Allergy (Patient Dossier)
1.0.0 - STU1

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## Resource Profile: BeAllergyIntolerance

Official URL: https://www.ehealth.fgov.be/standards/fhir/allergy/StructureDefinition/be-allergyintolerance | Version: 1.0.0
Active as of 2022-06-07 | Maturity Level: 1 | Responsible: eHealth Platform | Realm: BE | Computable Name: BeAllergyIntolerance

Belgian federal profile for an allergy and/or an intolerance. Initially based on the functional description of the NIHDI.

Usage:

- Examples for this Resource Profile: AllergyIntolerance/allergyintolerance1, AllergyIntolerance/allergyintolerance2

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from AllergyIntolerance

Summary

Mandatory: 3 elements
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- BePatient (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient)
- BePractitioner (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner)
- BePractitionerRole (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole)

Maturity: 1

This structure is derived from AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
type | S | 0..1 | code | allergy | intolerance - Underlying mechanism (if known)
category | S | 0..* | code | food | medication | environment | biologic
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: BeAllergyIntoleranceCode (extensible): Causative agent codes as defined by NIHDI
patient | S | 1..1 | Reference(BePatient) | Who the sensitivity is for
recordedDate | S | 1..1 | dateTime | Date first version of the resource instance was recorded
recorder | S | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | BePatient | BePractitioner | BePractitionerRole) | Who recorded the sensitivity
asserter | S | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
note | S | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: BeRiskManifestation (extensible)
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: BeExposureRoute (extensible)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
AllergyIntolerance | I | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ I | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ I | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: BeAllergyIntoleranceCode (extensible): Causative agent codes as defined by NIHDI
patient | S Σ | 1..1 | Reference(BePatient) | Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
recordedDate | S | 1..1 | dateTime | Date first version of the resource instance was recorded
recorder | S | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | BePatient | BePractitioner | BePractitionerRole) | Who recorded the sensitivity
asserter | S Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note | S | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: BeRiskManifestation (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: BeExposureRoute (extensible)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
AllergyIntolerance | I | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
clinicalStatus | ?!Σ I | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!Σ I | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
code | Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: BeAllergyIntoleranceCode (extensible): Causative agent codes as defined by NIHDI
patient | Σ | 1..1 | Reference(BePatient) | Who the sensitivity is for
recordedDate |  | 1..1 | dateTime | Date first version of the resource instance was recorded
recorder |  | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | BePatient | BePractitioner | BePractitionerRole) | Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
note |  | 0..* | Annotation | Additional text not captured in other fields
reaction |  | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
manifestation |  | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: BeRiskManifestation (extensible)
Documentation for this format

This structure is derived from AllergyIntolerance

Summary

Mandatory: 3 elements
Must-Support: 12 elements

Structures

This structure refers to these other structures:

- BePatient (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient)
- BePractitioner (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner)
- BePractitionerRole (https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole)

Maturity: 1

Differential View

This structure is derived from AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error
type | S | 0..1 | code | allergy | intolerance - Underlying mechanism (if known)
category | S | 0..* | code | food | medication | environment | biologic
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: BeAllergyIntoleranceCode (extensible): Causative agent codes as defined by NIHDI
patient | S | 1..1 | Reference(BePatient) | Who the sensitivity is for
recordedDate | S | 1..1 | dateTime | Date first version of the resource instance was recorded
recorder | S | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | BePatient | BePractitioner | BePractitionerRole) | Who recorded the sensitivity
asserter | S | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
note | S | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: BeRiskManifestation (extensible)
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: BeExposureRoute (extensible)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
AllergyIntolerance | I | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
id | Σ | 0..1 | string | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ I | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.
verificationStatus | ?!S Σ I | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
type | S Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | S Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: BeAllergyIntoleranceCode (extensible): Causative agent codes as defined by NIHDI
patient | S Σ | 1..1 | Reference(BePatient) | Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
recordedDate | S | 1..1 | dateTime | Date first version of the resource instance was recorded
recorder | S | 1..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | BePatient | BePractitioner | BePractitionerRole) | Who recorded the sensitivity
asserter | S Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note | S | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: BeRiskManifestation (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: BeExposureRoute (extensible)
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
AllergyIntolerance.language | preferred | CommonLanguages Max Binding: AllLanguages
AllergyIntolerance.clinicalStatus | required | AllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.verificationStatus | required | AllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.type | required | AllergyIntoleranceType
AllergyIntolerance.category | required | AllergyIntoleranceCategory
AllergyIntolerance.criticality | required | AllergyIntoleranceCriticality
AllergyIntolerance.code | extensible | BeAllergyIntoleranceCode
AllergyIntolerance.reaction.substance | example | SubstanceCode
AllergyIntolerance.reaction.manifestation | extensible | BeRiskManifestation
AllergyIntolerance.reaction.severity | required | AllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRoute | extensible | BeExposureRoute

#### Constraints

Id | Grade | Path | Details | Requirements
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists() |
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error : verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty() |
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | Best Practice | AllergyIntolerance | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | AllergyIntolerance.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | AllergyIntolerance.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | AllergyIntolerance.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | AllergyIntolerance.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | AllergyIntolerance.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.clinicalStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.verificationStatus | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.criticality | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.patient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.onset[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.recordedDate | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.recorder | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.asserter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.lastOccurrence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | AllergyIntolerance.reaction.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | AllergyIntolerance.reaction.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | AllergyIntolerance.reaction.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | AllergyIntolerance.reaction.substance | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.manifestation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.description | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.onset | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.severity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.exposureRoute | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | AllergyIntolerance.reaction.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |