AllergyIntolerance

• Overview
• Terminology Bindings
• Custom Extensions
• Search
  • Parameters
  • Headers
  • Example
  • Errors and Informational messages

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.

Search

GET /AllergyIntolerance?:parameters

Implementation Notes

• The API returns the most current AllergyIntolerance list.
• The API only returns allergies in an active status. It will not return allergies marked as entered-in-error.
• The Narrative includes additional information pertaining to the AllergyIntolerance and should be shown to the user to ensure completeness of clinical content and context.
• At this time, non-medication allergies are not coded and will be returned as freetext.

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.