The FHIR profiles used for the Allergies and Adverse Reactions list
Heading Description
The details of any known allergies, intolerances or adverse reactions.
The following FHIR profiles are used to form the Allergies and reactions list structure:
The following profiles are referenced from the Allergies and reactions list structure:
Allergies and Adverse Reactions List Structure
Maternity Data Standard Mapping to FHIR profiles
Mapping Overview
Data Standard Element | FHIR Profile Mapping | FHIR Element |
Date/Time Recorded | List | entry.date |
Date/Time Asserted | AllergyIntolerance | assertedDate |
Causative Agent | AllergyIntolerance | code.coding code.text |
Description of Reaction | AllergyIntolerance | reaction.manifestation.coding code.text |
Type of Reaction | AllergyIntolerance | type |
Certainty | AllergyIntolerance | verificationStatus |
Severity | AllergyIntolerance | severity |
Evidence | AllergyIntolerance | note |
Date First Experienced | AllergyIntolerance | onset |
Comment | AllergyIntolerance | note |
The following tables detail how to populate the FHIR resources and the mapping to the Maternity data standard.
Mapping for Allergies and Adverse Reactions List
> | Level 1 | List Resource | > | Level 2 | CareConnect-List-1 | > | Level 3 | None |
View Used FHIR Elements | View All FHIR Elements |
Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
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List | | Information summarized from a list of other resources Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource Constraint (lst-2): The deleted flag can only be used if the mode of the list is “changes” Constraint (lst-1): A list can only have an emptyReason if it is empty |
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- id | 0..1 | Optional | Id | Logical id of this artifact |
- meta | 0..1 | Mandatory | Meta | Metadata about the resource The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-List-1' |
- identifier | 0..* | Required | Identifier | Business identifier An identifier for this Allergies and adverse reactions list |
- - system | 1..1 | Required | Uri | The namespace for the identifier value The system from which the identifier came from |
- - value | 1..1 | Mandatory | String | The value that is unique Business identifier An identifier for this Allergies and adverse reactions list |
- - - display | 0..1 | Required | String | Text alternative for the resource The organization that allocated the identifier |
- status | 1..1 | Mandatory | Code | current : retired : entered-in-error Binding (required): The current state of the list ListStatus The status of the list MUST contain the value 'current' |
- mode | 1..1 | Mandatory | Code | working : snapshot : changes Binding (required): The processing mode that applies to this list ListMode The mode of the list MUST contain the value 'snapshot' |
- title | 0..1 | Mandatory | String | Descriptive name for the list This MUST contain the value 'Allergies and adverse reactions' Mapping to Maternity data item = 'PSRB Heading Allergies and adverse reactions' |
- code | 0..1 | Mandatory | CodeableConcept | What the purpose of this list is Binding (preferred): What the purpose of a list is CareConnect-ListCode-1 The PRSB heading for this list. Note: for Maternity the value stated below is used which is not from the preferred value set |
- - coding | 0..* | Mandatory | Coding | Code defined by a terminology system The SNOMED CT concept for the PRSB heading type |
- - - system | 0..1 | Mandatory | Uri | Identity of the terminology system This MUST contain the value 'http://snomed.info/sct' |
- - - code | 0..1 | Mandatory | Code | Symbol in syntax defined by the system This MUST contain the value '886921000000105' |
- - - display | 0..1 | Mandatory | String | Representation defined by the system This MUST contain the value 'Allergies and adverse reactions' Mapping to Maternity data item = 'PSRB Heading Allergies and adverse reactions' |
- subject | 0..1 | Mandatory | Reference | If all resources have the same subject Constraint (ref-1): SHALL have a contained resource if a local reference is provided This is a reference to the Patient who is the subject of the list. |
Mandatory | CareConnect-Patient-1 | This is the subject of the Allergies and adverse reactions List. This MUST use the CareConnect patient profile. See patient resource reference for information on how to populate the resource. |
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- - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL A reference to the patient resource included in the Patient demographics list within the FHIR Bundle. Note the Patient demographics list is mandatory in the FHIR bundle |
- date | 0..1 | Mandatory | dateTime | When the list was prepared This MUST contain a system date to indicate when the list was created or updated |
- note | 0..* | Optional | Annotation | Comments about the list |
Required | String | Who authored the comment on the list. | ||
- - time | 0..1 | Required | dateTime | When the annotation was made |
- - text | 1..1 | Required | String | The annotation - text content |
- entry | 0..* | Mandatory | BackboneElement | Entries in the list The entries MUST be as per the diagram for this PRSB headings list with the AllergyIntolerance resource being the focal resource. Multiple resources MAY be present |
- - date | 0..1 | Required | dateTime | When item added to list The SHOULD contain a system time of when the item was added to the list. Mapping to Maternity data item = 'Date/Time Recorded' |
- - item | 1..1 | Required | Reference | Actual entry Constraint (ref-1): SHALL have a contained resource if a local reference is provided A reference to an AllergyIntolerance resource included in the list This MUST use the CareConnect AllergyIntolerance profile. See AllergyIntolerance resource for information on how to populate the resource. |
- - - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL The reference to the included AllergyIntolerance resource. |
Patient Reference
The Allergies and adverse reactions list has a mandated subject reference to the Patient resource. This means that any exchange of the Allergies and adverse reactions heading data must also include the Patient demographics List.
Mapping for Allergies and Adverse Reactions AllergyIntolerance
> | Level 1 | AllergyIntolerance Resource | > | Level 2 | CareConnect-AllergyIntolerance-1 | > | Level 3 | None |
View Used FHIR Elements | View All FHIR Elements |
Name | Card. | Conformance | Type | Description, Constraints and mapping for Implementation |
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AllergyIntolerance | | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraint (dom-2): If the resource is contained in another resource, it SHALL NOT contain nested Resources Constraint (dom-1): If the resource is contained in another resource, it SHALL NOT contain any narrative Constraint (dom-4): If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated Constraint (dom-3): If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource Constraint (ait-1): AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. Constraint (ait-2): AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error |
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- id | 0..1 | Optional | Id | Logical id of this artifact |
- meta | 1..1 | Mandatory | Meta | Metadata about the resource |
- - profile | 1..1 | Mandatory | Uri | Profiles this resource claims to conform to The value attribute of the profile element MUST contain the value 'https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-AllergyIntolerance-1' |
- identifier | 0..* | Required | Identifier | External ids for this item |
- - system | 1..1 | Mandatory | Uri | The namespace for the identifier value |
- - value | 1..1 | Mandatory | String | The value that is unique |
- - assigner | 0..1 | Required | Reference | Organization that issued id (may be just text) Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
- - - display | 0..1 | Required | String | Text alternative for the resource |
- clinicalStatus | 1..1 | Mandatory | Code | active : inactive : resolved Binding (required): The clinical status of the allergy or intolerance. AllergyIntoleranceClinicalStatus |
- verificationStatus | 1..1 | Mandatory | Code | unconfirmed : confirmed Binding (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. CareConnect-AllergyVerificationStatus-1 This required ValueSet has mappings to SNOMED CT Mapping to Maternity data item = 'Certainty'. |
- type | 0..1 | Required | Code | allergy : intolerance - Underlying mechanism (if known) Binding (required): Identification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType Mapping to Maternity data item = 'Type of Reaction'. |
- code | 0..1 | Mandatory | CodeableConcept | Code that identifies the allergy or intolerance Binding (example): Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. AllergyIntolerance Substance/Product, Condition and Negation Codes Note the example ValueSet is not used for Maternity and the following should be used instead Coded text - SNOMED CT (<105590001 |SubstanceOR <373873005 |Pharmaceutical / biologic product|OR <716186003 |No known allergy|OR 196461000000101 |Transfer-degraded drug allergy|OR 196471000000108 |Transfer-degraded non-drug allergy) - Alternatively one of the following statements: 'No known drug allergies' Or 'Information not available'. |
- - coding | 0..* | Mandatory | Coding | Code defined by a terminology system Slicing: Discriminator: system, Ordering: false, Rules: Open |
- - coding (snomedCT) | 1..1 | Mandatory | Coding | Code defined by a terminology system Binding (example): A code from the SNOMED Clinical Terminology UK or a code from the v3 Code System NullFlavor specifying why a valid value is not present. CareConnect-AllergyCode-1 Note the example ValueSet is not used for Maternity and the following should be used instead Coded text - SNOMED CT (<105590001 |SubstanceOR <373873005 |Pharmaceutical / biologic product|OR <716186003 |No known allergy|OR 196461000000101 |Transfer-degraded drug allergy|OR 196471000000108 |Transfer-degraded non-drug allergy) - Alternatively one of the following statements: 'No known drug allergies' Or 'Information not available'. |
- - - system | 0..1 | Required | Uri | Identity of the terminology system This MUST contain the value 'http://snomed.info/sct' |
- - - code | 0..1 | Required | Code | Representation defined by the system Coded text - SNOMED CT (<105590001 |SubstanceOR <373873005 |Pharmaceutical / biologic product|OR <716186003 |No known allergy|OR 196461000000101 |Transfer-degraded drug allergy|OR 196471000000108 |Transfer-degraded non-drug allergy) |
- - - display | 0..1 | Required | String | Symbol in syntax defined by the system. This SHOULD be the preferred term for the SNOMED concept |
- - text | 0..1 | Required | String | Plain text representation of the concept This element SHOULD only be populated when the Allergy or adverse reaction cannot be coded or when stating one of the following statements: 'No known drug allergies' Or 'Information not available'. |
- patient | 1..1 | Mandatory | Reference | Who the sensitivity is for Constraint (ref-1): SHALL have a contained resource if a local reference is provided |
Mandatory | CareConnect-Patient-1 | A reference to the Patient resource. | ||
- - reference | 0..1 | Mandatory | String | Literal reference, Relative, internal or absolute URL This MUST use the CareConnect Patient profile.See patient resource reference for information on how to populate the resource. |
- onset[x] | 0..1 | Required | dateTime | When allergy or intolerance was identified. When the reaction was first experienced. May be a date or partial date (e.g. year) or text (e.g. during childhood). Mapping to Maternity data item = 'Date First Experienced'. |
Required | Age | |||
Required | String | |||
- assertedDate | 1..1 | Mandatory | dateTime | Date record was believed accurate Mapping to Maternity data item = 'Date/Time Asserted'. |
- note | 0..* | Required | Annotation | Additional text not captured in other fields Any additional comment or clarification about the allergy or adverse reaction Mapping to Maternity data item = 'Comment'.</b> This element is also used to carry text that is the results of investigations that confirmed the certainty of the diagnosis. Examples might include results of skin prick allergy tests. Mapping to Maternity data item = 'Evidence'. |
- - text | 1..1 | Mandatory | String | The annotation - text content |
- - manifestation | 1..* | Required | CodeableConcept | Clinical symptoms/signs associated with the Event Binding (extensible): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. CareConnect-AllergyManifestation-1 A description of the manifestation of the allergic or adverse reaction experienced by the patient. For example, skin rash, swelling at injection site etc. Mapping to Maternity data item = 'Description of Reaction'. |
- - - coding | 0..* | Required | Coding | Code defined by a terminology system Slicing: Discriminator: system, Ordering: false, Rules: Open |
- - - coding (snomedCT) | 0..1 | Required | Coding | Code defined by a terminology system Anything under ( 404684003 | clinical finding (finding) | ) . |
- - - - system | 1..1 | Mandatory | Uri | Identity of the terminology system The element MUST contain the value 'http://snomed.info/sct' |
- - - - code | 1..1 | Mandatory | Code | Symbol in syntax defined by the system A SNOMED concept as specified above |
- - - - display | 1..1 | Mandatory | String | Representation defined by the system This SHOULD be the preferred term associated with the concept |
- - - text | 0..1 | Required | String | Plain text representation of the concept Free text field to be used if no coded text available. Note: the CareConnect profile currently does not allow non-coded allergies. |
- - onset | 0..1 | Required | dateTime | Date(/time) when manifestations showed |
- - severity | 0..1 | Required | Code | mild : moderate : severe (of event as a whole) Binding (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations. CareConnect-ReactionEventSeverity-1 This required ValueSet has mappings to SNOMED CT |