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Allergies and Adverse Reactions List

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

Allergies and adverse reactions Allergies and Adverse Reactions List Resource Allergies and Adverse Reactions List Resource Allergies and Adverse ReactionsList Resource AllergyIntolerance Resource AllergyIntolerance Resource AllergyIntolerance Resource 1..1 M subject 1..1 M subject 1..1 Msubject 0..* R entry.item 0..* R entry.item 0..* Rentry.item Reference to Patient resource Reference to Patient resource Reference to Patient resource 1..1 M patient 1..1 M patient 1..1 Mpatient

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
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
- 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.
- - 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
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
- 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

Allergies and Adverse Reactions Heading Example

Tags: fhir

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