CH AllergyIntolerance (R4)
3.0.0 - trial-use Switzerland flag

This page is part of the CH-AllergyIntolerance (R4) (v3.0.0: STU 3) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Official URL: http://fhir.ch/ig/ch-allergyintolerance/ImplementationGuide/ch.fhir.ig.ch-allergyintolerance Version: 3.0.0
Active as of 2024-12-17 Computable Name: CHAllergyIntolerance

Copyright/Legal: CC0-1.0

Introduction

Swiss implementation guide (IG) for allergies and intolerances based on the recommendations of the interprofessional working group EPR (IPAG) and the implementation guide CH IPS, which is closely aligned with the HL7 IPS-UV specification. The "Implementation Guide for Use of SNOMED CT in Documentation of Allergy, Non-allergic Hypersensitivity and Intolerance", which was still in development at the time of the initial publication of this IG, has also been taken into account.

Significant changes, open and closed issues.

Download: You can download this implementation guide in npm format from here.

Goal

The goal of this IG is

  • the exchange of allergies and intolerances in a structured document (profile developed), e.g. in the context of the Swiss EPR
  • as a requirement on how allergy and intolerances are to be used, referenced or derived in order to obtain interoperability in Swiss projects (and therefore other IGs), e.g. in the context of vaccination or transition of care
  • clarify the usage of adverse sensitivity data (which encompasses allergy, non-allergic hypersensitivity and intolerance) by providing use cases and thus accelerating consistent implementation as intended by IPAG and the Allergies/Hypersensitivity and Intolerance Clinical Reference Group of SNOMED CT.

Must Support

The use of Must Support is in the sense of the Guidelines for Swiss IG developments:
"Required if known. If the sending application has data for the element, it is required to populate the element with a non-empty value. If the value is not known, the element may be omitted. A receiving application may ignore the information conveyed by the element. A receiving application shall not raise an error solely due to the presence or absence of the element."

CH AllergyIntolerance and CH AllergyIntolerance Condition are based on the corresponding profiles of CH IPS. CH IPS itself explicitly does not set any Must Support flags, but rather indicates that the same rules/elements apply as in HL7 IPS-UV (see here). This therefore also applies to this IG CH AllergyIntolerance. This mechanism also prevents discrepancies/contradictions between the individual specifications.
However, for the AllergyIntolerance resource, Must Support flags have been explicitly set here for all those fields that are Must Support in HL7 IPS-UV and are also part of the IPAG recommendations (see also here). In addition, the fields AllergyIntolerance.reaction.substance and AllergyIntolerance.category were also flagged as Must Support because these fields play an important role in the above mentioned recommendations.

The extensions defined by the interprofessional working group EPR (IPAG) have no Must Support flags in the present version but are easily identified in the differential view of the artifact.
The expectation is that allergy specialists tend to provide more detailed information applying these extended reaction details, whereas the general practitioner will document rather the Must Support attributes.

Value Sets

The value sets for coding of allergies, intolerances and hypersensitivities and related conditions are based on the historically most common values documented in the Swiss realm and stated as a defined list of findings, as well as the correspondent substances in the value set for reaction.substance, reviewed by the Swiss Society for Allergology and Immunology SGAI-SSAI.

Whereas this is explicitly desired by the professional representatives it is different than stated in the HL7 IPS-UV specification for example, where the binding is based on expanded value sets, but which has had very little real world feedback until to date. Experience and feedback is welcome therefore in this respect.

The actual value set AllergyIntolerance.code doesn't yet include codes which exist only as post coordinated SNOMED CT expressions. They will be suggested to SNOMED CT by eHealth Suisse and added to the ci-build as soon as available as precoordinated SNOMED CT codes and added to a future publication of this IG.

Safety Considerations

This implementation guide defines data elements, resources, formats, and methods for exchanging healthcare data between different participants in the healthcare process. As such, clinical safety is a key concern. Additional guidance regarding safety for the specification’s many and various implementations is available at: https://www.hl7.org/FHIR/safety.html.

Although the present specification does gives users the opportunity to observe data protection and data security regulations, its use does not guarantee compliance with these regulations. Effective compliance must be ensured by appropriate measures during implementation projects and in daily operations. The corresponding implementation measures are explained in the standard. In addition, the present specification can only influence compliance with the security regulations in the technical area of standardisation. It cannot influence organisational and contractual matters.

IP Statements

This document is licensed under Creative Commons "No Rights Reserved" (CC0).

HL7®, HEALTH LEVEL SEVEN®, FHIR® and the FHIR ® are trademarks owned by Health Level Seven International, registered with the United States Patent and Trademark Office.

This implementation guide contains and references intellectual property owned by third parties ("Third Party IP"). Acceptance of these License Terms does not grant any rights with respect to Third Party IP. The licensee alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize Third Party IP in connection with the specification or otherwise.

This publication includes IP covered under the following statements.

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (ch.fhir.ig.ch-allergyintolerance.r4) and R4B (ch.fhir.ig.ch-allergyintolerance.r4b) are available.

Dependency Table

Package hl7.fhir.uv.extensions.r4#5.1.0

This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package ch.fhir.ig.ch-core#5.0.0

FHIR implementation guide CH Core (built Tue, Dec 17, 2024 19:54+0000+00:00)

Package ihe.formatcode.fhir#1.3.0

Implementation Guide for IHE defined FormatCode vocabulary. (built Fri, May 17, 2024 12:02-0500-05:00)

Package ch.fhir.ig.ch-term#3.1.0

Implementation Guide for Swiss Terminology (built Tue, Dec 17, 2024 13:13+0000+00:00)

Package ch.fhir.ig.ch-ips#1.0.0

The FHIR implementation guide CH IPS is derived from the Swiss Core IG (CH Core) and ensures conformity with the International Patient Summary (IPS). (built Wed, Dec 18, 2024 08:06+0000+00:00)

Globals Table

There are no Global profiles defined