaction reporting
– To assist computerized knowledge-based activities such as clinical decision support and alerts

Use to record information about adverse reactions to a broad range of substances, including: biological & blood products; incipients and excipients in medicinal preparations; foods; metal salts; and organic chemical compounds.

Adverse reactions may be:
– An allergy (typically type I hypersensitivity, plus other “allergy-like” reactions, including pseudoallergy)
– An intolerance (typically non-immune adverse reactions that are not determined or perceived to be allergic or “allergy-like”, and are to some degree idiosyncratic and/or individually specific.

In clinical practice distinguishing between allergy and intolerance is difficult and might not be practical. Often the term “allergy” is used rather generically and may overlap with “intolerance”, and the boundaries between these concepts might not be well-defined or understood. The term “intolerance” should generally be applied to a propensity for adverse reactions which is either determined (to the extent that is possible) or perceived to not be allergic or “allergy-like”. If it is not possible to determine whether a particular propensity condition is an allergy or an intolerance, then the type element should be omitted from the resource. Identification of the type of reaction is not a proxy for seriousness or risk of harm to the patient, which is better expressed in the documentation of the clinical manifestation and the assessment of criticality.

The sensitivity in the case of either an allergy or intolerance is unique to the individual, and is distinguished from those reactions that are a property of the circumstance, such as toxicity of a food or drug, overdose, drug-drug, drug-food, or drug-disease interaction (which are reactions that would be expected to occur for any individual given the same circumstances).

This resource has been designed to allow recording of information about a specific substance (e.g., amoxicillin, oysters, or bee sting venom) or pharmaceutical product or, alternatively, a class of substance (e.g., penicillins). If a class of substance is recorded, then identification of the exact substance can be recorded on a per exposure basis.

The scope of this Fast Healthcare Interoperability Resources (FHIR) resource has deliberately focused on identifying a pragmatic data set that is used in most clinical systems or will be suitable for most common clinical scenarios; extensions can be used to add additional detail if required. Examples of clinical situations where the extension may be required include: a detailed allergist/immunologist assessment, for reporting to regulatory bodies or use in a clinical trial.

Fast Healthcare Interoperability Resources (FHIR) is a draft standard describing data formats and elements (known as “resources”) and an application programming interface (API) for exchanging electronic health records. The standard was created by the Health Level Seven International (HL7) health-care standards organization.

Its goal is to facilitate interoperation between legacy healthcare systems, to make it easy to provide healthcare information to healthcare providers and individuals on a wide variety of devices from computers to tablets to cell phones, and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.

FHIR provides an alternative to document-centric approaches by directly exposing discrete data elements as services. For example, basic elements of healthcare like patients, admissions, diagnostic reports and medications can each be retrieved and manipulated via their own resource URLs (Uniform Resource Locators). FHIR was supported at an American Medical Informatics Association meeting by many EHR (Electronic Health Record) vendors which value its open and extensible nature.

Date Created

2018-09-20

Last Modified

2018-12-27

Version

4.0.0

Update Frequency

Annual

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs; Health Level Seven International;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

FHIR, HL7, Medical Terminology, Processes Data, Processes Information, Processes Documentation, Health Information Exchange, Electronic Health Records, FHIR Smart, Smart on FHIR

Other Titles

FHIR Allergy Intolerance Resource, Electronic Health Records Exchange Through FHIR

NameDescriptionTypeConstraints
Concept_NameName of the concept in the FHIR structurestringrequired : 1
Computer_Ready_NameA Computer-ready name (e.g. a token) that identifies the structure - suitable for code generation. Note that this name (and other names relevant for code generation, including element & slice names, codes etc) may collide with reserved words in the relevant target language, and code generators will need to handle this.string-
TypeThe type the structure describes.string-
Dollar_RefThe Dollar_Ref ($ref) string value contains a Uniform Resource Identifier (URI) which identifies the location of the JSON (JavaScript Object Notation) value being referenced.string-
DescriptionA free text natural language description of the structure and its usestring-
ItemsThe value of the keyword should be an object or an array of objects. If the keyword value is an object, then for the data array to be valid each item of the array should be valid according to the schema in this value.string-
EnumThe enum is used to restrict a value to a fixed set of values. It must be an array with at least one element, where each element is unique.string-
RequiredThe value of the keyword should be an array of unique strings. The data object to be valid should contain all properties with names equal to the elements in the keyword value.string-
ConstThe value of this keyword can be anything. The data is valid if it is deeply equal to the value of the keyword.string-
Concept NameComputer Ready NameTypeDollar RefDescriptionItemsEnumRequiredConst
AllergyIntoleranceresourceTypeThis is a AllergyIntolerance resourceAllergyIntolerance
AllergyIntoleranceid#/definitions/idThe logical ID of the resource, as used in the URL for the resource. Once assigned, this value never changes.
AllergyIntolerancemeta#/definitions/MetaThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
AllergyIntoleranceimplicitRules#/definitions/uriA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
AllergyIntolerance_implicitRules#/definitions/ElementExtensions for implicitRules
AllergyIntolerancelanguage#/definitions/codeThe base language in which the resource is written.
AllergyIntolerance_language#/definitions/ElementExtensions for language
AllergyIntolerancetext#/definitions/NarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
AllergyIntolerancecontainedarrayThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.{'$ref': '#/definitions/ResourceList'}
AllergyIntoleranceextensionarrayMay 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.{'$ref': '#/definitions/Extension'}
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