Path | Short | Definition | Comments |
---|---|---|---|
Allergy or Intolerance (generally: Risk of adverse reaction to a substance) | Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a 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. | |
identifier | External ids for this item | Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. | This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. |
clinicalStatus | active | inactive | resolved | The clinical status of the allergy or intolerance. | Refer to [discussion](extensibility.html#Special-Case) if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. |
verificationStatus | unconfirmed | confirmed | refuted | entered-in-error | Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). | The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. |
type | allergy | intolerance - Underlying mechanism (if known) | Identification of the underlying physiological mechanism for the reaction risk. | Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource. |
category | food | medication | environment | biologic | Category of the identified substance. | This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. |
criticality | low | high | unable-to-assess | Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance. | The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent. |
code | Code that identifies the allergy or intolerance | Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. | It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. |
patient | Who the sensitivity is for | The patient who has the allergy or intolerance. | |
encounter | Encounter when the allergy or intolerance was asserted | The encounter when the allergy or intolerance was asserted. | |
onset[x] | When allergy or intolerance was identified | Estimated or actual date, date-time, or age when allergy or intolerance was identified. | |
recordedDate | Date 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. | |
recorder | Who recorded the sensitivity | Individual who recorded the record and takes responsibility for its content. | |
asserter | Source of the information about the allergy | The source of the information about the allergy that is recorded. | The recorder takes responsibility for the content, but can reference the source from where they got it. |
lastOccurrence | Date(/time) of last known occurrence of a reaction | Represents the date and/or time of the last known occurrence of a reaction event. | This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used. |
note | Additional text not captured in other fields | Additional narrative about the propensity for the Adverse Reaction, not captured in other fields. | For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes. |
reaction | Adverse Reaction Events linked to exposure to substance | Details about each adverse reaction event linked to exposure to the identified substance. | |
reaction.id | Unique id for inter-element referencing | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | |
reaction.extension | Additional content defined by implementations | May be used to represent additional information that is not part of the basic definition of the element. 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. | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
reaction.modifierExtension | Extensions that cannot be ignored even if unrecognized | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
reaction.substance | Specific substance or pharmaceutical product considered to be responsible for event | Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. | Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'. |
reaction.manifestation | Clinical symptoms/signs associated with the Event | Clinical symptoms and/or signs that are observed or associated with the adverse reaction event. | Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. |
reaction.description | Description of the event as a whole | Text description about the reaction as a whole, including details of the manifestation if required. | Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives. |
reaction.onset | Date(/time) when manifestations showed | Record of the date and/or time of the onset of the Reaction. | |
reaction.severity | mild | moderate | severe (of event as a whole) | Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations. | It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions. |
reaction.exposureRoute | How the subject was exposed to the substance | Identification of the route by which the subject was exposed to the substance. | Coding of the route of exposure with a terminology should be used wherever possible. |
reaction.note | Text about event not captured in other fields | Additional text about the adverse reaction event not captured in other fields. | Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased. |
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 characterized 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.
Note for Reviewers
Presently open issues for this resource:
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:
Use to record information about the positive presence of the risk of an adverse reaction:
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:
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. As noted above, 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).
The risk of an adverse reaction event or manifestation should not be recorded without identifying a proposed causative substance (including pharmaceutical products) or class of substance. If there is uncertainty that a specific substance is the cause, this uncertainty can be recorded using the 'verificationStatus' data element. If there are multiple possible substances that may have caused a reaction/manifestation, each substance should be recorded using a separate instance of this resource with the 'verificationStatus' set to an initial state of 'unconfirmed' so that adverse reaction checking can be supported in clinical systems. If a substance, agent or class is later proven not to be the cause for a given reaction then the 'verificationStatus' can be modified to 'refuted'.
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 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.
The act of recording any adverse reaction in a health record involves the clinical assessment that a potential hazard exists for an individual if they are exposed to the same substance/product/class in the future - that is, a relative contraindication - and, in the absence of additional information indicating a higher level of potential risk, the default 'criticality' value should be set to 'Low Risk'. If a clinician considers that it is not safe for the individual to be deliberately re-exposed to the substance/product again, for example, following a manifestation of a life-threatening anaphylaxis, then the 'criticality' data element should be amended to 'High Risk'.
A formal adverse event report to regulatory bodies is a document that will contain a broad range of information in addition to the specific details about the adverse reaction. The report could utilize parts of this resource plus include additional data as required per jurisdiction.
An adverse reaction or allergy/intolerance list is a record of all identified propensities for an adverse reaction for the individual upon future exposure to the substance/product or class, plus provides potential access to the evidence provided by details about each reaction event, such as manifestation.
Valuable first-level information that could be presented to the clinician when they need to assess propensity for future reactions are:
Second-level information can be drawn from each exposure event and links to additional detailed information such as history, examination and diagnoses stored elsewhere in the record, if it is available.
AllergyIntolerance and RiskAssessment
AllergyIntolerance describes a specific type of risk - propensity to reaction to a substance/product while RiskAssessment describes general risks to a subject, not generally based on a reaction.
AllergyIntolerance and Immunization.reaction
Immunization.reaction may be an indication of an allergy or intolerance. If this is deemed to be the case, a separate AllergyIntolerance record should be created to indicate it, as most systems will not query against past immunization.reactions.
Misuse
Feedback is welcome here. [%end-note%]
It is important to differentiate between affirmatively stating that a patient has no known allergies versus either not including allergies in the record (for example an episodic document where the allergies are not considered relevant to the document); or asserting that allergies were not reviewed and are unknown.
Allergies with the verificationStatus "entered-in-error" indicates that the allergy or intolerance statement is entered by mistake and hence invalid.
Allergies with the verificationStatus "refuted" must be displayed to indicate that a reaction to a substance has been ruled out with the high level of clinical certainty (e.g. additional testing, re-challenging).
Prior to adding a new allergy/intolerance, a list of existing negated and refuted reactions should be reviewed and reconciled.
Allergies Not Reviewed, Not Asked
When a sending system does not have any information about allergies being reviewed or the statement is about allergies not being asked yet, then the List resource should be used to indicate the List.emptyReason.code="notasked".
Allergies Reviewed, None Identified
Systems may use the List.emptyReason when a statement is about the full scope of the list (i.e. the patient has no known allergies or intolerances of any type). However, it is generally preferred to use a code for "No known allergies" (e.g., SNOMED CT: 716186003 |No known allergy (situation)|), so that all allergy data will be available and queryable from AllergyIntolerance resource instances. Negated AllergyIntolerance instances are also typically used when the record is more fine-grained (e.g. no drug allergies, no food allergies, no nut allergies, etc.).
However, it is possible to include negation statements that apply at the level of the whole list and it is also possible to have separate lists for things like medication allergies vs. food allergies, where that is appropriate to the architecture. Also note that care should be used when adding new AllergyIntolerances to a list to ensure that any negation statements that are voided by the addition of a new record are removed from the list. E.g. If the list contains a "no known food allergies" record and you add an "intolerance to grape flavor" record, then be sure you remove the "no known food allergies" record.
The substanceExposureRisk extension is also available for use as a more completely structured and flexible alternative to the 'code' element for representing positive and negative allergy and intolerance statements (either the 'code' element or the substanceExposureRisk extension may be used, but not both).
[%stu-note%] There are two primary ways of reporting "no known allergies" in the current specification: using the CodeableConcept, as described above, or using the List resource with emptyReason. The third available option is using the substanceExposureRisk extension. During the STU period, it is not recommended to use the List resource for "no known allergies" reporting purposes. The principal reason for this is to allow all allergy or intolerance data to be found and to be consistently queryable from the single location of the AllergyIntolerance resource.Provide feedback here. [%end-note%]
No Known Allergies, using List.emptyReason (discouraged)
<List xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ..\..\schema\list.xsd"> <id value="example-empty-allergy"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> The patient is not aware of any allergies.</p> </div> </text> <code> <coding> <system value="http://loinc.org"/> <code value="52472-8"/> <display value="Allergies and Adverse Drug Reactions"/> </coding> <text value="Current Allergy List"/> </code> <source> <reference value="Patient/example"/> </source> <status value="current"/> <date value="2012-11-26T07:30:23+11:00"/> <mode value="snapshot"/> <emptyReason> <coding> <system value="http://hl7.org/fhir/special-values"/> <code value="nil-known"/> <display value="Nil Known"/> </coding> <text value="The patient is not aware of any allergies."/> </emptyReason> </List>
No Known Food Allergies and Medication Allergy List
<?xml version="1.0" encoding="UTF-8"?> <List xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ..\..\schema\list.xsd"> <id value="current-allergies"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p>Patient Peter Chalmers, DOB = Dec 25, 1974, MRN = 12345 (Acme Healthcare) has the following allergies</p> <ul> <li>No known food allergies</li> <li>Allergenic extract, penicillin (high)</li> </ul> </div> </text> <code> <coding> <system value="http://loinc.org"/> <code value="52472-8"/> <display value="Allergies and Adverse Drug Reactions"/> </coding> <text value="Current Allergy List"/> </code> <source> <reference value="Patient/example"/> </source> <status value="current"/> <date value="2015-07-14T23:10:23+11:00"/> <mode value="snapshot"/> <entry> <item> <reference value="AllergyIntolerance/nofoodallergies"/> </item> </entry> <entry> <item> <reference value="AllergyIntolerance/penicillin"/> </item> </entry> </List>
If a new allergy is discovered, the negated allergy record must be updated with the "refuted" verificationStatus - to ensure that systems referring to this record are aware that this is no longer true.
Systems that only support one notion will have to determine whether what they're capturing is criticality or severity and map to the appropriate place. Criticality refers to the likelihood the allergy/intolerance could result in significant harm. Severity refers to the degree of manifestation of the reaction symptom. Moderate breathing difficulty would have high criticality while a severe rash would have low criticality. Severity is specific to a particular reaction occurrence.
For systems that only track generic reaction characteristics rather than a specific reaction will provide guidance to use the "reaction" structure and simply provide no date.
asserter | Source of the information about the allergy | AllergyIntolerance.asserter |
category | food | medication | environment | biologic | AllergyIntolerance.category |
clinical-status | active | inactive | resolved | AllergyIntolerance.clinicalStatus |
code | Multiple Resources: * [AllergyIntolerance](allergyintolerance.html): Code that identifies the allergy or intolerance * [Condition](condition.html): Code for the condition * [DeviceRequest](devicerequest.html): Code for what is being requested/ordered * [DiagnosticReport](diagnosticreport.html): The code for the report, as opposed to codes for the atomic results, which are the names on the observation resource referred to from the result * [FamilyMemberHistory](familymemberhistory.html): A search by a condition code * [List](list.html): What the purpose of this list is * [Medication](medication.html): Returns medications for a specific code * [MedicationAdministration](medicationadministration.html): Return administrations of this medication code * [MedicationDispense](medicationdispense.html): Returns dispenses of this medicine code * [MedicationRequest](medicationrequest.html): Return prescriptions of this medication code * [MedicationStatement](medicationstatement.html): Return statements of this medication code * [Observation](observation.html): The code of the observation type * [Procedure](procedure.html): A code to identify a procedure * [ServiceRequest](servicerequest.html): What is being requested/ordered | AllergyIntolerance.code | AllergyIntolerance.reaction.substance | Condition.code | (DeviceRequest.code as CodeableConcept) | DiagnosticReport.code | FamilyMemberHistory.condition.code | List.code | Medication.code | (MedicationAdministration.medication as CodeableConcept) | (MedicationDispense.medication as CodeableConcept) | (MedicationRequest.medication as CodeableConcept) | (MedicationStatement.medication as CodeableConcept) | Observation.code | Procedure.code | ServiceRequest.code |
criticality | low | high | unable-to-assess | AllergyIntolerance.criticality |
date | Multiple Resources: * [AllergyIntolerance](allergyintolerance.html): Date first version of the resource instance was recorded * [CarePlan](careplan.html): Time period plan covers * [CareTeam](careteam.html): Time period team covers * [ClinicalImpression](clinicalimpression.html): When the assessment was documented * [Composition](composition.html): Composition editing time * [Consent](consent.html): When this Consent was created or indexed * [DiagnosticReport](diagnosticreport.html): The clinically relevant time of the report * [Encounter](encounter.html): A date within the period the Encounter lasted * [EpisodeOfCare](episodeofcare.html): The provided date search value falls within the episode of care's period * [FamilyMemberHistory](familymemberhistory.html): When history was recorded or last updated * [Flag](flag.html): Time period when flag is active * [Immunization](immunization.html): Vaccination (non)-Administration Date * [List](list.html): When the list was prepared * [Observation](observation.html): Obtained date/time. If the obtained element is a period, a date that falls in the period * [Procedure](procedure.html): When the procedure was performed * [RiskAssessment](riskassessment.html): When was assessment made? * [SupplyRequest](supplyrequest.html): When the request was made | AllergyIntolerance.recordedDate | CarePlan.period | CareTeam.period | ClinicalImpression.date | Composition.date | Consent.dateTime | DiagnosticReport.effective | Encounter.period | EpisodeOfCare.period | FamilyMemberHistory.date | Flag.period | Immunization.occurrence | List.date | Observation.effective | Procedure.performed | (RiskAssessment.occurrence as dateTime) | SupplyRequest.authoredOn |
identifier | Multiple Resources: * [AllergyIntolerance](allergyintolerance.html): External ids for this item * [CarePlan](careplan.html): External Ids for this plan * [CareTeam](careteam.html): External Ids for this team * [Composition](composition.html): Version-independent identifier for the Composition * [Condition](condition.html): A unique identifier of the condition record * [Consent](consent.html): Identifier for this record (external references) * [DetectedIssue](detectedissue.html): Unique id for the detected issue * [DeviceRequest](devicerequest.html): Business identifier for request/order * [DiagnosticReport](diagnosticreport.html): An identifier for the report * [DocumentManifest](documentmanifest.html): Unique Identifier for the set of documents * [DocumentReference](documentreference.html): Master Version Specific Identifier * [Encounter](encounter.html): Identifier(s) by which this encounter is known * [EpisodeOfCare](episodeofcare.html): Business Identifier(s) relevant for this EpisodeOfCare * [FamilyMemberHistory](familymemberhistory.html): A search by a record identifier * [Goal](goal.html): External Ids for this goal * [ImagingStudy](imagingstudy.html): Identifiers for the Study, such as DICOM Study Instance UID and Accession number * [Immunization](immunization.html): Business identifier * [List](list.html): Business identifier * [MedicationAdministration](medicationadministration.html): Return administrations with this external identifier * [MedicationDispense](medicationdispense.html): Returns dispenses with this external identifier * [MedicationRequest](medicationrequest.html): Return prescriptions with this external identifier * [MedicationStatement](medicationstatement.html): Return statements with this external identifier * [NutritionOrder](nutritionorder.html): Return nutrition orders with this external identifier * [Observation](observation.html): The unique id for a particular observation * [Procedure](procedure.html): A unique identifier for a procedure * [RiskAssessment](riskassessment.html): Unique identifier for the assessment * [ServiceRequest](servicerequest.html): Identifiers assigned to this order * [SupplyDelivery](supplydelivery.html): External identifier * [SupplyRequest](supplyrequest.html): Business Identifier for SupplyRequest * [VisionPrescription](visionprescription.html): Return prescriptions with this external identifier | AllergyIntolerance.identifier | CarePlan.identifier | CareTeam.identifier | Composition.identifier | Condition.identifier | Consent.identifier | DetectedIssue.identifier | DeviceRequest.identifier | DiagnosticReport.identifier | DocumentManifest.masterIdentifier | DocumentManifest.identifier | DocumentReference.masterIdentifier | DocumentReference.identifier | Encounter.identifier | EpisodeOfCare.identifier | FamilyMemberHistory.identifier | Goal.identifier | ImagingStudy.identifier | Immunization.identifier | List.identifier | MedicationAdministration.identifier | MedicationDispense.identifier | MedicationRequest.identifier | MedicationStatement.identifier | NutritionOrder.identifier | Observation.identifier | Procedure.identifier | RiskAssessment.identifier | ServiceRequest.identifier | SupplyDelivery.identifier | SupplyRequest.identifier | VisionPrescription.identifier |
last-date | Date(/time) of last known occurrence of a reaction | AllergyIntolerance.lastOccurrence |
manifestation | Clinical symptoms/signs associated with the Event | AllergyIntolerance.reaction.manifestation |
onset | Date(/time) when manifestations showed | AllergyIntolerance.reaction.onset |
patient | Multiple Resources: * [AllergyIntolerance](allergyintolerance.html): Who the sensitivity is for * [CarePlan](careplan.html): Who the care plan is for * [CareTeam](careteam.html): Who care team is for * [ClinicalImpression](clinicalimpression.html): Patient or group assessed * [Composition](composition.html): Who and/or what the composition is about * [Condition](condition.html): Who has the condition? * [Consent](consent.html): Who the consent applies to * [DetectedIssue](detectedissue.html): Associated patient * [DeviceRequest](devicerequest.html): Individual the service is ordered for * [DeviceUseStatement](deviceusestatement.html): Search by subject - a patient * [DiagnosticReport](diagnosticreport.html): The subject of the report if a patient * [DocumentManifest](documentmanifest.html): The subject of the set of documents * [DocumentReference](documentreference.html): Who/what is the subject of the document * [Encounter](encounter.html): The patient or group present at the encounter * [EpisodeOfCare](episodeofcare.html): The patient who is the focus of this episode of care * [FamilyMemberHistory](familymemberhistory.html): The identity of a subject to list family member history items for * [Flag](flag.html): The identity of a subject to list flags for * [Goal](goal.html): Who this goal is intended for * [ImagingStudy](imagingstudy.html): Who the study is about * [Immunization](immunization.html): The patient for the vaccination record * [List](list.html): If all resources have the same subject * [NutritionOrder](nutritionorder.html): The identity of the person who requires the diet, formula or nutritional supplement * [Observation](observation.html): The subject that the observation is about (if patient) * [Procedure](procedure.html): Search by subject - a patient * [RiskAssessment](riskassessment.html): Who/what does assessment apply to? * [ServiceRequest](servicerequest.html): Search by subject - a patient * [SupplyDelivery](supplydelivery.html): Patient for whom the item is supplied * [VisionPrescription](visionprescription.html): The identity of a patient to list dispenses for | AllergyIntolerance.patient | CarePlan.subject.where(resolve() is Patient) | CareTeam.subject.where(resolve() is Patient) | ClinicalImpression.subject.where(resolve() is Patient) | Composition.subject.where(resolve() is Patient) | Condition.subject.where(resolve() is Patient) | Consent.patient | DetectedIssue.patient | DeviceRequest.subject.where(resolve() is Patient) | DeviceUseStatement.subject | DiagnosticReport.subject.where(resolve() is Patient) | DocumentManifest.subject.where(resolve() is Patient) | DocumentReference.subject.where(resolve() is Patient) | Encounter.subject.where(resolve() is Patient) | EpisodeOfCare.patient.where(resolve() is Patient) | FamilyMemberHistory.patient.where(resolve() is Patient) | Flag.subject.where(resolve() is Patient) | Goal.subject.where(resolve() is Patient) | ImagingStudy.subject.where(resolve() is Patient) | Immunization.patient | List.subject.where(resolve() is Patient) | NutritionOrder.patient | Observation.subject.where(resolve() is Patient) | Procedure.subject.where(resolve() is Patient) | RiskAssessment.subject.where(resolve() is Patient) | ServiceRequest.subject.where(resolve() is Patient) | SupplyDelivery.patient | VisionPrescription.patient |
recorder | Who recorded the sensitivity | AllergyIntolerance.recorder |
route | How the subject was exposed to the substance | AllergyIntolerance.reaction.exposureRoute |
severity | mild | moderate | severe (of event as a whole) | AllergyIntolerance.reaction.severity |
type | Multiple Resources: * [AllergyIntolerance](allergyintolerance.html): allergy | intolerance - Underlying mechanism (if known) * [Composition](composition.html): Kind of composition (LOINC if possible) * [DocumentManifest](documentmanifest.html): Kind of document set * [DocumentReference](documentreference.html): Kind of document (LOINC if possible) * [Encounter](encounter.html): Specific type of encounter * [EpisodeOfCare](episodeofcare.html): Type/class - e.g. specialist referral, disease management | AllergyIntolerance.type | Composition.type | DocumentManifest.type | DocumentReference.type | Encounter.type | EpisodeOfCare.type |
verification-status | unconfirmed | confirmed | refuted | entered-in-error | AllergyIntolerance.verificationStatus |