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retired Template  eHDSI Allergies And Intolerances

Id 1.3.6.1.4.1.12559.11.10.1.3.1.3.17 Effective Date 2021‑06‑21 10:36:45
Other versions this id:
Status retired Retired Version Label
Name eHDSIAllergiesAndIntolerances Display Name eHDSI 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.

Context Parent nodes of template element with id 1.3.6.1.4.1.12559.11.10.1.3.1.3.17
Classification CDA Entry Level Template
Open/Closed Open (other than defined elements are allowed)
Associated with
Associated with 5 concepts
Id Name Data Set
epsos-dataelement-70 draft Onset Date draft epSOS Data Set
epsos-dataelement-209 draft Agent Code draft epSOS Data Set
epsos-dataelement-208 draft Agent description draft epSOS Data Set
epsos-dataelement-68 draft Allergy description draft epSOS Data Set
epsos-dataelement-69 draft Allergy code draft epSOS Data Set
Used by / Uses
Used by 0 transactions and 0 templates, Uses 5 templates
Uses as Name Version
1.3.6.1.4.1.12559.11.10.1.3.1.3.7 Containment active eHDSI Problem DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.8 Containment active eHDSI Severity DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.33 Containment active eHDSI Criticality Observation DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.35 Containment active eHDSI Allergy Certainty Observation DYNAMIC
1.3.6.1.4.1.12559.11.10.1.3.1.3.34 Containment active eHDSI Allergy Status Observation DYNAMIC
Relationship 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)
ref
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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>
Item DT Card Conf Description Label
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.

(eHDdotsces)
@classCode
cs 1 … 1 F OBS
@moodCode
cs 1 … 1 F EVN
@negationInd
bl 0 … 1  
hl7:templateId
II.EPSOS 1 … 1 M eHDSI Allergies And Intolerances (eHDdotsces)
@root
uid 1 … 1 F 1.3.6.1.4.1.12559.11.10.1.3.1.3.17
hl7:templateId
II.EPSOS 0 … 1 R IHE Problem Entry (IHE PCC) (eHDdotsces)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.5
hl7:templateId
II.EPSOS 0 … 1 R IHE Allergies And Intolerances Entry (IHE PCC) (eHDdotsces)
@root
uid 1 … 1 F 1.3.6.1.4.1.19376.1.5.3.1.4.6
hl7:templateId
II.EPSOS 0 … 1 R Alert observation (CCD) (eHDdotsces)
@root
uid 1 … 1 F 2.16.840.1.113883.10.20.1.18
hl7:templateId
II.EPSOS 0 … 1 R Problem observation (CCD) (eHDdotsces)
@root
uid 1 … 1 F 2.16.840.1.113883.10.20.1.28
hl7:id
II.EPSOS 0 … * R (eHDdotsces)
hl7:code
CD 1 … 1 R

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.

(eHDdotsces)
 
target
epsos-dataelement-69 draft Allergy code draft epSOS 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
ED 1 … 1 R (eHDdotsces)
 
target
epsos-dataelement-68 draft Allergy description draft epSOS Data Set
hl7:reference
TEL 1 … 1 M (eHDdotsces)
@value
1 … 1 R Reference pointing to the narrative, typically #{label}-{generated-id}, e.g. #xxx-1
hl7:statusCode
CS 1 … 1 R (eHDdotsces)
@code
CONF 0 … 1 F completed
hl7:effectiveTime
IVL_TS 0 … 1 R (eHDdotsces)
 
target
epsos-dataelement-70 draft Onset Date draft epSOS 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
CD 0 … 1 C A 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. (eHDdotsces)
where [1]
hl7:value
CD 0 … 1 C When the value is used to describe the absence of information, the participant used for indicating the allergy agent shall be omitted. (eHDdotsces)
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 … 1 C

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.

(eHDdotsces)
@typeCode
cs 1 … 1 F CSM
  Constraint IF 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 … 1 R (eHDdotsces)
@classCode
cs 1 … 1 F MANU
hl7:playingEntity
1 … 1 R (eHDdotsces)
@classCode
cs 1 … 1 F MMAT
hl7:code
CD.EPSOS 1 … 1 R Code for the substance causing the allergy or intolerance. (eHDdotsces)
 
target
epsos-dataelement-209 draft Agent Code draft epSOS 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
PN 0 … * R Name for the substance causing the allergy or intolerance. (eHDdotsces)
 
target
epsos-dataelement-208 draft Agent description draft epSOS 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'>

The entry contained with this entry relationship is some sort of problem that is a manifestation of the allergy. It is recorded using the Problem Entry structure.


Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.7 eHDSI Problem (DYNAMIC)
(eHDdotsces)
@typeCode
cs 1 … 1 F MFST
hl7:entryRelationship
0 … 1 R

An optional <entryRelationship> element may be present indicating the severity of the problem. If present, this <entryRelationship> element shall contain a severity observation conforming to the eHDSI Severity entry template (1.3.6.1.4.1.12559.11.10.1.3.1.3.8).

The related statement is made about the severity of the condition, concern, or allergy). This observation is recorded inside an <entryRelationship> element occurring in the containing entry. The containing <entry> is the subject (typeCode='SUBJ') of this new observation, which is the inverse of the normal containment structure, thus inversionInd='true'.

The related statement is another event (moodCode='EVN') observing (<observation classCode='OBS'>) the severity of the (surrounding) related entry (e.g., a condition or allergy).


Contains 1.3.6.1.4.1.12559.11.10.1.3.1.3.8 eHDSI Severity (DYNAMIC)
(eHDdotsces)
@typeCode
cs 1 … 1 F SUBJ
  Example <!-- The encompasing condition or allergy observation -->
<observation classCode="COND" moodCode="EVN">
  <!-- ... -->
  <entryRelationship typeCode="SUBJ" inversionInd="true">
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="1.3.6.1.4.1.12559.11.10.1.3.1.3.8"/>      <code code="SEV" displayName="Severity" codeSystem="2.16.840.1.113883.5.4" codeSystemName="ActCode"/>      <text>
        <reference value="#severity-2"/>      </text>
      <statusCode code="completed"/>      <!-- This code is from SNOMED, according to the eHDSISeverity value set -->
      <value type="CD" code="" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>    </observation>
  </entryRelationship>
  <!-- ... -->
</observation>
hl7:entryRelationship
0 … * R 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)
(eHDdotsces)
@typeCode
cs 1 … 1 F SUBJ
hl7:entryRelationship
0 … * R 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)
(eHDdotsces)
@typeCode
cs 1 … 1 F SUBJ
hl7:entryRelationship
0 … * R 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)
(eHDdotsces)
@typeCode
cs 1 … 1 F REFR