Interweave Implementation Guide
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Resource Profile: InterweaveAllergyIntolerance

Official URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Interweave-AllergyIntolerance Version: 0.1.0
Active as of 2024-06-10 Computable Name: InterweaveAllergyIntolerance

Interweave AllergyIntolerance resource profile

  Status: Active: Approved (STU)

Introduction

This profile sets out the expectations for the interweave allergy intolerance resource. We use the CareConnect-AllergyIntolerance-1 structure definition as a base to this profile.

Mandatory fields

The following mandatory fields are defined:

  1. verificationStatus – Specify whether the allergy/intolerance is confirmed or unconfirmed.

  2. type – Specify whether an allergy or intolerance is being modelled.

  3. patient – The person who has the allergy/intolerance.

  4. assertedDate – This field has been renamed to recordedDate in R4 – this should be the date that the allergy/intolerance was recorded. The date that the allergy/intolerance was identified should be captured in the onset[x] field.

  5. code – What is the allergy or intolerance. We stipulate a preferred binding to the SNOMED concepts below, with the understanding that local code sets are widely in use and mapping from these to SNOMED maybe troublesome. However, every effort should be made to map to SNOMED, and where it is deemed unachievable, you will need to contact interweave to gain explicit permission to use your own local code set:

    • Include codes from SNOMED_CT where constraint Equal («105590001 (Substance) OR «373873005 (Pharmaceutical / biologic product) OR «716186003 (No known allergy) OR 196461000000101 (Transfer-degraded drug allergy) OR 196471000000108 (Transfer-degraded non-drug allergy))

Must Support fields

In addition the following fields are “Must Support” – ie they must be populated if relevant and known.

  1. clinicalStatus – It is important to provide the clinical status of the allergy or intolerance. Please See Invariants here which must be observed when populating this field CARECONNECT-BASE\AllergyIntolerance-1 - Definitions - FHIR v3.0.2 (interopen.github.io)

  2. category – The classification of the substance or pharmaceutical product that is considered to be responsible for the adverse reaction. This is a must support field as not all clinical systems currently capture this information.

  3. criticality – Used to record the severity of the reaction.

  4. Onset[x] – When the allergy or intolerance was identified. The Estimated or actual date, date-time, or age when allergy or intolerance was identified. We have removed the Range and String data types from this field as they were deemed unnecessary, and it reduced the complexity of processing multiple data types for the data consumer.

  5. asserter – The source of the information about the allergy. This can be a reference to a patient, related person, or a practitioner.

  6. reaction – This field can be used to present the history of known reactions. The reaction field has a number of important child fields that should/must be provide as below:

    • manifestation – This is a mandatory field when providing the reaction. It is used to record the signs/symptoms of the reaction.

    • onset – this is a must support field which gives the date/time of when the reaction occurred.

    • severity – another important must support field which details the severity of the reaction event.

    • substance – This is an optional field, but it is important to note its usage. This is the specific substance or pharmaceutical product considered to be responsible for the event. e.g. If a patient is allergic to egg, if they are given a vaccine containing egg, which initiates a reaction, it is the vaccine that should be recorded here.

Optional fields

Other fields are optional and may be populated if known – on the understanding that not all data consumers will necessarily make use of them. Points of note include:

  • identifier – Usually a Local Id that is provided which can be quoted if manually getting in touch to find out more information. In most Interweave profiles this is a must support field, however, it is more likely that a patient identifier(NHS number) would be quoted when wanting to find out more about a persons allergies, and therefore this is marked as optional.

  • encounter – This is an extension introduced by care connect to pre-adopt the new ‘encounter’ field which is present in R4. It can be used to provide a link to the encounter where the allergy or intolerance was asserted.

  • allergyEnd – Option to provide the date and reason that the allergy is not longer valid.

  • evidence – Option to provide a reference to a diagnostic report which confirms the presence of an allergy or an intolerance.

  • recorder: Option to provide the practitioner or patient who recorded the adverse reaction.

  • note – Additional information about the allergy/intolerance, which is not captured elsewhere, can be entered within the notes section. For example, this could be information about how to care for an individual after exposure to a reactive substance. Care must be taken when populating this field, and only information which is deemed suitable for use within the shared care record should be populated here.

Discouraged or Removed fields

  • last Occurrence – This field has been discouraged. It is used to record the date/time of the last known occurrence of a reaction. However, it is deemed that this could be misleading unless records are routinely checked and kept up to date.

Usage:

Formal Views of Profile Content

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

This structure is derived from CareConnect-AllergyIntolerance-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... clinicalStatus S0..1codeactive | inactive | resolved
... verificationStatus S1..1codeunconfirmed | confirmed
... type S1..1codeallergy | intolerance - Underlying mechanism (if known)
... category S0..*codefood | medication | environment | biologic
... criticality S0..1codelow | high | unable-to-assess
... code S1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
... patient S1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... onset[x] 0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... asserter S0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (preferred)
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: Care Connect Allergy Manifestation (required)
.... onset S0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: Care Connect Allergy Exposure Route (preferred)
.... note 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
AllergyIntolerance.codepreferredCare Connect Allergy Code
AllergyIntolerance.reaction.substancepreferredSubstance Code
AllergyIntolerance.reaction.manifestationrequiredCare Connect Allergy Manifestation
AllergyIntolerance.reaction.exposureRoutepreferredCare Connect Allergy Exposure Route
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... encounter 0..1Reference(Encounter)Associated Encounter
URL: http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
... allergyEnd 0..1(Complex)Supports the date and reason that the allergy was no longer valid
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AllergyIntoleranceEnd-1
... evidence 0..1Reference(DiagnosticReport)A reference to results of investigations that confirmed the certainty of the diagnosis
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-Evidence-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... clinicalStatus ?!SΣC0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣC1..1codeunconfirmed | confirmed
Binding: AllergyIntoleranceVerificationStatus (required)
... type SΣ1..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Allergy Code (example): A code from the SNOMED Clinical Terminology UK or a code from the v3 Code System NullFlavor specifying why a valid value is not present.


...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
... patient SΣ1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... onset[x] S0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... asserter SΣ0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (preferred)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: Care Connect Allergy Manifestation (required)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
.... onset S0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: Care Connect Allergy Exposure Route (preferred)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.meta.securityextensibleAll Security Labels
AllergyIntolerance.meta.tagexampleCommon Tags
AllergyIntolerance.meta.tag:SourceexampleCommon Tags
AllergyIntolerance.meta.tag:ProvenanceexampleCommon Tags
AllergyIntolerance.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatus
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatus
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codepreferredCare Connect Allergy Code
AllergyIntolerance.code.coding:snomedCTexampleCare Connect Allergy Code
AllergyIntolerance.reaction.substancepreferredSubstance Code
AllergyIntolerance.reaction.manifestationrequiredCare Connect Allergy Manifestation
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoutepreferredCare Connect Allergy Exposure Route

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus='entered-in-error' or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus!='entered-in-error' or clinicalStatus.empty()
dom-1errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorAllergyIntoleranceIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... encounter 0..1Reference(Encounter)Associated Encounter
URL: http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
... allergyEnd 0..1(Complex)Supports the date and reason that the allergy was no longer valid
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AllergyIntoleranceEnd-1
... evidence 0..1Reference(DiagnosticReport)A reference to results of investigations that confirmed the certainty of the diagnosis
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-Evidence-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... clinicalStatus ?!SΣC0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣC1..1codeunconfirmed | confirmed
Binding: AllergyIntoleranceVerificationStatus (required)
... type SΣ1..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Allergy Code (example): A code from the SNOMED Clinical Terminology UK or a code from the v3 Code System NullFlavor specifying why a valid value is not present.


...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... onset[x] S0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... recorder 0..1Reference(CareConnectPatient1 | CareConnect-Practitioner-1)Who recorded the sensitivity
... asserter SΣ0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... note 0..*AnnotationAdditional text not captured in other fields
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorReferenceReference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)
..... authorStringstring
.... time Σ0..1dateTimeWhen the annotation was made
.... text 1..1stringThe annotation - text content
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (preferred)
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... id 0..1stringxml:id (or equivalent in JSON)
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: Care Connect Allergy Manifestation (required)
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... id 0..1stringxml:id (or equivalent in JSON)
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... description 0..1stringDescription of the event as a whole
.... onset S0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: Care Connect Allergy Exposure Route (preferred)
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... id 0..1stringxml:id (or equivalent in JSON)
....... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.meta.securityextensibleAll Security Labels
AllergyIntolerance.meta.tagexampleCommon Tags
AllergyIntolerance.meta.tag:SourceexampleCommon Tags
AllergyIntolerance.meta.tag:ProvenanceexampleCommon Tags
AllergyIntolerance.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.identifier.userequiredIdentifierUse
AllergyIntolerance.identifier.typeextensibleIdentifier Type Codes
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatus
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatus
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codepreferredCare Connect Allergy Code
AllergyIntolerance.code.coding:snomedCTexampleCare Connect Allergy Code
AllergyIntolerance.reaction.substancepreferredSubstance Code
AllergyIntolerance.reaction.manifestationrequiredCare Connect Allergy Manifestation
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoutepreferredCare Connect Allergy Exposure Route

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from CareConnect-AllergyIntolerance-1

Summary

Mandatory: 6 elements (6 nested mandatory elements)
Must-Support: 23 elements
Fixed Value: 2 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

  • The element AllergyIntolerance.meta.tag is sliced based on the value of value:system

Differential View

This structure is derived from CareConnect-AllergyIntolerance-1

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id S0..1idLogical id of this artifact
... meta
.... versionId S0..1idVersion specific identifier
.... lastUpdated S0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile S0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security 0..*CodingDISCOURAGED - may not be honoured by Data Consumers
.... Slices for tag 0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
..... tag:Source S0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code S1..1codeThe Data Provider Id of the system supplying the data
...... display S1..1stringName of the system supplying the data
..... tag:Provenance S0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
...... system 1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code S1..1codeThe ODS Code of the organisation responsible for the data
...... display S1..1stringName of the organisation supplying the data
... implicitRules 0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... clinicalStatus S0..1codeactive | inactive | resolved
... verificationStatus S1..1codeunconfirmed | confirmed
... type S1..1codeallergy | intolerance - Underlying mechanism (if known)
... category S0..*codefood | medication | environment | biologic
... criticality S0..1codelow | high | unable-to-assess
... code S1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
... patient S1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... reference 1..1stringReference to a resource (could be Contained)
.... identifier 0..1IdentifierIf relevant could include an id
.... display 1..1stringDescription of the referenced resource
... onset[x] 0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... asserter S0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (preferred)
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: Care Connect Allergy Manifestation (required)
.... onset S0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: Care Connect Allergy Exposure Route (preferred)
.... note 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
AllergyIntolerance.codepreferredCare Connect Allergy Code
AllergyIntolerance.reaction.substancepreferredSubstance Code
AllergyIntolerance.reaction.manifestationrequiredCare Connect Allergy Manifestation
AllergyIntolerance.reaction.exposureRoutepreferredCare Connect Allergy Exposure Route

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... encounter 0..1Reference(Encounter)Associated Encounter
URL: http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
... allergyEnd 0..1(Complex)Supports the date and reason that the allergy was no longer valid
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AllergyIntoleranceEnd-1
... evidence 0..1Reference(DiagnosticReport)A reference to results of investigations that confirmed the certainty of the diagnosis
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-Evidence-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... clinicalStatus ?!SΣC0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣC1..1codeunconfirmed | confirmed
Binding: AllergyIntoleranceVerificationStatus (required)
... type SΣ1..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Allergy Code (example): A code from the SNOMED Clinical Terminology UK or a code from the v3 Code System NullFlavor specifying why a valid value is not present.


...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
... patient SΣ1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... onset[x] S0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... asserter SΣ0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... reaction S0..*BackboneElementAdverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event
Binding: Substance Code (preferred)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
.... manifestation S1..*CodeableConceptClinical symptoms/signs associated with the Event
Binding: Care Connect Allergy Manifestation (required)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system
.... onset S0..1dateTimeDate(/time) when manifestations showed
.... severity S0..1codemild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance
Binding: Care Connect Allergy Exposure Route (preferred)
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:snomedCT Σ0..1CodingCode defined by a terminology system
....... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
....... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... code Σ1..1codeSymbol in syntax defined by the system
....... display Σ1..1stringRepresentation defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.meta.securityextensibleAll Security Labels
AllergyIntolerance.meta.tagexampleCommon Tags
AllergyIntolerance.meta.tag:SourceexampleCommon Tags
AllergyIntolerance.meta.tag:ProvenanceexampleCommon Tags
AllergyIntolerance.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatus
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatus
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codepreferredCare Connect Allergy Code
AllergyIntolerance.code.coding:snomedCTexampleCare Connect Allergy Code
AllergyIntolerance.reaction.substancepreferredSubstance Code
AllergyIntolerance.reaction.manifestationrequiredCare Connect Allergy Manifestation
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoutepreferredCare Connect Allergy Exposure Route

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus='entered-in-error' or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus!='entered-in-error' or clinicalStatus.empty()
dom-1errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorAllergyIntoleranceIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*CareConnect-AllergyIntolerance-1Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... id SΣ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... versionId SΣ0..1idVersion specific identifier
.... lastUpdated SΣ0..1instantMANDATORY except in Contained Resources. When the resource version last changed.
.... profile SΣ0..*uriProfiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
.... security Σ0..*CodingDISCOURAGED - may not be honoured by Data Consumers
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... Slices for tag Σ0..*CodingTags applied to this resource
Slice: Unordered, Open by value:system
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


..... tag:Source SΣ0..1CodingMANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Source
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe Data Provider Id of the system supplying the data
...... display SΣ1..1stringName of the system supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... tag:Provenance SΣ0..1CodingMANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"


...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
Fixed Value: https://yhcr.nhs.uk/Provenance
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeThe ODS Code of the organisation responsible for the data
...... display SΣ1..1stringName of the organisation supplying the data
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... implicitRules ?!Σ0..1uriDISCOURAGED - may not be honoured by Data Consumers
... text 0..1NarrativeDISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... encounter 0..1Reference(Encounter)Associated Encounter
URL: http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
... allergyEnd 0..1(Complex)Supports the date and reason that the allergy was no longer valid
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AllergyIntoleranceEnd-1
... evidence 0..1Reference(DiagnosticReport)A reference to results of investigations that confirmed the certainty of the diagnosis
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-Evidence-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ1..1stringThe value that is unique
Example General: 123456
.... period Σ0..1PeriodTime period when id is/was valid for use
.... assigner Σ0..1Reference(CareConnect-Organization-1)Organization that issued id (may be just text)
... clinicalStatus ?!SΣC0..1codeactive | inactive | resolved
Binding: AllergyIntoleranceClinicalStatus (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!SΣC1..1codeunconfirmed | confirmed
Binding: AllergyIntoleranceVerificationStatus (required)
... type SΣ1..1codeallergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category SΣ0..*codefood | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance.


... criticality SΣ0..1codelow | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code SΣ1..1CodeableConceptCode that identifies the allergy or intolerance
Binding: Care Connect Allergy Code (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by value:system
..... coding:snomedCT Σ0..1CodingCode defined by a terminology system
Binding: Care Connect Allergy Code (example): A code from the SNOMED Clinical Terminology UK or a code from the v3 Code System NullFlavor specifying why a valid value is not present.


...... id 0..1stringxml:id (or equivalent in JSON)
...... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
...... snomedCTDescriptionID 0..*(Complex)The SNOMED CT Description ID for the display
URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... patient SΣ1..1Reference(CareConnectPatient1)Who the sensitivity is for
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC1..1stringReference to a resource (could be Contained)
.... identifier Σ0..1IdentifierIf relevant could include an id
.... display Σ1..1stringDescription of the referenced resource
... onset[x] S0..1When allergy or intolerance was identified
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
... assertedDate S1..1dateTimeDate record was believed accurate
... recorder 0..1Reference(CareConnectPatient1 | CareConnect-Practitioner-1)Who recorded the sensitivity
... asserter SΣ0..1Reference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)Source of the information about the allergy
... lastOccurrence 0..1dateTimeDISCOURAGED – maybe misleading unless information is kept acutely up to date.
... note 0..*AnnotationAdditional text not captured in other fields
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... author[x] Σ0..1Individual responsible for the annotation
..... authorReferenceReference(RelatedPerson | CareConnectPatient1 | CareConnect-Practitioner-1)