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:
- Allergy id
- Allergy substance
- Status
- Patient with allergy/intolerance
- Date of allergy onset
- Date/Time recorded
- Who recorded
- Who reported
- Criticality/potential harm
- Category (medication, food, environment)
- Adverse reaction (clinical symptoms/manifestation)
- Comment
Terminology Bindings
AllergyIntolerance.substance |
AllergyIntolerance.reaction.manifestation |
|
Search
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.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?patient=12742399
Response
Status: 200 OK
{
"resourceType": "Bundle",
"id": "7c99ef7b-3d34-40af-a86e-426375329d7b",
"type": "searchset",
"total": 2,
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?patient=12742399"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760019",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "12760019",
"meta": {
"versionId": "12760019",
"lastUpdated": "2020-03-04T20:15:37.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: acetaminophen</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Reactions</b>: Rash</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:15:37.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "161",
"display": "Acetaminophen",
"userSelected": false
}
],
"text": "acetaminophen"
},
"status": "active",
"criticality": "CRITH",
"reaction": [
{
"id": "12760021",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)",
"userSelected": false
}
],
"text": "Rash"
}
]
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760025",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "12760025",
"meta": {
"versionId": "12760025",
"lastUpdated": "2020-03-04T20:16:02.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: Egg</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Breathing abnormal</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:16:02.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)",
"userSelected": false
}
],
"text": "Egg"
},
"status": "active",
"criticality": "CRITH",
"type": "allergy",
"category": "food",
"reaction": [
{
"id": "12760027",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "386813002",
"display": "Abnormal breathing (finding)",
"userSelected": false
}
],
"text": "Breathing abnormal"
}
]
}
]
}
}
]
}
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Search by status Example
Request
GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?patient=12742399&status=active
Response
Status: 200 OK
{
"resourceType": "Bundle",
"id": "fb2804ce-a379-4ae0-ae48-a608787f83f1",
"type": "searchset",
"total": 2,
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?patient=12742399&status=active"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760025",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "12760025",
"meta": {
"versionId": "12760025",
"lastUpdated": "2020-03-04T20:16:02.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: Egg</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Breathing abnormal</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:16:02.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)",
"userSelected": false
}
],
"text": "Egg"
},
"status": "active",
"criticality": "CRITH",
"type": "allergy",
"category": "food",
"reaction": [
{
"id": "12760027",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "386813002",
"display": "Abnormal breathing (finding)",
"userSelected": false
}
],
"text": "Breathing abnormal"
}
]
}
]
}
},
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760019",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "12760019",
"meta": {
"versionId": "12760019",
"lastUpdated": "2020-03-04T20:15:37.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: acetaminophen</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Reactions</b>: Rash</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:15:37.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "161",
"display": "Acetaminophen",
"userSelected": false
}
],
"text": "acetaminophen"
},
"status": "active",
"criticality": "CRITH",
"reaction": [
{
"id": "12760021",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "271807003",
"display": "Eruption of skin (disorder)",
"userSelected": false
}
],
"text": "Rash"
}
]
}
]
}
}
]
}
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Search by id Example
Request
GET https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?_id=12760025
Response
Status: 200 OK
{
"resourceType": "Bundle",
"id": "f458542b-3e85-4930-949c-606f0941510e",
"type": "searchset",
"total": 1,
"link": [
{
"relation": "self",
"url": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance?_id=12760025"
}
],
"entry": [
{
"fullUrl": "https://fhir-open.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760025",
"resource": {
"resourceType": "AllergyIntolerance",
"id": "12760025",
"meta": {
"versionId": "12760025",
"lastUpdated": "2020-03-04T20:16:02.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: Egg</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Breathing abnormal</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:16:02.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)",
"userSelected": false
}
],
"text": "Egg"
},
"status": "active",
"criticality": "CRITH",
"type": "allergy",
"category": "food",
"reaction": [
{
"id": "12760027",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "386813002",
"display": "Abnormal breathing (finding)",
"userSelected": false
}
],
"text": "Breathing abnormal"
}
]
}
]
}
}
]
}
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes 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.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760025
Response
Status: 200 OK
{
"resourceType": "AllergyIntolerance",
"id": "12760025",
"meta": {
"versionId": "12760025",
"lastUpdated": "2020-03-04T20:16:02.000Z"
},
"text": {
"status": "generated",
"div": "<div><p><b>Allergy Intolerance</b></p><p><b>Patient</b>: SMART, SANDY A</p><p><b>Allergy</b>: Egg</p><p><b>Status</b>: Active</p><p><b>Criticality</b>: High Risk</p><p><b>Category</b>: Food</p><p><b>Reactions</b>: Breathing abnormal</p><p><b>Onset</b>: Dec 2019</p></div>"
},
"onset": "2019-12",
"recordedDate": "2020-03-04T14:16:02.000-06:00",
"patient": {
"reference": "Patient/12742399",
"display": "SMART, SANDY A"
},
"substance": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)",
"userSelected": false
}
],
"text": "Egg"
},
"status": "active",
"criticality": "CRITH",
"type": "allergy",
"category": "food",
"reaction": [
{
"id": "12760027",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "386813002",
"display": "Abnormal breathing (finding)",
"userSelected": false
}
],
"text": "Breathing abnormal"
}
]
}
]
}
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes 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 | Type | |
---|---|---|---|
resourceType
|
Yes |
string |
|
|
|||
contained
|
No |
List of Resource |
|
|
|||
onset
|
No |
dateTime |
|
|
|||
recordedDate
|
Yes |
dateTime |
|
|
|||
recorder
|
No |
Reference (Practitioner ) |
|
|
|||
patient
|
Yes |
Reference (Patient ) |
|
|
|||
reporter
|
Yes |
Reference (Patient ) | contained Reference (Practitioner | RelatedPerson ) |
|
|
|||
substance
|
Yes |
CodeableConcept |
|
|
|||
status
|
Yes |
code |
|
|
|||
criticality
|
Yes |
code |
|
|
|||
type
|
No |
code |
|
|
|||
category
|
Yes |
code |
|
|
|||
note
|
No |
Annotation |
|
|
|||
note.authorReference
|
No |
Reference (Practitioner ) |
|
|
|||
note.time
|
No |
dateTime |
|
|
|||
note.text
|
Yes |
string |
|
|
|||
reaction
|
No |
List of BackboneElement |
|
|
|||
reaction.manifestation
|
Yes |
List of CodeableConcept |
|
|
Example
Request
POST https://fhir-ehr-code.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/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/12742399"
},
"reporter": {
"reference": "Patient/12742399"
},
"recorder": {
"reference": "Practitioner/683925"
},
"reaction": [
{
"manifestation": [
{
"text": "Hives"
}
]
}
],
"note": {
"authorReference": {
"reference": "Practitioner/683925"
},
"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 X-Xss-Protection: 1; mode=block Pragma: no-cache X-Request-Id: b0fee21c20d2a240d9b4b86cfbcbd87c Etag: W/"6167733" X-Frame-Options: SAMEORIGIN 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-code.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/6167733 Content-Length: 0 Content-Type: application/json
The ETag
response header indicates the current If-Match
version to use on subsequent updates.
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.
Update
Update an existing allergy.
PUT /AllergyIntolerance/:id
Implementation Notes
- Any field which is missing will be interpreted as nulling out or removing data from the resource. See FHIR® Update for additional details about update operations.
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
Notes:
-
note
cannot be added ifnote
already exists. An existingnote
field cannot be modified.
Name | Required | Type | |
---|---|---|---|
resourceType
|
Yes |
string |
|
|
|||
id
|
Yes |
id |
|
|
|||
contained
|
No |
List of Resource |
|
|
|||
onset
|
No |
dateTime |
|
|
|||
recordedDate
|
Yes |
dateTime |
|
|
|||
recorder
|
No |
Reference (Practitioner ) |
|
|
|||
patient
|
Yes |
Reference (Patient ) |
|
|
|||
reporter
|
Yes |
Reference (Patient ) | contained Reference (Practitioner | RelatedPerson ) |
|
|
|||
substance
|
Yes |
CodeableConcept |
|
|
|||
status
|
Yes |
code |
|
|
|||
criticality
|
Yes |
code |
|
|
|||
type
|
No |
code |
|
|
|||
category
|
Yes |
code |
|
|
|||
note
|
No |
Annotation |
|
|
|||
note.authorReference
|
No |
Reference (Practitioner ) |
|
|
|||
note.time
|
No |
dateTime |
|
|
|||
note.text
|
Yes |
string |
|
|
|||
reaction
|
No |
List of BackboneElement |
|
|
|||
reaction.id
|
Yes |
id |
|
|
|||
reaction.manifestation
|
Yes |
List of CodeableConcept |
|
|
Example
Request
PUT https://fhir-ehr-code.cerner.com/dstu2/ec2458f2-1e24-41c8-b71b-0e701af7583d/AllergyIntolerance/12760025
Body
{
"resourceType": "AllergyIntolerance",
"id": "12760025",
"meta": {
"versionId": "12760025",
"lastUpdated": "2020-03-04T20:16:02.000Z"
},
"contained": [
{
"resourceType": "Practitioner",
"id": "638994",
"practitionerRole": [
{
"role": {
"coding": [
{
"system": "http://hl7.org/fhir/practitioner-role",
"code": "doctor",
"display": "Doctor"
}
],
"text": "Doctor"
}
}
]
}
],
"onset": "2020-2",
"recordedDate": "2020-05-04T14:16:02.000-06:00",
"patient": {
"reference": "Patient/12742399"
},
"substance": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "102263004",
"display": "Eggs (edible) (substance)",
"userSelected": false
}
],
"text": "Egg"
},
"status": "active",
"criticality": "CRITH",
"category": "food",
"reaction": [
{
"id": "3363737",
"manifestation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "79962008",
"display": "Diffuse spasm of esophagus (disorder)",
"userSelected": false
}
],
"text": "Barsony-Teschendorf syndrome"
}
]
}
]
}
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 X-Xss-Protection: 1; mode=block Pragma: no-cache X-Request-Id: d30766e5445f973b32efa9ec516cb5db Etag: W/"6167741" X-Frame-Options: SAMEORIGIN X-Content-Type-Options: nosniff Expires: Mon, 01 Jan 1990 00:00:00 GMT Last-Modified: Tue, 28 Feb 2017 21:03:00 GMT Content-Length: 0 Content-Type: application/json
The ETag
response header indicates the current If-Match
version to use on subsequent updates.
Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.
Errors
The common errors and OperationOutcomes may be returned.