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Template eHDSI Allergies And Intolerances 2022‑03‑01 14:37:02

Id1.3.6.1.4.1.12559.11.10.1.3.1.3.17Effective Date2022‑03‑01 14:37:02
Statusretired RetiredVersion Label
NameeHDSIAllergiesAndIntolerancesDisplay NameeHDSI Allergies And Intolerances
Description

Allergies and intolerances are special kinds of problems, and so are also recorded in the CDA <observation> element, with classCode='OBS'. They follow the same pattern as the problem entry, with exceptions noted below.

Parent Template

This is an adaptation of the IHE PCC Allergies And Intolerances Entry (1.3.6.1.4.1.19376.1.5.3.1.4.6) and of the CCD Alert observation (2.16.840.1.113883.10.20.1.18) templates.

ContextParent nodes of template element with id 1.3.6.1.4.1.12559.11.10.1.3.1.3.17
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Associated with
Associated with 10 concepts
IdNameData Set
ehdsi-dataelement-13draft Status draft eHDSI Data Set
ehdsi-dataelement-16draft Allergen code draft eHDSI Data Set
ehdsi-dataelement-7draft Type of propensity draft eHDSI Data Set
ehdsi-dataelement-10draft End date draft eHDSI Data Set
ehdsi-dataelement-9draft Onset date draft eHDSI Data Set
ehdsi-dataelement-8draft Allergy Manifestation draft eHDSI Data Set
ehdsi-dataelement-14draft Certainty draft eHDSI Data Set
ehdsi-dataelement-5draft Allergy/Intolerance description draft eHDSI Data Set
ehdsi-dataelement-15draft Allergen description draft eHDSI Data Set
ehdsi-dataelement-12draft Criticality draft eHDSI Data Set
Used by / Uses
Used by 0 transactions and 0 templates, Uses 4 templates
Uses as NameVersion
1.3.6.1.4.1.12559.11.10.1.3.1.3.33Containmentactive eHDSI Criticality ObservationDYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.34Containmentactive eHDSI Allergy Status ObservationDYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.35Containmentactive eHDSI Allergy Certainty ObservationDYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.44Containmentactive eHDSI Reaction ManifestationDYNAMIC
RelationshipVersion: template 1.3.6.1.4.1.12559.11.10.1.3.1.3.17 eHDSI Allergies And Intolerances (2021‑06‑21 10:36:45)
Version: template 1.3.6.1.4.1.12559.11.10.1.3.1.3.17 eHDSI Allergies And Intolerances (2020‑09‑02 15:26:02)
Adaptation: template 2.16.840.1.113883.10.20.1.18 (DYNAMIC)
Adaptation: template 1.3.6.1.4.1.19376.1.5.3.1.4.6 eHDSI Allergies And Intolerances (DYNAMIC)
Example
Example
<observation classCode="OBS" moodCode="EVN" negationInd="false">
  <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.17"/>  <id root=" " extension=" "/>  <!-- This is the code that shows what kind of allergy or intolerance derived from the eHDSIAdverseEventType Value Set-->
  <code code="" codeSystem="2.16.840.1.113883.6.96"/>  <text>
    <reference value=" "/>  </text>  <statusCode code="completed"/>  <effectiveTime>
    <low value=" "/>    <high value=" "/>  </effectiveTime>  <!-- value element is present only to indicate no known allergies, in all other cases is used for referenicng text in the narrative -->
  <value type="CD"/>  <!-- This is the allergen - the substance that caused the allergy -->
  <participant typeCode="CSM">
    <participantRole classCode="MANU">
      <playingEntity classCode="MMAT">
        <code code=" " codeSystem=" ">
          <originalText>
            <reference value="#substance"/>          </originalText>        </code>        <name/>      </playingEntity>    </participantRole>  </participant>  <!-- This is how the allergy manifests itself -->
  <entryRelationship typeCode="MFST">
    <templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6.1"/>    <!-- a problem entry -->
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.7"/>      <!-- The code tells us that the observation is a symptom -->
      <code code="418799008" codeSystem="2.16.840.1.113883.6.96" displayName="Finding reported by subject or history provider" codeSystemName="SNOMED CT"/>      <text>
        <reference value="#manifest-1"/>      </text>      <statusCode code="completed"/>      <!-- The value tells us what the symptom (i.e. allergy manifestation) is -->
      <!-- This is where anaphylaxy or angiooedema will be coded -->
      <value type="CD" code=" " codeSystem=" " displayName=" " codeSystemName=" "/>    </observation>  </entryRelationship>  <!-- This is how the severity of the allergy is described (Optional)-->
  <entryRelationship typeCode="SUBJ" inversionInd="true">
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.7"/>      <!-- This code is from HL7 and indicates that the observation is about severity -->
      <code code="SEV" displayName="Severity" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>      <text>
        <reference value="#severity-1"/>      </text>      <statusCode code="completed"/>      <!-- This code is from SNOMED, according to the epSOS value set-->
      <value type="CD" code="" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>    </observation>  </entryRelationship></observation>
ItemDTCardConfDescriptionLabel
hl7:observation
R

This entry is an adaptation of the IHE Allergies And Intolerances Entry and IHE Problem Entry (IHE PCC).

Note: including the templateId '1.3.6.1.4.1.19376.1.5.3.1.4.5' requires that also the template ID '2.16.840.1.113883.10.20.1.28' is included.

eHDSdotsnces
@classCode
cs1 … 1FOBS
@moodCode
cs1 … 1FEVN
@negationInd
bl0 … 1 
hl7:templateId
II.EPSOS1 … 1MeHDSI Allergies And IntoleranceseHDSdotsnces
@root
uid1 … 1F1.3.6.1.4.1.12559.11.10.1.3.1.3.17
hl7:templateId
II.EPSOS0 … 1RIHE Problem Entry (IHE PCC)eHDSdotsnces
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.5
hl7:templateId
II.EPSOS0 … 1RIHE Allergies And Intolerances Entry (IHE PCC)eHDSdotsnces
@root
uid1 … 1F1.3.6.1.4.1.19376.1.5.3.1.4.6
hl7:templateId
II.EPSOS0 … 1RAlert observation (CCD)eHDSdotsnces
@root
uid1 … 1F2.16.840.1.113883.10.20.1.18
hl7:templateId
II.EPSOS0 … 1RProblem observation (CCD)eHDSdotsnces
@root
uid1 … 1F2.16.840.1.113883.10.20.1.28
hl7:id
II.EPSOS0 … *ReHDSdotsnces
hl7:code
CD1 … 1R

The <code> element represents the kind of allergy observation made, to a drug, food or environmental agent, and whether it is an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance). The <code> element of an allergy entry shall be provided, and a code and codeSystem attribute shall be present.

eHDSdotsnces
 
target
ehdsi-dataelement-7draft Type of propensity draft eHDSI Data Set
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.18 eHDSIAdverseEventType (DYNAMIC)
hl7:text
ED1 … 1ReHDSdotsnces
 
target
ehdsi-dataelement-5draft Allergy/Intolerance description draft eHDSI Data Set
hl7:reference
TEL1 … 1MeHDSdotsnces
@value
1 … 1RReference pointing to the narrative, typically #{label}-{generated-id}, e.g. #xxx-1
hl7:statusCode
CS1 … 1ReHDSdotsnces
@code
CONF0 … 1Fcompleted
hl7:effectiveTime
IVL_TS0 … 1ReHDSdotsnces
 
target
ehdsi-dataelement-10draft End date draft eHDSI Data Set
ehdsi-dataelement-9draft Onset date draft eHDSI Data Set
Choice

The coded form of the observation value can be used:

  • to contain a description of the allergy or adverse reaction.
  • to indicate known absent conditions or the nonavailability of information.
Elements to choose from:
  • hl7:value[1]
  • hl7:value[2]
hl7:value
CD0 … 1CA description of the allergy or adverse reaction. The preferred approach would be to include the agent in the participant structure. If distinct agent data cannot be provided, a 'diagnosis' can be included in the value.eHDSdotsnces
where [1]
hl7:value
CD0 … 1CWhen the value is used to describe the absence of information, the participant used for indicating the allergy agent shall be omitted.eHDSdotsnces
where [2]
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.47 eHDSIAbsentOrUnknownAllergy (DYNAMIC)
hl7:participant
0 … 1C

The substance that causes the allergy or intolerance should be specified in the <participant> structure.
This is the preferred way an allergy is supposed to be expressed.
However it is recognized that in some contexts a controlled vocabulary is used for describing the allergy to a substance; or for asserting known absence or unavailability of information.
In this case the <participant> structure shall be omitted.
The agent responsible for an allergy or adverse reaction is not always a manufactured material (for example, food allergies), nor is it necessarily consumed. The following constraints reflect limitations in the base CDA R2 specification, and should be used to represent any type of responsible agent, i.e., use playingEntity classCode = "MMAT" for all agents, manufactured or not.

eHDSdotsnces
@typeCode
cs1 … 1FCSM
 ConstraintIF the observation/value element is present and valued with a code indicating the known absence/no information on allergies THEN the observation/participant element used to describe the agent SHALL be omitted.
hl7:participantRole
1 … 1ReHDSdotsnces
@classCode
cs1 … 1FMANU
hl7:playingEntity
1 … 1ReHDSdotsnces
@classCode
cs1 … 1FMMAT
hl7:code
CD.EPSOS1 … 1RCode for the substance causing the allergy or intolerance.eHDSdotsnces
 
target
ehdsi-dataelement-16draft Allergen code draft eHDSI Data Set
 CONF
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.19 eHDSIAllergenNoDrug (DYNAMIC)
or
The value of @code shall be drawn from value set 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 eHDSIActiveIngredient (DYNAMIC)
hl7:name
PN0 … *RName for the substance causing the allergy or intolerance.eHDSdotsnces
 
target
ehdsi-dataelement-15draft Allergen description draft eHDSI Data Set
hl7:entryRelationship
0 … *R

An allergy entry can record the reactions that are manifestations of the allergy or intolerance as shown below. It uses a related entry (<entryRelationship>) that indicates the manifestations (typeCode='MFST') the reported allergy or intolerance. These are events that may occur, or have occurred in the past as a reaction to the allergy or intolerance<entryRelationship typeCode='MFST'>


Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.44 eHDSI Reaction Manifestation (DYNAMIC)		eHDSdotsnces
 
target
ehdsi-dataelement-8draft Allergy Manifestation draft eHDSI Data Set
@typeCode
cs1 … 1FMFST
hl7:entryRelationship
0 … 1R Criticality
The contained entry describes the gravity of the potential risk for future life-threatening adverse reactions when exposed to a substance known to cause an adverse reaction in that individual.
Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.33 eHDSI Criticality Observation (DYNAMIC)		eHDSdotsnces
 
target
ehdsi-dataelement-12draft Criticality draft eHDSI Data Set
@typeCode
cs1 … 1FSUBJ
hl7:entryRelationship
0 … 1R Certainty or Verification Status
The contained entry describes the certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.35 eHDSI Allergy Certainty Observation (DYNAMIC)		eHDSdotsnces
 
target
ehdsi-dataelement-14draft Certainty draft eHDSI Data Set
@typeCode
cs1 … 1FSUBJ
hl7:entryRelationship
0 … 1R Status of the Allergy or Intolerance
The contained entry describes the current status of the allergy or intolerance, for example, whether it is active, in remission, resolved, and so on ...
Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.34 eHDSI Allergy Status Observation (DYNAMIC)		eHDSdotsnces
 
target
ehdsi-dataelement-13draft Status draft eHDSI Data Set
@typeCode
cs1 … 1FREFR