AllergyIntolerance

Overview

For the AllergyIntolerance resource query, the API returns the current state of the patient’s allergy list as charted in Soarian. The allergy list represents a clinical assessment of a patient’s allergy or intolerance when exposed to a specific substance or class of substance.

Soarian’s list supports medication, food, environmental, and other allergen categories. Allergy and Intolerance are not differentiated. A charted assertion of no allergy is different than an empty list; the response will include any charted assertions such as NKA (no known allergies), NKDA (no known drug allergy), NKFA (no known food allergy), No Latex Allergy, and/or No IV contrast Allergy. The list represents a consolidated collection of allergens, reactions, and severities that providers have charted in the Soarian Allergy List. Only allergies in the active state are returned.

Terminology Bindings

Medication allergens are coded in RxNorm. Negations are indicated by SNOMED codes. All other allergens (e.g., environmental substances) are returned as text only.

AllergyIntolerance.substance
  • Description
    • Type of the substance and negation codes for reporting no known allergies.
  • Note
    • RxNorm is supportted for medication allergies and SNOMED is supported for negations. At this time, non-medication, non-negated allergies are not coded.
  • Details: RxNorm
    System: http://www.nlm.nih.gov/research/umls/rxnorm

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

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/

Custom Extensions

The bundle extension can be returned, see possible codes in the errors section below.

GET /AllergyIntolerance?:parameters

Implementation Notes

Parameters

Name Required? Type Description
patientId Y reference The patient identifier provided in a pre-requisite authorization step.

Headers

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

Example

Request

GET https://fhir-myrecord.sandboxcerner.com/dstu2/123abc/AllergyIntolerance?patientId=52930295-B52D-4685-B922-DC5F181CF786

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "9f29ee0a-16b9-4967-bfdf-51c21a0faf8b",
  "meta": {
    "lastUpdated": "2017-02-27T15:54:09.388-05:00"
  },
  "extension": [
    {
      "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
      "valueExtension": {
        "url": "http://cerner.hs.fhir.com/StructureDefinition/bundle-result-messages",
        "extension": [
          {
            "url": "Severity",
            "valueString": "info"
          },
          {
            "url": "Code",
            "valueString": "papi001"
          },
          {
            "url": "Message",
            "valueString": "This is the most current, known allergy list and may not reflect the state of allergies known at a previous date."
          }
        ]
      }
    }
  ],
  "type": "searchset",
  "link": [
    {
      "relation": "self",
      "url": "base-url/bf615549-44cc-4899-bfa9-2cfd86bf358c/AllergyIntolerance?patientId=52930295-B52D-4685-B922-DC5F181CF786&_format=json"
    }
  ],
  "entry": [
    {
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "10433",
        "text": {
          "status": "additional",
          "div": "<div ccdRefId=\"ZCCD-Allergies.CCD-Allergies.10433\"> <b>aspirin</b> causes Moderate Bleeding. Onset Last year.</div>"
        },
        "identifier": [
          {
            "use": "official",
            "value": "10433"
          }
        ],
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "substance": {
          "coding": [
            {
              "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
              "code": "1191",
              "display": "Aspirin"
            }
          ],
          "text": "aspirin"
        },
        "status": "active",
        "type": "allergy",
        "category": "medication",
        "reaction": [
          {
            "manifestation": [
              {
                "coding": [
                  {
                    "display": "Bleeding"
                  }
                ],
                "text": "Bleeding"
              }
            ],
            "severity": "moderate"
          }
        ]
      }
    },
    {
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "NKFA",
        "text": {
          "status": "additional",
          "div": "<div ccdRefId=\"ZCCD-Allergies.CCD-Allergies.NKFA\">No Known Food Allergies.</div>"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "substance": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "429625007",
              "display": "No Known Food Allergies"
            }
          ],
          "text": "No Known Food Allergies"
        }
      }
    },
    {
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "NoLatex",
        "text": {
          "status": "additional",
          "div": "<div ccdRefId=\"ZCCD-Allergies.CCD-Allergies.NoLatex\">No Latex Allergy.</div>"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "substance": {
          "text": "No Latex Allergy"
        }
      }
    },
    {
      "resource": {
        "resourceType": "AllergyIntolerance",
        "id": "NoContrast",
        "text": {
          "status": "additional",
          "div": "<div ccdRefId=\"ZCCD-Allergies.CCD-Allergies.NoContrast\">No IV Contrast Allergy.</div>"
        },
        "patient": {
          "reference": "Patient/52930295-B52D-4685-B922-DC5F181CF786"
        },
        "substance": {
          "text": "No IV Contrast Allergy"
        }
      }
    }
  ]
}

Errors and Informational messages

The common errors and informational messages can be returned.

These additional informational messages may be returned within the bundle extension:

Code Message
papi001 This is the most current, known allergy list and may not reflect the state of allergies known at a previous date.
papi002 No allergy information is available.