{
"description": null,
"_filename": "DwAllergyIntolerance.json",
"package_name": "telus.dw.emr.extract",
"date": "2024-05-03T22:11:40.4165223+00:00",
"derivation": "constraint",
"meta": {
"lastUpdated": "2024-05-03T19:47:25.8150594+00:00"
},
"publisher": null,
"fhirVersion": "4.0.1",
"name": "DwAllergyIntolerance",
"mapping": [ {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
} ],
"abstract": false,
"type": "AllergyIntolerance",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "1.0.0",
"status": "draft",
"id": "8e188b7a-a28b-4564-8a56-e718456896cd",
"kind": "resource",
"url": "https://www.telus.com/health/fhir/dwemrextract/StructureDefinition/DwAllergyIntolerance",
"version": null,
"differential": {
"element": [ {
"id": "AllergyIntolerance.id",
"path": "AllergyIntolerance.id",
"comment": "UUID\r\n\r\nThe only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.meta",
"path": "AllergyIntolerance.meta"
}, {
"id": "AllergyIntolerance.meta.lastUpdated",
"path": "AllergyIntolerance.meta.lastUpdated",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus",
"path": "AllergyIntolerance.clinicalStatus",
"comment": "The clinical status must be empty when the verification status is \"entered-in-error\"\r\n\r\nPS if allergy present in CPP status = active \r\n All refuted allergies except for incorrect or entered-in-error = inactive\r\n \r\nMA Allergy Active = active\r\n Refuted = inactive \r\n\r\n\r\nRefer to [discussion](extensibility.html#Special-Case) if clincalStatus is missing data.\nThe data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding",
"min": 1,
"path": "AllergyIntolerance.clinicalStatus.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus",
"max": "1",
"path": "AllergyIntolerance.clinicalStatus.coding",
"binding": {
"strength": "required",
"valueSet": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
},
"sliceName": "HL7AllergyIntoleranceClinicalStatus",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.system",
"path": "AllergyIntolerance.clinicalStatus.coding.system",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.version",
"path": "AllergyIntolerance.clinicalStatus.coding.version",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.code",
"path": "AllergyIntolerance.clinicalStatus.coding.code",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display",
"path": "AllergyIntolerance.clinicalStatus.coding.display",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation",
"max": "1",
"path": "AllergyIntolerance.clinicalStatus.coding.display.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
} ],
"sliceName": "translation",
"isModifier": false
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:HL7AllergyIntoleranceClinicalStatus.display.extension:translation.extension",
"min": 2,
"path": "AllergyIntolerance.clinicalStatus.coding.display.extension.extension"
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA",
"path": "AllergyIntolerance.clinicalStatus.coding",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/allergyintolerancestatuscode"
},
"comment": "Usage note: One of active; inactive; resolved. In PSS this is active; inactive;\r\n\r\nCodes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
"sliceName": "statusCodeSCTCA",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.system",
"path": "AllergyIntolerance.clinicalStatus.coding.system",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.version",
"path": "AllergyIntolerance.clinicalStatus.coding.version",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.code",
"path": "AllergyIntolerance.clinicalStatus.coding.code",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display",
"path": "AllergyIntolerance.clinicalStatus.coding.display",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation",
"max": "1",
"path": "AllergyIntolerance.clinicalStatus.coding.display.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
} ],
"sliceName": "translation",
"isModifier": false
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.display.extension:translation.extension",
"min": 2,
"path": "AllergyIntolerance.clinicalStatus.coding.display.extension.extension"
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:statusCodeSCTCA.userSelected",
"path": "AllergyIntolerance.clinicalStatus.coding.userSelected",
"mustSupport": true
}, {
"id": "AllergyIntolerance.clinicalStatus.text",
"path": "AllergyIntolerance.clinicalStatus.text",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus",
"path": "AllergyIntolerance.verificationStatus",
"comment": "PSS->FHIR - \r\nSuspected = unconfirmed\r\nConfirmed = confirmed \r\nRefuted = Refuted \r\ndeleted or Refuted status of entered in error or Incorrect = entered-in-error\r\nMA ->FHIR \r\n Confirmed = confirmed \r\nSuspected = unconfirmed\r\nUnconfimred = unconfirmed\r\nRefuted = Refuted \r\nDeleted = entered-in-error\r\n\r\nThe data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding",
"path": "AllergyIntolerance.verificationStatus.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus",
"path": "AllergyIntolerance.verificationStatus.coding",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergyintolerance-verification"
},
"sliceName": "HL7VerificationStatus",
"definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).\r\nOne of unconfirmed | presumed | confirmed | refuted | entered in error",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.system",
"path": "AllergyIntolerance.verificationStatus.coding.system",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.version",
"path": "AllergyIntolerance.verificationStatus.coding.version",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.code",
"path": "AllergyIntolerance.verificationStatus.coding.code",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.display",
"path": "AllergyIntolerance.verificationStatus.coding.display",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.coding:HL7VerificationStatus.userSelected",
"path": "AllergyIntolerance.verificationStatus.coding.userSelected",
"mustSupport": true
}, {
"id": "AllergyIntolerance.verificationStatus.text",
"path": "AllergyIntolerance.verificationStatus.text",
"comment": "Display the text as it is shown in the EMR\r\n\r\nVery often the text is the same as a displayName of one of the codings.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.type",
"path": "AllergyIntolerance.type",
"comment": "FHIR->PSS - \r\nallergy->allergy \r\nintollerance->side-effect, exagerated effect, other. \r\nFHIR>MA \r\n Allergy-> drug allergy, non-drug allergy \r\nIntollerance-> drug intollerance, non-drug intollerance\r\n\r\n\r\nAllergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term \"allergy\" is used rather generically and may overlap with the use of \"intolerance\" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.category",
"path": "AllergyIntolerance.category",
"comment": "PSS - FHIR\r\nMedication and Allergy group = medication \r\nFood = food\r\nStinging insect and Pollen & Dander = environment\r\n\r\nMA->FHIR\r\nDrug Allergy and Drug Intolerance = medication \r\n\r\n\r\n\r\n\r\nThis data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to [search](search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.criticality",
"path": "AllergyIntolerance.criticality",
"mustSupport": true
}, {
"id": "AllergyIntolerance.code",
"min": 1,
"path": "AllergyIntolerance.code",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "coding.system",
"type": "value"
} ]
},
"mustSupport": true
}, {
"id": "AllergyIntolerance.code:absentOrUnknownAllergyIntolerance",
"path": "AllergyIntolerance.code",
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-allergies-uv-ips"
},
"sliceName": "absentOrUnknownAllergyIntolerance",
"mustSupport": true
}, {
"id": "AllergyIntolerance.code:codeAllergyCA",
"path": "AllergyIntolerance.code",
"binding": {
"strength": "preferred",
"valueSet": "https://tgateway.infoway-inforoute.ca/vs/pharmaceuticalbiologicproductandsubstancecode"
},
"sliceName": "codeAllergyCA",
"mustSupport": true
}, {
"id": "AllergyIntolerance.code:codeAllergyICD10CA",
"path": "AllergyIntolerance.code",
"binding": {
"strength": "required",
"valueSet": "http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD10CA"
},
"comment": "Usage Note: For future consideration\r\n\r\nIt is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen a substance or product code is specified for the 'code' element, the \"default\" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the \"Causative agent\" relationship.\r\rThe 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make \"no known allergy\" (or \"no risk of adverse reaction\") statements regarding any coded substance/product (including cases when a pre-coordinated \"no allergy to x\" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.",
"sliceName": "codeAllergyICD10CA"
}, {
"id": "AllergyIntolerance.code:codeAllergyICD10CA.text",
"path": "AllergyIntolerance.code.text",
"mustSupport": true
}, {
"id": "AllergyIntolerance.patient",
"path": "AllergyIntolerance.patient",
"mustSupport": true
}, {
"id": "AllergyIntolerance.patient.reference",
"min": 1,
"path": "AllergyIntolerance.patient.reference",
"comment": "Internal reference to a patient: urn:telus:emr:::\r\n\r\nUsing absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.encounter",
"path": "AllergyIntolerance.encounter",
"mustSupport": true
}, {
"id": "AllergyIntolerance.encounter.reference",
"path": "AllergyIntolerance.encounter.reference",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.\r\nInternal Encounter Reference: \r\nurn:telus:emr:pss:5197:encounter:112~20040823~DRAA"
}, {
"id": "AllergyIntolerance.onset[x]",
"path": "AllergyIntolerance.onset[x]",
"mustSupport": true
}, {
"id": "AllergyIntolerance.recordedDate",
"path": "AllergyIntolerance.recordedDate",
"mustSupport": true
}, {
"id": "AllergyIntolerance.recorder",
"path": "AllergyIntolerance.recorder",
"mustSupport": true
}, {
"id": "AllergyIntolerance.note",
"path": "AllergyIntolerance.note",
"comment": "Usage Note: This is the current value of the notes on the allergy record, which includes the latest manifestation/reaction notes. EMRs who capture notes on a per reaction basis may include them here.\r\n\r\nNotes MA, PSS and MS and CHR support this. \r\nPSS - two text areas - \"brief description\" and \"long details\". Current value of these two fields is most valuable\r\n\r\nFor example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.substance.text",
"path": "AllergyIntolerance.reaction.substance.text",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation",
"path": "AllergyIntolerance.reaction.manifestation",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/clinicalfindingcode"
},
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding",
"path": "AllergyIntolerance.reaction.manifestation.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
}
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA",
"path": "AllergyIntolerance.reaction.manifestation.coding",
"binding": {
"strength": "required",
"valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/clinicalfindingcode"
},
"sliceName": "manifestationSCTCA",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.system",
"path": "AllergyIntolerance.reaction.manifestation.coding.system",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.version",
"path": "AllergyIntolerance.reaction.manifestation.coding.version",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.code",
"path": "AllergyIntolerance.reaction.manifestation.coding.code",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display",
"path": "AllergyIntolerance.reaction.manifestation.coding.display",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation",
"max": "1",
"path": "AllergyIntolerance.reaction.manifestation.coding.display.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/translation" ]
} ],
"sliceName": "translation",
"isModifier": false
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.display.extension:translation.extension",
"min": 2,
"path": "AllergyIntolerance.reaction.manifestation.coding.display.extension.extension"
}, {
"id": "AllergyIntolerance.reaction.manifestation.coding:manifestationSCTCA.userSelected",
"path": "AllergyIntolerance.reaction.manifestation.coding.userSelected",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.manifestation.text",
"path": "AllergyIntolerance.reaction.manifestation.text",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.onset",
"path": "AllergyIntolerance.reaction.onset",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.severity",
"path": "AllergyIntolerance.reaction.severity",
"mustSupport": true
}, {
"id": "AllergyIntolerance.reaction.exposureRoute.text",
"path": "AllergyIntolerance.reaction.exposureRoute.text",
"mustSupport": true
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"
}