AU Core Implementation Guide
2.0.0-ballot - Ballot

AU Core Implementation Guide - Downloaded Version 2.0.0-ballot See the Directory of published versions

## Resource Profile: AU Core AllergyIntolerance

Official URL: http://hl7.org.au/fhir/core/StructureDefinition/au-core-allergyintolerance | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | 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.

Upcoming NCTS ValueSet Availability

Balloters should note that AU Base has submitted a request to NCTS to add a specific value set with agreed changed terminology defined for binding to `AllergyIntolerance.reaction.manifestation`. This request is pending release and the value set is not available in this guide at the time of publishing.

Balloters should consider the content of the indicative reference set available now that the new NCTS ValueSet will be based on.

Related JIRA issue with details is AU Base: FHIR-47076.

See Comparison with other national and international IGs for a comparison between AU Core profiles and profiles in other implementation guides.

### 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

### Profile Specific Implementation Guidance

- 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 1003774007 |No known Hevea brasiliensis latex allergy|) is used in `AllergyIntolerance.code`
- The use of coding can vary significantly across systems, requesters need to understand that they may encounter codes they do not recognise and be prepared to handle those resources appropriately. Responders SHOULD populate `AllergyIntolerance.code.text` and/or `AllergyIntolerance.code.coding.display` so that requesters can at least display the condition even if the requester 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. 1003755004 |Allergy to latex|), the substance is sent in `AllergyIntolerance.code`

The additional obligation for `AllergyIntolerance.onsetDateTime` for AU Core Responder is SHOULD:populate. There is no additional obligation for AU Core Requester, the obligation of SHALL:no-error applies.

This obligation is present in the underlying structure but due to a tooling limitation is not currently rendered in the profile view. See Zulip discussion for more information.

Usages:

- Examples for this Profile: AllergyIntolerance/lactose, AllergyIntolerance/noneknown and AllergyIntolerance/penicillin
- CapabilityStatements using this Profile: AU Core Requester CapabilityStatement and AU Core Responder CapabilityStatement

You can also check for usages in the FHIR IG Statistics

Changes since version 1.0.0:

- The resource metadata has changed (description)
- The data elements list has changed

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context Constraints: ait-1, ait-2
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | ?!SO Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO Σ | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1` From the FHIR Standard
AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1` From the FHIR Standard
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation | preferred | ClinicalFinding `https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity `http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() |
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from AUBaseAllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context
clinicalStatus | SO | 0..1 | CodeableConcept | active | inactive | resolved
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | SO | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context Constraints: ait-1, ait-2
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | ?!SO Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | SO Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO Σ | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: Adverse Reaction Agent (preferred)
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: Route of Administration (preferred)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
AllergyIntolerance.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1` From the FHIR Standard
AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1` From the FHIR Standard
AllergyIntolerance.type | required | AllergyIntoleranceType `http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1` From the FHIR Standard
AllergyIntolerance.category | required | AllergyIntoleranceCategory `http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1` From the FHIR Standard
AllergyIntolerance.criticality | required | AllergyIntoleranceCriticality `http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1` From the FHIR Standard
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.substance | preferred | AdverseReactionAgent `https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation | preferred | ClinicalFinding `https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity `http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1` From the FHIR Standard
AllergyIntolerance.reaction.exposureRoute | preferred | RouteOfAdministration `https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() |
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from AUBaseAllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 9 elements

Structures

This structure refers to these other structures:

- AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context Constraints: ait-1, ait-2
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | ?!SO Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO Σ | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1` From the FHIR Standard
AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1` From the FHIR Standard
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation | preferred | ClinicalFinding `https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity `http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() |
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

Differential View

This structure is derived from AUBaseAllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context
clinicalStatus | SO | 0..1 | CodeableConcept | active | inactive | resolved
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | SO | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
code | SO | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AUBaseAllergyIntolerance | An allergy or intolerance statement in an Australian healthcare context Constraints: ait-1, ait-2
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!SO Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
verificationStatus | ?!SO Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | SO Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Indicator of Hypersensitivity or Intolerance to Substance (extensible)
Additional Bindings | Purpose
Adverse Reaction Substances and Negated Findings | candidate
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
patient | SO Σ | 1..1 | Reference(AU Core Patient) | Who the sensitivity is for
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] | SO | 0..1 |  | When allergy or intolerance was identified
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note | SO | 0..* | Annotation | Additional text not captured in other fields
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
reaction | SO | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: Adverse Reaction Agent (preferred)
manifestation | SO | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: Clinical Finding (preferred)
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity | SO | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
Obligations | Actor
SHALL:populate-if-known | AU Core Responder
SHALL:no-error | AU Core Requester
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: Route of Administration (preferred)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
AllergyIntolerance.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1` From the FHIR Standard
AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes `http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1` From the FHIR Standard
AllergyIntolerance.type | required | AllergyIntoleranceType `http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1` From the FHIR Standard
AllergyIntolerance.category | required | AllergyIntoleranceCategory `http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1` From the FHIR Standard
AllergyIntolerance.criticality | required | AllergyIntoleranceCriticality `http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1` From the FHIR Standard
AllergyIntolerance.code | extensible | IndicatorOfHypersensitivityOrIntoleranceToSubstance `https://healthterminologies.gov.au/fhir/ValueSet/indicator-hypersensitivity-intolerance-to-substance-2` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.substance | preferred | AdverseReactionAgent `https://healthterminologies.gov.au/fhir/ValueSet/adverse-reaction-agent-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.manifestation | preferred | ClinicalFinding `https://healthterminologies.gov.au/fhir/ValueSet/clinical-finding-1` From https://tx.ontoserver.csiro.au/fhir
AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity `http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1` From the FHIR Standard
AllergyIntolerance.reaction.exposureRoute | preferred | RouteOfAdministration `https://healthterminologies.gov.au/fhir/ValueSet/route-of-administration-1` From https://tx.ontoserver.csiro.au/fhir

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() |
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |

This structure is derived from AUBaseAllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 9 elements

Structures

This structure refers to these other structures:

- AU Core Patient (http://hl7.org.au/fhir/core/StructureDefinition/au-core-patient)

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

### Notes:

Below is an overview of the mandatory and optional search parameters and combined search parameters. See the AU Core CapabilityStatements for a complete list of supported RESTful interactions for this IG.

FHIR search operations are described here and the syntax used to describe AU Core interactions is defined 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 requester SHALL provide at least an id value and MAY provide both the Type and id values. The responder SHALL support both. The requester SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile. The responder SHOULD support chained search patient.identifier using IHI, Medicare Number, and DVA Number identifiers as defined in the AU Core Patient profile.
patient+clinical-status | SHOULD | `reference`+`token` |
clinical-status | MAY | `token` | The requester SHALL provide at least a code value and MAY provide both the system and code values. The responder 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:
   - 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:
   - 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

   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)