AU Core Implementation Guide
0.2.2-preview - Preview Australia flag

This page is part of the Australian Core IG (v0.2.2-preview: AU Core) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Resource Profile: AU Core AllergyIntolerance

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance Version: 0.2.2-preview
Standards status: Draft Maturity Level: 0 Computable Name: AUCoreAllergyIntolerance

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.

This profile sets minimum expectations for an AllergyIntolerance resource to record, search, and fetch allergies/adverse reactions associated with a patient. It is based on the AU Base Allergy Intolerance profile and identifies the additional mandatory core elements, extensions, vocabularies and value sets that SHALL be present in the AllergyIntolerance resource when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.

Usage scenarios

The following are supported usage scenarios for this profile:

  • Query for a patient’s allergies/adverse reactions
  • Record or update a patient’s allergies/adverse reactions

Comparison with other national and international specifications

A resource conforming to this profile is conformant to:

Conformance in reverse is not guaranteed, i.e. a resource conforming to International Patient Access, International Patient Summary, or US Core MAY NOT conform to AU Core.

Profile specific implementation guidance

  • AllergyIntolerance.verificationStatus is “unconfirmed” where a sending system does not clearly have this element or “confirmed” depending on the level of certainty
  • To represent that a patient does not have an allergy or category of allergies, an appropriate negation code (e.g. 716186003 |No known allergy| or 716184000 |No known latex allergy|) is used in AllergyIntolerance.code
  • The use of coding can vary significantly across systems, client applications need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Servers SHOULD populate AllergyIntolerance.code.text and/or AllergyIntolerance.code.coding.display so that client applications can at least display the condition even if the client application does not recognise the code supplied.
  • Refutation is not expected to be handled except as above - an appropriate negation code in AllergyIntolerance.code and AllergyIntolerance.verificationStatus of “confirmed” or “unconfirmed”
  • Where only substance is known (e.g. 111088007 |Latex|) and not a statement of allergy or intolerance (e.g. 300916003 |Allergy to latex|), the substance will be sent in AllergyIntolerance.code and optionally in AllergyIntolerance.reaction.substance

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from AUBaseAllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AUBaseAllergyIntoleranceAn allergy or intolerance statement in an Australian healthcare context
... clinicalStatus S0..1CodeableConceptactive | inactive | resolved
... verificationStatus S0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error
... type S0..1codeallergy | intolerance - Underlying mechanism (if known)
... code S1..1CodeableConceptCode that identifies the allergy or intolerance
... patient S1..1Reference(AU Core Patient)Who the sensitivity is for
... encounter S0..1Reference(AU Core Encounter)Encounter when the allergy or intolerance was asserted
... onset[x] S0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
... recorder S0..1Reference(AU Core Practitioner | AU Core Patient | AU Core RelatedPerson | AU Core PractitionerRole)Who recorded the sensitivity
... asserter S0..1Reference(AU Core Patient | AU Core RelatedPerson | AU Core Practitioner | AU Core PractitionerRole)Source of the information about the allergy
... note S0..*AnnotationAdditional text not captured in other fields
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance S0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
.... severity S0..1codemild | moderate | severe (of event as a whole)

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. FHIR search operations and the syntax used to describe the interactions is described here.

Any search parameter defined in FHIR may be ‘allowed’ by the system unless explicitly marked as “SHALL NOT”. A few items are marked as MAY in this implementation guide to highlight their potential relevance.

Parameter(s) Conformance Type(s) Requirements (when used alone or in combination)
patient SHALL reference The client SHALL provide at least an id value and MAY provide both the Type and id values. The server SHALL support both.
patient+clinical-status SHOULD reference+token
patient.identifier SHOULD reference.token The client SHALL provide both the system and code values. The server SHALL support both.

The client SHOULD support search using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The server SHOULD support search using the using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
clinical-status MAY token The client SHALL provide at least a code value and MAY provide both the system and code values. The server SHALL support both.

Mandatory Search Parameters

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching using the patient search parameter:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/AllergyIntolerance?patient={Type/}[id] or optionally GET [base]/AllergyIntolerance?patient.identifier=[system|][code]

    Example:

    1. GET [base]/AllergyIntolerance?patient=5678
    2. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/medicare-number|32788511952
    3. GET [base]/AllergyIntolerance?patient.identifier=http://ns.electronichealth.net.au/id/hi/ihi/1.0|8003608833357361

    Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient (how to search by reference and how to search by token)

Optional Search Parameters

The following search parameters and search parameter combinations SHOULD be supported:

  1. SHOULD support searching using the combination of the patient and clinical-status search parameters:
    • SHALL support these _revinclude parameters: Provenance:target
    • SHOULD support chained searching of patient canonical identifier patient.identifier (e.g. patient.identifier=[system|][code])

    GET [base]/AllergyIntolerance?patient={Type/}[id]&clinical-status={system|}[code]{,{system|}[code],...}

    Example:

    1. GET [base]/AllergyIntolerance?patient=5678&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active
    2. GET [base]/AllergyIntolerance?patient=5678&clinical-status=http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical active&_revinclude=Provenance:target

    Implementation Notes: Fetches a bundle of all AllergyIntolerance resources for the specified patient and status (how to search by reference and how to search by token)