2.16.840.1.113883.10.22.4.1/static-2016-11-10T000000

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Id2.16.840.1.113883.10.22.4.1Effective Date2016‑11‑10
Other versions this id:
    StatusKyellow.png DraftVersion Label
    NameIPSEntryAllergyOrIntoleranceDisplay NameIPS Allergy or Intolerance
    Description
    This template reflects a discrete observation about a patient's allergy or intolerance.
    Because it is a discrete observation, it will have a statusCode of "completed".
    The effectiveTime, also referred to as the "biologically relevant time" is the time at which the observation holds for the patient.
    For a provider seeing a patient in the clinic today, observing a history of penicillin allergy that developed five years ago, the effectiveTime is five years ago.
    The effectiveTime of the Allergy - Intolerance Observation gives an indication of whether or not the underlying allergy/intolerance is resolved. If known to be resolved, then an effectiveTime/high would be present. 
    If the date of resolution is not known, then effectiveTime/high will be present with a nullFlavor of "UNK". 
    It is recommended that the agent responsible for an allergy or adverse reaction would be used for describing the allergy, however the possibility that pre-coordinate codes (e.g. "allergy to nuts") will be used has been here also considered.
    The agent responsible for  an allergy or adverse reaction it is not always a manufactured material (for example, food allergies), nor is it necessarily consumed; however  the playingEntity classCode = "MMAT" for all agents, manufactured or not is expected to be used. This choice depends on thecharacteristics of the base CDA R2 specification.
    ContextParent nodes of template element with id 2.16.840.1.113883.10.22.4.1
    ClassificationCDA Entry Level Template
    Open/ClosedOpen (other than defined elements are allowed)
    Associated with
    Associated with 12 concepts
    IdNameData Set
    hl7ips-data​element-188Kyellow.png End Date Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-173Kyellow.png Agent Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-191Kyellow.png Type of propensity Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-196Kyellow.png Agent code Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-189Kyellow.png Criticality Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-182Kyellow.png Allergies/Intolerances Content Status Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-187Kyellow.png Onset date Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-190Kyellow.png Certainty Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-184Kyellow.png Allergy/Intolerance Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-185Kyellow.png Diagnosis Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-186Kyellow.png Clinical Status Kyellow.png CEN/TC 251 prEN 17269
    hl7ips-data​element-192Kyellow.png Reaction Kyellow.png CEN/TC 251 prEN 17269
    Used by / Uses
    Used by 0 transactions and 3 templates, Uses 4 templates
    Used by as NameVersion
    2.16.840.1.113883.10.22.4.5ContainmentKyellow.png IPS Allergy and Intolerance Concern2016‑11‑11
    2.16.840.1.113883.10.22.3.2Link.pngKyellow.png IPS Allergies and Intolerances Section2016‑11‑11
    2.16.840.1.113883.10.22.1.1Link.pngKyellow.png International Patient Summary2017‑04‑11
    Uses as NameVersion
    2.16.840.1.113883.10.22.4.6ContainmentKyellow.png IPS Reaction ManifestationDYNAMIC
    2.16.840.1.113883.10.22.4.18ContainmentKyellow.png IPS Criticality ObservationDYNAMIC
    2.16.840.1.113883.10.22.10ContainmentKyellow.png IPS Allergy Certainty ObservationDYNAMIC
    2.16.840.1.113883.10.22.4.21ContainmentKyellow.png IPS Allergy Status ObservationDYNAMIC
    RelationshipAdaptation: template 2.16.840.1.113883.10.20.1.18 (DYNAMIC)
    Adaptation: template 1.3.6.1.4.1.19376.1.5.3.1.4.5 (DYNAMIC)
    Adaptation: template 1.3.6.1.4.1.19376.1.5.3.1.4.6 (DYNAMIC)
    Example
    Example
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="2.16.840.1.113883.10.22.4.1"/>  <id root=" " extension=" "/>  <!-- This is the code that shows what kind of allergy or intolerance -->
      <code code="OINT" displayName="Allergy or Intolerance" codeSystem="2.16.840.1.113883.5.4"/>  <text>
        <reference value="#ref1"/>  </text>
      <statusCode code="completed"/>  <effectiveTime>
        <low value="20170701"/>  </effectiveTime>
      <!-- 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>...</name>      </playingEntity>
        </participantRole>
      </participant>
      <!-- This is how the allergy manifests itself -->
      <entryRelationship typeCode="MFST" inversionInd="true">
        <!-- template 2.16.840.1.113883.10.22.4.6 'IPS Reaction Manifestation' (dynamic) -->
      </entryRelationship>
      <entryRelationship typeCode="SUBJ" inversionInd="true">
        <!-- template 2.16.840.1.113883.10.22.4.18 'IPS Criticality Observation' (dynamic) -->
      </entryRelationship>
      <entryRelationship typeCode="SUBJ" inversionInd="true">
        <!-- template 2.16.840.1.113883.10.22.4.19 'IPS Certainty Observation' (dynamic) -->
      </entryRelationship>
      <entryRelationship typeCode="REFR" inversionInd="false">
        <!-- template 2.16.840.1.113883.10.22.4.21 'IPS Allergy Status Observation' (dynamic) -->
      </entryRelationship>
    </observation>
    Example
    No Known Allergies
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="2.16.840.1.113883.10.22.4.1"/>  <code code="allergy" displayName="Allergy" codeSystem="2.16.840.1.113883.4.642.1.122"/>  <statusCode code="completed"/>  <effectiveTime>
        <low nullFlavor="UNK"/>  </effectiveTime>
      <value code="X-NoKnownAllergy" displayName="No known allergy" codeSystem="2.16.840.1.113883.5.1150.2"/></observation>
    Example
    No Information available about allergies or intolerances
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="2.16.840.1.113883.10.22.4.1"/>  <code code="OINT" displayName="Allergy or Intolerance" codeSystem="2.16.840.1.113883.5.4"/>  <statusCode code="completed"/>  <effectiveTime>
        <low nullFlavor="NA"/>  </effectiveTime>
      <value code="no-allergy-info" displayName="No information about allergies" codeSystem="2.16.840.1.113883.5.1150.1"/></observation>
    Example
    Minimum Set (active propensity; agent known)
    <observation classCode="OBS" moodCode="EVN">
      <templateId root="2.16.840.1.113883.10.22.4.1"/>  <code code="OINT" displayName="Allergy or Intolerance" codeSystem="2.16.840.1.113883.5.4"/>  <statusCode code="completed"/>  <effectiveTime>
        <low nullFlavor="UNK"/>  </effectiveTime>
      <participant typeCode="CSM">
        <participantRole classCode="MANU">
          <playingEntity classCode="MMAT">
            <code code="13577000" codeSystem="2.16.840.1.113883.6.96" displayName="Nut"/>      </playingEntity>
        </participantRole>
      </participant>
    </observation>
    ItemDTCardConfDescriptionLabel
    hl7:observation
    R(IPS...nce)
     
    Target.png
    hl7ips-data​element-184Kyellow.png Allergy/Intolerance Kyellow.png CEN/TC 251 prEN 17269
    Treetree.png@classCode
    cs1 … 1FOBS
    Treetree.png@moodCode
    cs1 … 1FEVN
    Treetree.pnghl7:templateId
    II1 … 1M(IPS...nce)
    Treeblank.pngTreetree.png@root
    uid1 … 1F2.16.840.1.113883.10.22.4.1
    Treetree.pnghl7:id
    II0 … *R(IPS...nce)
    Treetree.pnghl7:code
    CD.IPS1 … 1MThis element describes whether this condition refers to an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance).(IPS...nce)
     
    Target.png
    hl7ips-data​element-191Kyellow.png Type of propensity Kyellow.png CEN/TC 251 prEN 17269
     CONF
    The value of @code shall be drawn from value set 2.16.840.1.113883.11.22.2 Allergy or Intolerance Type (DYNAMIC)
    Treetree.pnghl7:text
    ED0 … 1RThe text element if present points to the text describing the problem being recorded; including any dates, comments, et cetera. The <reference> contains a URI in value attribute. This URI points to the free text description of the problem in the document that is being described.</reference>(IPS...nce)
    Treeblank.pngTreetree.pnghl7:reference
    TEL1 … 1M(IPS...nce)
    Treeblank.pngTreeblank.pngTreetree.png@value
    1 … 1RWhen used it shall refer to the narrative, typically #{label}-{generated-id}, e.g. #xxx-1
    Treetree.pnghl7:statusCode
    CS1 … 1MA clinical document normally records only those condition observation events that have been completed, not observations that are in any other state. Therefore, the <statusCode> shall always have code='completed'.</statusCode>(IPS...nce)
    Treeblank.pngTreetree.png@code
    cs1 … 1Fcompleted
    Treetree.pnghl7:effectiveTime
    IVL_TS1 … 1M The effectiveTime, also referred to as the "biologically relevant time" is the time at which the observation holds for the patient. For a provider seeing a patient in the clinic today, observing a history of penicillin allergy that developed five years ago, the effectiveTime is five years ago. The effectiveTime of the Allergy - Intolerance  Observation may give an indication of whether or not the underlying allergy/intolerance is resolved. 
    The <low> and <high> values should be no more precise than known, but as precise as possible.
    (IPS...nce)
    Treeblank.pngTreetree.pnghl7:low
    IVXB_TS1 … 1RThe effectiveTime/low (a.k.a. "onset date") asserts when the allergy/intolerance became biologically active.(IPS...nce)
     
    Target.png
    hl7ips-data​element-187Kyellow.png Onset date Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.pnghl7:high
    IVXB_TS0 … 1CThe effectiveTime/high (a.k.a. "resolution date") asserts when the allergy/intolerance became biologically resolved.
    If the date of resolution is not known, then effectiveTime/high will be present with a nullFlavor of "UNK".
    (IPS...nce)
     
    Target.png
    hl7ips-data​element-188Kyellow.png End Date Kyellow.png CEN/TC 251 prEN 17269
     ConstraintIf this condition is known to be resolved, then the effectiveTime/high would be present.
    Choice0 … 1
    The coded form of the observation value can be used :
    • either to indicate known absent conditions (e.g. NKA) or the nonavailability of information; 
    • or to provide pre-coordinated codes describing the propensity to specific substances (e.g. allergy to nuts). 
    The choice reflects these options.
    Elements to choose from:
    • hl7:value[1]
    • hl7:value[2]
    Treeblank.pngTreetree.pnghl7:value
    CD.IPS (preferred)0 … 1(IPS...nce)
    Treeblank.pngTreeblank.png where [1]
     
    Target.png
    hl7ips-data​element-185Kyellow.png Diagnosis Kyellow.png CEN/TC 251 prEN 17269
     CONF
    The value of @code comes preferably from value set 2.16.840.1.113883.11.22.10 IPS Allergy or Intolerance Conditions (DYNAMIC)
    Treeblank.pngTreetree.pnghl7:value
    CD.IPS (required)0 … 1CWhen the value is used to describe the absence of information the participant used for indicating the allergy agent shall be omitted.
    (IPS...nce)
    Treeblank.pngTreeblank.png where [2]
     
    Target.png
    hl7ips-data​element-182Kyellow.png Allergies/Intolerances Content Status Kyellow.png CEN/TC 251 prEN 17269
     CONF
    The value of @code shall be drawn from value set 2.16.840.1.113883.11.22.9 Absent or Unknown Allergies (DYNAMIC)
    Treetree.pnghl7:participant
    0 … 1CThe 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.
    (IPS...nce)
     
    Target.png
    hl7ips-data​element-173Kyellow.png Agent Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.png@typeCode
    cs1 … 1FCSM
     ConstraintIF the observation/value element is present and valued with a code derived form the  2.16.840.1.113883.11.22.9 Absent or Unknown Allergies value set THEN the  observation/participant element used to describe the agent SHALL be omitted.
    Treeblank.pngTreetree.pnghl7:participantRole
    1 … 1R(IPS...nce)
    Treeblank.pngTreeblank.pngTreetree.png@classCode
    cs1 … 1FMANU
    Treeblank.pngTreeblank.pngTreetree.pnghl7:playingEntity
    1 … 1R(IPS...nce)
    Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@classCode
    cs1 … 1FMMAT
    Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pnghl7:code
    CD.IPS (preferred)1 … 1RCode for the substance causing the allergy or intolerance.(IPS...nce)
     
    Target.png
    hl7ips-data​element-196Kyellow.png Agent code Kyellow.png CEN/TC 251 prEN 17269
     CONF
    The value of @code comes preferably from value set 2.16.840.1.113883.11.22.11 Adverse Reaction Agents (DYNAMIC)
    Treetree.pnghl7:entryRelationship
    0 … *RThe contained entry describes the reactions that are manifestations (typeCode='MFST') of the reported allergy or intolerance.
    Contains 2.16.840.1.113883.10.22.4.6 IPS Reaction Manifestation (DYNAMIC)
    (IPS...nce)
    Treeblank.png where [hl7:observation [hl7:code [concat(@code, @codeSystem) = doc('include/voc-2.16.840.1.113883.11.22.16-2017-04-07T000000.xml')//valueSet [1]/conceptList/concept/concat(@code, @codeSystem) or @nullFlavor]]]
     
    Target.png
    hl7ips-data​element-192Kyellow.png Reaction Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.png@typeCode
    cs1 … 1FMFST
    Treeblank.pngTreetree.png@inversionInd
    cs1 … 1Ftrue
    Treetree.pnghl7:entryRelationship
    0 … 1RCriticality
    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 2.16.840.1.113883.10.22.4.18 IPS Criticality Observation (DYNAMIC)
    (IPS...nce)
    Treeblank.png where [hl7:observation [hl7:code [(@code = '82606-5' and @codeSystem = '2.16.840.1.113883.6.1')]]]
     
    Target.png
    hl7ips-data​element-189Kyellow.png Criticality Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.png@typeCode
    cs1 … 1FSUBJ
    Treeblank.pngTreetree.png@inversionInd
    cs1 … 1Ftrue
    Treetree.pnghl7:entryRelationship
    0 … 1RCertainty or Verification Status
    The contained entry describes the certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
    Contains 2.16.840.1.113883.10.22.10 IPS Allergy Certainty Observation (DYNAMIC)
    (IPS...nce)
    Treeblank.png where [hl7:observation [hl7:code [(@code = '66455-7' and @codeSystem = '2.16.840.1.113883.6.1')]]]
     
    Target.png
    hl7ips-data​element-190Kyellow.png Certainty Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.png@typeCode
    cs1 … 1FSUBJ
    Treeblank.pngTreetree.png@inversionInd
    cs1 … 1Ftrue
    Treetree.pnghl7:entryRelationship
    0 … 1RStatus 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 2.16.840.1.113883.10.22.4.21 IPS Allergy Status Observation (DYNAMIC)
    (IPS...nce)
    Treeblank.png where [hl7:observation [hl7:code [(@code = '33999-4' and @codeSystem = '2.16.840.1.113883.6.1') or @nullFlavor]]]
     
    Target.png
    hl7ips-data​element-186Kyellow.png Clinical Status Kyellow.png CEN/TC 251 prEN 17269
    Treeblank.pngTreetree.png@typeCode
    cs1 … 1FREFR
    Treeblank.pngTreetree.png@inversionInd
    cs1 … 1Ffalse