Millennium

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

Provider | Patient | System

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

Provider | Patient | System

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

Provider | System

Headers

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

Body fields

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • AllergyIntolerance
  • Notes
    • resourceType must be AllergyIntolerance
contained No List of Resource
  • Description
    • Contained, inline Resources.
  • Example
    • Contained RelatedPerson
{
  "contained": [
    {
      "resourceType": "RelatedPerson",
      "id": "5366328",
      "relationship": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/RoleCode",
            "code": "SIGOTHR"
          }
        ]
      }
    }
  ]
}
  • Example
    • Contained Practitioner
{
  "contained": [
    {
      "resourceType": "Practitioner",
      "id": "123",
      "practitionerRole": [
        {
          "role": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/v2/0286",
                "code": "RP"
              }
            ]
          }
        }
      ]
    }
  ]
}
  • Notes
onset No dateTime
  • Description
    • Date(/time) when manifestations showed.
  • Example
    • {
  "onset: "2012-07-13T00:00:00Z"
}
recordedDate Yes dateTime
  • Description
    • When the sensitivity was recorded.
  • Example
    • {
  "recordedDate": "2015-10-14T13:13:20-06:00"
}
recorder No Reference (Practitioner)
  • Description
    • Who recorded the sensitivity.
  • Example
    • {
  "recorder": {
    "reference": "Practitioner/21500971"
  }
}
  • Notes
patient Yes Reference (Patient)
  • Description
    • Who the sensitivity is for.
  • Example
    • {
  "patient": {
    "reference": "Patient/5366327"
  }
}
reporter Yes Reference (Patient) | contained Reference (Practitioner | RelatedPerson)
  • Description
    • Source of the information about the allergy.
  • Example
    • Reporter as a Patient Reference
{
  "reporter": {
    "reference": "Patient/5366327"
  }
}
  • Example
    • Reporter as a contained reference
{
  "reporter": "#5366328"
}
  • Notes
substance Yes 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 code
  • Description
    • Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance.
  • Example
    • {
  "status": "resolved"
}
criticality Yes code
  • Description
    • Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
  • Example
    • {
  "criticality": "CRITU"
}
type No code
  • Description
    • Identification of the underlying physiological mechanism for the reaction risk.
  • Example
    • {
  "type": "allergy"
}
category Yes code
  • Description
  • Example
    • {
  "type": "food"
}
note No 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 Reference (Practitioner)
  • Description
    • Individual responsible for the annotation.
  • Example
    • {
  "note": {
    "authorReference": {
      "reference": "Practitioner/21500971"
    }
  }
}
note.time No dateTime
  • Description
    • When the annotation was made.
  • Example
    • {
  "note": {
    "time": "2015-10-14T13:13:20-06:00"
  }
}
note.text Yes string
  • Description
    • The text content.
  • Example
    • {
  "note": {
    "text": "Patient complains of discomfort"
  }
}
reaction No List of 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 List of 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"
            }
          ]
        }
      ]
    }
  ]
}
  • Example
    • Manifestation with a freetext value:
{
  "reaction": [
    {
      "manifestation": [
        {
          "text": "Anaphylactic reaction"
        }
      ]
    }
  ]
}

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

Authorization Types

Provider | System

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:

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • AllergyIntolerance
  • Notes
    • resourceType must be AllergyIntolerance
id Yes 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 List of Resource
  • Description
    • Contained, inline Resources.
  • Example
    • Contained RelatedPerson
{
  "contained": [
    {
      "resourceType": "RelatedPerson",
      "id": "5366328",
      "relationship": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/RoleCode",
            "code": "SIGOTHR"
          }
        ]
      }
    }
  ]
}
  • Example
    • Contained Practitioner
{
  "contained": [
    {
      "resourceType": "Practitioner",
      "id": "123",
      "practitionerRole": [
        {
          "role": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/v2/0286",
                "code": "RP"
              }
            ]
          }
        }
      ]
    }
  ]
}
  • Notes
onset No dateTime
  • Description
    • Date(/time) when manifestations showed.
  • Example
    • {
  "onset: "2012-07-13T00:00:00Z"
}
recordedDate Yes dateTime
  • Description
    • When the sensitivity was recorded.
  • Example
    • {
  "recordedDate": "2015-10-14T13:13:20-06:00"
}
recorder No Reference (Practitioner)
  • Description
    • Who recorded the sensitivity.
  • Example
    • {
  "recorder": {
    "reference": "Practitioner/21500971"
  }
}
  • Notes
patient Yes Reference (Patient)
  • Description
    • Who the sensitivity is for.
  • Example
    • {
  "patient": {
    "reference": "Patient/5366327"
  }
}
reporter Yes Reference (Patient) | contained Reference (Practitioner | RelatedPerson)
  • Description
    • Source of the information about the allergy.
  • Example
    • Reporter as a Patient Reference
{
  "reporter": {
    "reference": "Patient/5366327"
  }
}
  • Example
    • Reporter as a contained reference
{
  "reporter": "#5366328"
}
  • Notes
substance Yes 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 code
  • Description
    • Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance.
  • Example
    • {
  "status": "resolved"
}
criticality Yes code
  • Description
    • Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
  • Example
    • {
  "criticality": "CRITU"
}
type No code
  • Description
    • Identification of the underlying physiological mechanism for the reaction risk.
  • Example
    • {
  "type": "allergy"
}
category Yes code
  • Description
  • Example
    • {
  "type": "food"
}
note No 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 Reference (Practitioner)
  • Description
    • Individual responsible for the annotation.
  • Example
    • {
  "note": {
    "authorReference": {
      "reference": "Practitioner/21500971"
    }
  }
}
note.time No dateTime
  • Description
    • When the annotation was made.
  • Example
    • {
  "note": {
    "time": "2015-10-14T13:13:20-06:00"
  }
}
note.text Yes string
  • Description
    • The text content.
  • Example
    • {
  "note": {
    "text": "Patient complains of discomfort"
  }
}
reaction No List of 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 id
  • Description
    • Logical id of the reaction event.
  • Example
    • {
  "id": "543123"
}
reaction.manifestation Yes List of 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"
            }
          ]
        }
      ]
    }
  ]
}
  • Example
    • Manifestation with a freetext value:
{
  "reaction": [
    {
      "manifestation": [
        {
          "text": "Anaphylactic reaction"
        }
      ]
    }
  ]
}

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.