AllergyIntolerance

Overview

The AllergyIntolerance resource provides the clinical assessment of a patient’s allergy or intolerance when exposed to a specific substance or class of substance including information about the adverse reaction. Substances include, but are not limited to, medications, foods, environment (such as plants and animals), and insect bites. The Allergy/Intolerance list exists as a patient safety tool for clinical decision support when ordering medications and nutrition or guiding clinical treatments. This resource does NOT include adverse reactions or adverse events which are expected for the circumstance such as an over-dose or drug-drug interaction or an error/failure in the clinical process. References to implicitRules and modifierExtensions are NOT supported and will fail a Create or Update request.

No Known Allergies (NKA) or No Known Medication Allergies (NKMA) will be conveyed with predefined codes while Not Asked is conveyed via the absence of information (empty query response). Consumers can supply the negation codes No Known Allergies (160244002) or No Known Medication Allergies (409137002) as long as there are no other active allergies on the patient’s profile. If there are other active allergies on the patient’s profile and the consumer tries to add one of the codes above, the service will throw an exception.

If NKA and/or NKMA exist on the patient’s allergy profile and a new allergy is added, the NKA and NKMA will be canceled.

If the consumer is sending in what is deemed to be a duplicate (codified or free text), the service will update the existing allergy or reaction rather than adding a duplicate allergy or reaction.

Assuming a patient safety or decision support use case, a consumer should avoid querying by status since it is not a required field and can ignore any entered-in-error allergies or intolerances.

The following fields are returned if valued:

Terminology Bindings

AllergyIntolerance.substance
  • Description
    • Type of the substance and negation codes for reporting no known allergies.
  • Details: RxNorm
    System: http://www.nlm.nih.gov/research/umls/rxnorm

  • Details: SNOMED CT
    System: http://snomed.info/sct

    • SNOMED CT is supported for non-medication substances and for negations.
AllergyIntolerance.reaction.manifestation
  • Description
    • Clinical symptoms and/or signs that are observed or associated with an adverse reaction event.
  • Details: SNOMED CT
    System: http://snomed.info/sct

Search for AllergyIntolerances that meet supplied query parameters:

GET /AllergyIntolerance?:parameters

Authorization Types

Parameters

Name Required? Type Description
_id This or patient, if populated all other parameters are not allowed token The logical resource id associated with the resource. Example: 12345
patient This or _id reference Who the sensitivity is for. Example: 12345
status N token Certainty of the allergy or intolerance. Example: confirmed

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?patient=4342010

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "c7330db8-59df-499b-9f97-9f89b79dbfb4",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?patient=4342010"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/5703737",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "5703737",
        "meta": {
          "versionId": "5703737",
          "lastUpdated": "2016-06-27T14:10:11.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: Smart, Joe</p><p><b>Allergy</b>: Peanuts</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Dyspnea</p><p><b>Onset</b>: 1982</p></div>"
        },
        "onset": "1982",
        "recordedDate": "2016-06-27T09:10:11.000-05:00",
        "recorder": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "256349002",
              "display": "Peanut - dietary (substance)",
              "userSelected": false
            }
          ],
          "text": "Peanuts"
        },
        "status": "active",
        "criticality": "CRITH",
        "type": "allergy",
        "category": "food",
        "reaction": [
          {
            "id": "5703739",
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "267036007",
                    "display": "Dyspnea (finding)",
                    "userSelected": false
                  }
                ],
                "text": "Dyspnea"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/5703733",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "5703733",
        "meta": {
          "versionId": "5703733",
          "lastUpdated": "2016-06-27T14:08:41.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: Smart, Joe</p><p><b>Allergy</b>: No known medicine allergy</p><p><b>Status</b>: Active</p></div>"
        },
        "recordedDate": "2016-06-27T09:08:41.000-05:00",
        "recorder": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "409137002",
              "display": "No known drug allergies (context-dependent category)",
              "userSelected": false
            }
          ],
          "text": "No known medicine allergy"
        },
        "status": "active",
        "type": "allergy"
      }
    }
  ]
}

Search by status Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?patient=4342010&status=active

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "c7330db8-59df-499b-9f97-9f89b79dbfb4",
  "type": "searchset",
  "total": 2,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?patient=4342010&status=active"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/5703737",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "5703737",
        "meta": {
          "versionId": "5703737",
          "lastUpdated": "2016-06-27T14:10:11.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: Smart, Joe</p><p><b>Allergy</b>: Peanuts</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Dyspnea</p><p><b>Onset</b>: 1982</p></div>"
        },
        "onset": "1982",
        "recordedDate": "2016-06-27T09:10:11.000-05:00",
        "recorder": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "256349002",
              "display": "Peanut - dietary (substance)",
              "userSelected": false
            }
          ],
          "text": "Peanuts"
        },
        "status": "active",
        "criticality": "CRITH",
        "type": "allergy",
        "category": "food",
        "reaction": [
          {
            "id": "5703739",
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "267036007",
                    "display": "Dyspnea (finding)",
                    "userSelected": false
                  }
                ],
                "text": "Dyspnea"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/5703733",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "5703733",
        "meta": {
          "versionId": "5703733",
          "lastUpdated": "2016-06-27T14:08:41.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: Smart, Joe</p><p><b>Allergy</b>: No known medicine allergy</p><p><b>Status</b>: Active</p></div>"
        },
        "recordedDate": "2016-06-27T09:08:41.000-05:00",
        "recorder": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "409137002",
              "display": "No known drug allergies (context-dependent category)",
              "userSelected": false
            }
          ],
          "text": "No known medicine allergy"
        },
        "status": "active",
        "type": "allergy"
      }
    }
  ]
}

Search by id Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?_id=5703737

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "db663826-30c9-4278-a6e2-b2b6843334f7",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance?_id=5703737"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/5703737",
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "5703737",
        "meta": {
          "versionId": "5703737",
          "lastUpdated": "2016-06-27T14:10:11.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: Smart, Joe</p><p><b>Allergy</b>: Peanuts</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Dyspnea</p><p><b>Onset</b>: 1982</p></div>"
        },
        "onset": "1982",
        "recordedDate": "2016-06-27T09:10:11.000-05:00",
        "recorder": {
          "reference": "Practitioner/1912007",
          "display": "Who, Doctor"
        },
        "patient": {
          "reference": "Patient/4342010",
          "display": "Smart, Joe"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "256349002",
              "display": "Peanut - dietary (substance)",
              "userSelected": false
            }
          ],
          "text": "Peanuts"
        },
        "status": "active",
        "criticality": "CRITH",
        "type": "allergy",
        "category": "food",
        "reaction": [
          {
            "id": "5703739",
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "267036007",
                    "display": "Dyspnea (finding)",
                    "userSelected": false
                  }
                ],
                "text": "Dyspnea"
              }
            ]
          }
        ]
      }
    }
  ]
}

Errors

The common errors may be returned.

Retrieve by id

List an individual AllergyIntolerance by its id:

GET /AllergyIntolerance/:id

Authorization Types

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/3643739

Response

Status: 200 OK
{
  "resourceType": "AllergyIntolerance",
  "id": "3643739",
  "meta": {
    "versionId": "3643739",
    "lastUpdated": "2015-03-11T20:36:08.000Z"
  },
  "text": {
    "status": "generated",
    "div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: RHEUM, TEST ONE</p><p><b>Allergy</b>: Dust allergy</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: </p><p><b>Category</b>: Environment</p><p><b>Reactions</b>: </p><p><b>Onset</b>: </p><p><b>Note</b>: </p></div>"
  },
  "recordedDate": "2015-03-11T15:36:08.000",
  "recorder": {
    "reference": "Practitioner/3270007",
    "display": "Who, Doctor"
  },
  "patient": {
    "reference": "Patient/2744010",
    "display": "RHEUM, TEST ONE"
  },
  "substance": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "390952000",
        "display": "Dust allergy (disorder)",
        "userSelected": true
      }
    ],
    "text": "Dust allergy"
  },
  "status": "active",
  "type": "allergy",
  "category": "environment"
}

Errors

The common errors may be returned.

Create

Create new allergies.

POST /AllergyIntolerance

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Accept: application/json+fhir
Content-Type: application/json+fhir

Body fields

Name Required Cardinality Type
resourceType Yes 1..1 string
  • Description
    • The type of the FHIR resource.
  • Example
    • AllergyIntolerance
  • Notes
    • resourceType must be AllergyIntolerance
contained No 0..* Resource
  • Description
    • Contained, inline Resources.
  • Example
    • Contained RelatedPerson
      {
        "contained": [
          {
            "resourceType": "RelatedPerson",
            "id": "5366328",
            "relationship": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v3/RoleCode",
                  "code": "SIGOTHR"
                }
              ]
            }
          }
        ]
      }
      
      Contained Practitioner
      {
        "contained": [
          {
            "resourceType": "Practitioner",
            "id": "123",
            "practitionerRole": [
              {
                "role": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/v2/0286",
                      "code": "RP"
                    }
                  ]
                }
              }
            ]
          }
        ]
      }
      
  • Notes
onset No 0..1 dateTime
  • Description
    • Date(/time) when manifestations showed.
  • Example
    • {
        "onset: "2012-07-13T00:00:00Z"
      }
      
recordedDate Yes 0..1 dateTime
  • Description
    • When the sensitivity was recorded.
  • Example
    • {
        "recordedDate": "2015-10-14T13:13:20-06:00"
      }
      
recorder No 0..1 Reference (Practitioner)
  • Description
    • Who recorded the sensitivity.
  • Example
    • {
        "recorder": {
          "reference": "Practitioner/21500971"
        }
      }
      
  • Notes
patient Yes 1..1 Reference (Patient)
  • Description
    • Who the sensitivity is for.
  • Example
    • {
        "patient": {
          "reference": "Patient/5366327"
        }
      }
      
reporter Yes 0..1 Reference (Patient) | contained Reference (Practitioner | RelatedPerson)
  • Description
    • Source of the information about the allergy.
  • Example
    • Reporter as a Patient Reference
      {
        "reporter": {
          "reference": "Patient/5366327"
        }
      }
      
      Reporter as a contained reference
      {
        "reporter": "#5366328"
      }
      
  • Notes
substance Yes 1..1 CodeableConcept
  • Description
    • Substance, (or class) considered to be responsible for risk
  • Example
    • {
        "substance": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "4125",
              "display": "Ethiodized oil"
            }
          ]
        }
      }
      
status Yes 0..1 code
  • Description
    • Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance.
  • Example
    • {
        "status": "resolved"
      }
      
criticality Yes 0..1 code
  • Description
    • Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
  • Example
    • {
        "criticality": "CRITU"
      }
      
type No 0..1 code
  • Description
    • Identification of the underlying physiological mechanism for the reaction risk.
  • Example
    • {
        "type": "allergy"
      }
      
category Yes 0..1 code
  • Description
  • Example
    • {
        "type": "food"
      }
      
note No 0..1 Annotation
  • Description
    • Additional text not captured in other fields.
  • Example
    • {
        "note": {
          "authorReference": {
            "reference": "Practitioner/21500971"
          },
          "time": "2015-10-14T13:13:20-06:00",
          "text": "Patient complains of discomfort"
        }
      }
      
note.authorReference No 0..1 Reference (Practitioner)
  • Description
    • Individual responsible for the annotation.
  • Example
    • {
        "note": {
          "authorReference": {
            "reference": "Practitioner/21500971"
          }
        }
      }
      
note.time No 0..1 dateTime
  • Description
    • When the annotation was made.
  • Example
    • {
        "note": {
          "time": "2015-10-14T13:13:20-06:00"
        }
      }
      
note.text Yes 1..1 string
  • Description
    • The text content.
  • Example
    • {
        "note": {
          "text": "Patient complains of discomfort"
        }
      }
      
reaction No 0..* BackboneElement
  • Description
    • Adverse reaction events linked to exposure to substance.
  • Example
    • {
        "reaction": [
          {
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "39579001",
                    "display": "Anaphylactic reaction"
                  }
                ]
              }
            ]
          }
        }
      }
      
reaction.manifestation Yes 1..* CodeableConcept
  • Description
    • Clinical symptoms/signs associated with the event.
  • Example
    • Manifestation with a coding:
      {
        "reaction": [
          {
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "39579001",
                    "display": "Anaphylactic reaction"
                  }
                ]
              }
            ]
          }
        }
      }
      
      Manifestation with a freetext value:
      {
        "reaction": [
          {
            "manifestation": [
              {
                "text": "Anaphylactic reaction"
              }
            ]
          }
        ]
      }
      

Example

Request

POST https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance

Body

{
  "resourceType": "AllergyIntolerance",
  "category": "medication",
  "criticality": "CRITL",
  "recordedDate": "2017-02-28T15:03:00-06:00",
  "status": "active",
  "type": "allergy",
  "onset": "2015-12-15T00:00:00Z",
  "patient": {
    "reference": "Patient/1316020"
  },
  "reporter": {
    "reference": "Patient/1316020"
  },
  "recorder": {
    "reference": "Practitioner/1316007"
  },
  "reaction": [
    {
      "manifestation": [
        {
          "text": "Hives"
        }
      ]
    }
  ],
  "note": {
    "authorReference": {
      "reference": "Practitioner/41562141"
    },
    "time": "2017-02-28T09:03:00Z",
    "text": "Note 1"
  },
  "substance": {
    "coding": [
      {
        "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code": "3498"
      }
    ]
  }
}

Response

Status: 201 Created
    Date → Tue, 28 Feb 2017 21:08:20 GMT
    Cache-Control → no-cache
    Vary → Origin,User-Agent,Accept-Encoding
    Strict-Transport-Security → max-age=631152000
    Server-Response-Time → 10023.126891
    X-Xss-Protection → 1; mode=block
    Pragma → no-cache
    X-Request-Id → b0fee21c20d2a240d9b4b86cfbcbd87c
    Etag → W/"6167733"
    X-Frame-Options → SAMEORIGIN
    X-Runtime → 10.023081
    X-Content-Type-Options → nosniff
    Expires → Mon, 01 Jan 1990 00:00:00 GMT
    Last-Modified → Tue, 28 Feb 2017 21:03:00 GMT
    Location → https://fhir-ehr.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/6167733
    Status → 201 Created
    Content-Length → 0
    Content-Type → application/json

The ETag response header indicates the current If-Match version to use on subsequent updates.

Errors

The common errors may be returned. In addition, OperationOutcomes may be returned in the following scenarios:

HTTP Status Cause Severity Code
422 Body contained modifier extensions error extension
422 Body contained implicit rules error unsupported

Update

Update an existing allergy.

PUT /AllergyIntolerance/:id

Implementation Notes

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Accept: application/json+fhir
Content-Type: application/json+fhir
If-Match: W/"<Current version of the AllergyIntolerance resource>"

Body fields

Name Required Cardinality Type
resourceType Yes 1..1 string
  • Description
    • The type of the FHIR resource.
  • Example
    • AllergyIntolerance
  • Notes
    • resourceType must be AllergyIntolerance
id Yes 0..1 id
  • Description
    • The logical id of the resource to update.
  • Example
    • {
        "id": "123412"
      }
      
  • Notes
    • The id value must match the AllergyIntolerance/<id> value.
contained No 0..* Resource
  • Description
    • Contained, inline Resources.
  • Example
    • Contained RelatedPerson
      {
        "contained": [
          {
            "resourceType": "RelatedPerson",
            "id": "5366328",
            "relationship": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/v3/RoleCode",
                  "code": "SIGOTHR"
                }
              ]
            }
          }
        ]
      }
      
      Contained Practitioner
      {
        "contained": [
          {
            "resourceType": "Practitioner",
            "id": "123",
            "practitionerRole": [
              {
                "role": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/v2/0286",
                      "code": "RP"
                    }
                  ]
                }
              }
            ]
          }
        ]
      }
      
  • Notes
onset No 0..1 dateTime
  • Description
    • Date(/time) when manifestations showed.
  • Example
    • {
        "onset: "2012-07-13T00:00:00Z"
      }
      
recordedDate Yes 0..1 dateTime
  • Description
    • When the sensitivity was recorded.
  • Example
    • {
        "recordedDate": "2015-10-14T13:13:20-06:00"
      }
      
recorder No 0..1 Reference (Practitioner)
  • Description
    • Who recorded the sensitivity.
  • Example
    • {
        "recorder": {
          "reference": "Practitioner/21500971"
        }
      }
      
  • Notes
patient Yes 1..1 Reference (Patient)
  • Description
    • Who the sensitivity is for.
  • Example
    • {
        "patient": {
          "reference": "Patient/5366327"
        }
      }
      
reporter Yes 0..1 Reference (Patient) | contained Reference (Practitioner | RelatedPerson)
  • Description
    • Source of the information about the allergy.
  • Example
    • Reporter as a Patient Reference
      {
        "reporter": {
          "reference": "Patient/5366327"
        }
      }
      
      Reporter as a contained reference
      {
        "reporter": "#5366328"
      }
      
  • Notes
substance Yes 1..1 CodeableConcept
  • Description
    • Substance, (or class) considered to be responsible for risk
  • Example
    • {
        "substance": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "4125",
              "display": "Ethiodized oil"
            }
          ]
        }
      }
      
status Yes 0..1 code
  • Description
    • Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance.
  • Example
    • {
        "status": "resolved"
      }
      
criticality Yes 0..1 code
  • Description
    • Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
  • Example
    • {
        "criticality": "CRITU"
      }
      
type No 0..1 code
  • Description
    • Identification of the underlying physiological mechanism for the reaction risk.
  • Example
    • {
        "type": "allergy"
      }
      
category Yes 0..1 code
  • Description
  • Example
    • {
        "type": "food"
      }
      
note No 0..1 Annotation
  • Description
    • Additional text not captured in other fields.
  • Example
    • {
        "note": {
          "authorReference": {
            "reference": "Practitioner/21500971"
          },
          "time": "2015-10-14T13:13:20-06:00",
          "text": "Patient complains of discomfort"
        }
      }
      
note.authorReference No 0..1 Reference (Practitioner)
  • Description
    • Individual responsible for the annotation.
  • Example
    • {
        "note": {
          "authorReference": {
            "reference": "Practitioner/21500971"
          }
        }
      }
      
note.time No 0..1 dateTime
  • Description
    • When the annotation was made.
  • Example
    • {
        "note": {
          "time": "2015-10-14T13:13:20-06:00"
        }
      }
      
note.text Yes 1..1 string
  • Description
    • The text content.
  • Example
    • {
        "note": {
          "text": "Patient complains of discomfort"
        }
      }
      
reaction No 0..* BackboneElement
  • Description
    • Adverse reaction events linked to exposure to substance.
  • Example
    • {
        "reaction": [
          {
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "39579001",
                    "display": "Anaphylactic reaction"
                  }
                ]
              }
            ]
          }
        }
      }
      
reaction.id Yes 0..1 id
  • Description
    • Logical id of the reaction event.
  • Example
    • {
        "id": "543123"
      }
      
reaction.manifestation Yes 1..* CodeableConcept
  • Description
    • Clinical symptoms/signs associated with the event.
  • Example
    • Manifestation with a coding:
      {
        "reaction": [
          {
            "manifestation": [
              {
                "coding": [
                  {
                    "system": "http://snomed.info/sct",
                    "code": "39579001",
                    "display": "Anaphylactic reaction"
                  }
                ]
              }
            ]
          }
        }
      }
      
      Manifestation with a freetext value:
      {
        "reaction": [
          {
            "manifestation": [
              {
                "text": "Anaphylactic reaction"
              }
            ]
          }
        ]
      }
      

Example

Request

PUT https://fhir-open.sandboxcerner.com/dstu2/0b8a0111-e8e6-4c26-a91c-5069cbc6b1ca/AllergyIntolerance/6167733

Body

{
  "resourceType": "AllergyIntolerance",
  "id": "6167733",
  "meta": {
    "versionId": "6167733",
    "lastUpdated": "2017-02-28T21:08:25.000Z"
  },
  "contained": [
    {
      "resourceType": "RelatedPerson",
      "id": "19775887",
      "patient": {
        "reference": "Patient/1316020"
      },
      "relationship": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/RoleCode",
            "code": "ONESELF",
            "display": "self"
          }
        ],
        "text": "self"
      }
    }
  ],
  "onset": "2015-12-14T16:00:00.000-08:00",
  "recordedDate": "2017-02-28T15:03:00.000-06:00",
  "recorder": {
    "reference": "Practitioner/1316007"
  },
  "patient": {
    "reference": "Patient/1316020"
  },
  "reporter": {
    "reference": "#19775887"
  },
  "substance": {
    "text": "calamine-diphenhydrAMINE topical"
  },
  "status": "active",
  "criticality": "CRITH",
  "type": "allergy",
  "category": "medication",
  "note": {
    "text": "2017-02-28T09:03:00.000Z - Note 1"
  },
  "reaction": [
    {
      "id": "6167735",
      "manifestation": [
        {
          "text": "Hives"
        }
      ]
    }
  ]
}

Response

Status: 200 OK
    Date →  Tue, 28 Feb 2017 21:19:18 GMT
    Cache-Control →  no-cache
    Vary →  Origin,User-Agent,Accept-Encoding
    Strict-Transport-Security →  max-age=631152000
    Server-Response-Time →  647.014821
    X-Xss-Protection →  1; mode=block
    Pragma →  no-cache
    X-Request-Id →  d30766e5445f973b32efa9ec516cb5db
    Etag →  W/"6167741"
    X-Frame-Options →  SAMEORIGIN
    X-Runtime →  0.646992
    X-Content-Type-Options →  nosniff
    Expires →  Mon, 01 Jan 1990 00:00:00 GMT
    Last-Modified →  Tue, 28 Feb 2017 21:03:00 GMT
    Status →  200 OK
    Content-Length →  0
    Content-Type →  application/json

The ETag response header indicates the current If-Match version to use on subsequent updates.

Errors

The common errors may be returned. In addition, OperationOutcomes may be returned in the following scenarios:

HTTP Status Cause Severity Code
422 Body contained modifier extensions error extension
422 Body contained implicit rules error unsupported