statusCode [1..1]
CS |
The status code must be present and must be valued as "completed" |
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effectiveTime [1..1]
IVL_TS |
The effectiveTime must be present and indicates the range of time in which the allergy observation is effective. |
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value [1..*]
CD
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The value must carry a concept descriptor (CD) valued which describes the adverse reaction or allergy. |
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participant [1..1]
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The participant relationship will contain information related to the agent or substance which caused the allergic reaction or adverse event. |
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entryRelationship [0..*] |
Entry relationships with typeCode of MFST (Manifestation) and template id 1.3.6.1.4.1.19376.1.5.3.1.4.6.1 shall contain a problem entry describing the manifestation of the allergy (for example: hives, anaphylaxis, etc.). See 3.4.2.17 for more information. |
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Entry relationships with a typeCode of SUBJ (SubjectOf), an inversionInd of true and an observation with template 1.3.6.1.4.1.19376.1.5.3.1.4.1 shall contain a severity observation describing the severity of the allergic reaction / manifestation. |
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OpenSHR Implementation Notes |
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Data Model |
Obs |
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Code File |
AllergiesAndIntolerancesEntryProcessor.java |
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Permitted Moods |
EVN |
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Additional Constraints |
- IHE PCC constraints allow for value to carry textual information without a code, however due to OpenSHR's data model this type of value is not permitted. It is recommended local coding schemes be used by content creators to express the value of the observation.
- IHE PCC permits additional entryRelationships on the allergy / intolerance observation which describe clinical status and comments, however these relationships are not supported by OpenSHR in the current release.
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Example |
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The following example illustrates a drug allergy to Penicillin active since January 15 2007. The allergy is severe and manifests itself as anaphylaxis.
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<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.28"/>
<templateId root="2.16.840.1.113883.10.20.1.18"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5"/>
<id root="7aea1b00-b972-48e8-acb6-adc0e9cef77b"/>
<id root="1.2.3.4.5.3" extension="46"/>
<code code="ALG" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ObservationIntoleranceType" displayName="Other Allergy"/>
<text representation="TXT" language="en-US">
<reference value="#obs5fecf51f"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20070115141530"/>
</effectiveTime>
<value xsi:type="CD" code="373270004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Penicillin Allergy">
<originalText representation="TXT" language="en-US">
<reference value="#txt2f7efeb1"/>
</originalText>
</value>
<participant typeCode="CSM" contextControlCode="OP">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT" determinerCode="INSTANCE">
<code code="373270004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Penicillin">
<originalText representation="TXT" language="en-US">
<reference value="#txtdaa972ef"/>
</originalText>
</code>
<name>Penicillin</name>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="SUBJ" inversionInd="true" contextConductionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.1"/>
<templateId root="2.16.840.1.113883.10.20.1.55"/>
<id root="54046e7f-692b-4aa6-bfdd-b91f7de095e3"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode" displayName="Severity"/>
<text representation="TXT" language="en-US">
<reference value="#obsb7aa29ea"/>
</text>
<statusCode code="completed"/>
<value xsi:type="CD" code="H" codeSystem="2.16.840.1.113883.5.1063" codeSystemName="ObservationValue">
<originalText representation="TXT" language="en-US">
<reference value="#txt0ae2f10e"/>
</originalText>
</value>
</observation>
</entryRelationship>
<entryRelationship typeCode="MFST" contextConductionInd="true">
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6.1"/>
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.54"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5"/>
<templateId root="2.16.840.1.113883.10.20.1.28"/>
<id root="853845cb-9f28-4185-a452-96153137e59b"/>
<id root="1.2.3.4.5.3" extension="47"/>
<code code="PROBLEM" codeSystem="1.3.6.1.4.1.19376.1.5.3.2" codeSystemName="1.3.6.1.4.1.19376.1.5.3.2">
<originalText representation="TXT" language="en-US">
<reference value="#txtc8e29691"/>
</originalText>
</code>
<text representation="TXT" language="en-US">
<reference value="#obs8bcd9dfd"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low value="20070115141530"/>
</effectiveTime>
<value xsi:type="CD" code="39579001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Anaphylaxis">
<originalText representation="TXT" language="en-US">
<reference value="#txtb2fec89a"/>
</originalText>
</value>
</observation>
</entryRelationship>
</observation> |
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The following observation indicates that the patient is NOT allergic to Latex.
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<observation classCode="OBS" moodCode="EVN" negationInd="true">
<templateId root="2.16.840.1.113883.10.20.1.28"/>
<templateId root="2.16.840.1.113883.10.20.1.18"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5"/>
<id root="b907fb72-4965-4eba-a938-63aefbe4c8bb"/>
<code code="ALG" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ObservationIntoleranceType" displayName="Other Allergy"/>
<text representation="TXT" language="en-US">
<reference value="#obsa26f3ad7"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
<high nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD" code="300916003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Latex">
<originalText representation="TXT" language="en-US">
<reference value="#txt5d678bd4"/>
</originalText>
</value>
</observation> |
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