alertDevice"Describes any type of allergy alert device the patient may be carrying or wearing." - HL7 Version 2.8, IAM-16. HL7 Version 2 has the following suggested values (table 437): Bracelet; Necklace; Wallet Card.
clinicalStatus"The clinical status of the allergy or intolerance." - HL7 FHIR, AllergyIntolerance.clinicalStatus. Possible values are Active; Inactive; Resolved.Note that this property re-defines the inherited clinicalStatus property from HealthConcern to bind to a slightly different terminology.
criticalityProvides an indication of the seriousness or intensity of a reaction that the patient would be expected to experience upon a further exposure to the Reactant."Indicates the general severity of the allergy" - HL7 Version 2.8, AL1-4, IAM-4, and IAR-2. HL7 Version 2 has the following suggested values (table 128): Severe; Moderate; Mild; Unknown."Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance." - HL7 FHIR, AllergyIntolerance.criticality. Possible values are Low Risk, High Risk, Unable to Assess Risk.The Common Terminology Criteria for Adverse Events (CTCAE) has the following values:Grade 1: Mild; asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated.Grade 2: Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL*.Grade 3: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self care ADL**.Grade 4: Life-threatening consequences; urgent intervention indicated.Grade 5: Death related to AE.
intoleranceCategoryProvides a categorization of the Intolerance Condtion. Possible values are members of the SNOMED Allergy Event value set. This property is required for Meaningful Use. It is noted that the HITSP value set mixes categorization of the reaction and categorization of the mechanism (i.e., allergy versus intolerance). It is included in the FHIM because Meaningful Use requires it, but the FHIM models these two categorizations separately as well using the mechanism and reactant category properties. It is potentially possible to calculate this property based on the values of the mechanism and reactant category properties.
isAbsolutelyContraIndicatedA flag that indicates that the patient should under no circumstances be exposed to the reactant. Generally used only for medication-related allergies. In some cases, a clinician may choose to provide a medication that is known to cause an adverse reaction in the patient, because the benefit of the medication outweighs the risk of the reaction. When this flag is true, the clinician should never provide the medication as any resulting reaction will likely be severe and potentially life-threatening."An absolute contraindication is a situation which makes a particular treatment or procedure absolutely inadvisable. In children, for example, aspirin is almost always contraindicated because of the danger that aspirin will cause Reye syndrome." - MedicineNet.com
lastOccurrence"Represents the date and/or time of the last known occurrence of a reaction event." - HL7 FHIR, AllergyIntolerance.lastOccurrence
mechanismCategorizes whether the underlying process (mechanism) of the Intolerance Condition is an Immunoglobulin-E (IgE)-mediated response, an exepected response to a pharmacologic substance, or unknown. Allergy: An allergy reaction must have symptoms (reaction) consistent with an actual allergy - rash, hives, severe swelling, redness, itchiness, difficulty breathing (due to swelling around breathing areas), etc. Pharmacologic: A pharmacologic reaction is an adverse event rather then an allergy. It is a reaction based on the pharmacologic properties of the drug and has to do with a reaction that can be expected due to the pharmacologic activity of the drug. It can occur when the patient takes the right amount or an amount greater or less than the recommended doses. Some examples are: an antidiarrheal agent (like Immodium) causing constipation, a laxative causing diarrhea, a beta blocker causing bradycardia (slow heart rate), furosemide (a diuretic) causing excessive urination, or a blood pressure medication causing low blood pressure (will be fully modeled in a subsequent phase). Unknown: An unknown reaction is a reaction experienced by the patient that cannot be explained by either of the other two mechanisms, for example, eating a pear and developing a cough or taking a blood pressure medication and developing right elbow pain. This type of reaction is consistent, disappears upon withdrawing the agent, and reappears when the agent or food item is restarted/eaten again."Contains the reason why the patient should not be exposed to a substance." - HL7 Version 2.8, IAM-9 and IAR-3. HL7 Version 2 has the following suggested values (table 436): Adverse Reaction (Not otherwise classified); Allergy; Contraindication; Intolerance; Side Effect."Identification of the underlying physiological mechanism for the reaction risk." - HL7 FHIR, AllergyIntolerance.type. Possible values are Allergy; Intolerance.
reactantIdentifies the substance to which the patient has an intolerance or allergy. The reactant is bound to a grouping value-set which will be a superset of value-sets for Drug Product, Drug Class, Ingredient, Food Product, and Environmental reactants."Uniquely identifies a particular allergen." - HL7 Version 2.8, AL1-3 and IAM-3"Identifies the specific allergic reaction that was documented." - HL7 Version 2.8, IAR-1."Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance." - HL7 FHIR, AllergyIntolerance.reaction.substance
reactantCategoryCategorizes the reactant to which the patient has demonstrated an intolerance or an allergy. Possible values include Drug Product, Drug Class, Ingredient, Food Product, and Environmental. Note that this property may contain more than one value. It should be noted that this property is included in the FHIM because many legacy systems include this concept in order to group allergies in an allergy list, and in some cases to determine which allergies to examine during order checking. However, because these categories are not mutually exclusive (e.g., caffeine can be categorized as a food ingredient and as a drug ingredient), any system performing order checks should check all allergies regardless of how they are categorized. A clinician exercises clinical judgement and applies his/her preferences when categorizing a particular allergy. While there is some value in preserving this, another clinician may categorize the same allergy differently. Therefore, this property should be treated as informational, and not be used for any automated reasoning."Indicates a general allergy category (drug, food, pollen, etc.)." - HL7 Version 2.8, AL1-2 and IAM-2. HL7 Version 2 has the following suggested values (table 127): Drug allergy; Food allergy; Miscellaneous allergy; Miscellaneous contraindication; Environmental Allergy; Animal Allergy; Plant Allergy; Pollen Allergy."Category of the identified substance." - HL7 FHIR, AllergyIntolerance.category. Possible values are Food; Medication; Environment; Biologic.
reactionPointer to a set of Observation(s) of any adverse physiological response(s) attributed to the exposure of the Patient to the given substance."Details about each adverse reaction event linked to exposure to the identified substance." - HL7 FHIR, AllergyIntolerance.reaction
sensitivityTestPointer to a set of Observation(s) (i.e., tests) performed in order to confirm (or refute) the sensitivity, and/or to determine the mechanism of the sensitivity."Observations that confirm or refute the sensitivity." - HL7 FHIR, Allergy resource.
FHIM::HealthConcern::HealthConcern