ch-ips-allergyintolerance
type: StructureDefinition
node role: treeRoot
id:
  v: ch-ips-allergyintolerance
text:
  status:
    v: extensions
  div: Generated Narrative: StructureDefinition ch-ips-allergyintolerance Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> AllergyIntolerance 0..* CHCoreAllergyIntolerance CH IPS AllergyIntolerance This profile also imposes the profile Allergy Intolerance (IPS) patient 1..1 Reference(CH IPS Patient) Who the sensitivity is for <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-imposeProfile
  value: canonical
    v: http://hl7.org/fhir/uv/ips/StructureDefinition/AllergyIntolerance-uv-ips
    link: http://hl7.org/fhir/uv/ips/StructureDefinition/AllergyIntolerance-uv-ips
url:
  v: http://fhir.ch/ig/ch-ips/StructureDefinition/ch-ips-allergyintolerance
version:
  v: 2.0.0-ballot
name:
  v: ChIpsAllergyIntolerance
title:
  v: CH IPS AllergyIntolerance
status:
  v: active
date:
  v: 2025-05-22T08:10:43+00:00
publisher:
  v: HL7 Switzerland
contact:
  name:
    v: HL7 Switzerland
  telecom:
    system:
      v: url
    value:
      v: https://www.hl7.ch/
contact:
  name:
    v: HL7 Switzerland
  telecom:
    system:
      v: url
    value:
      v: https://www.hl7.ch/
    use:
      v: work
description:
  v: This CH IPS profile for the resource AllergyIntolerance is derived from the corresponding CH Core profile and also ensures IPS conformity via the IPS profile referenced by the so-called imposeProfile extension.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
    code:
      v: CHE
copyright:
  v: CC0-1.0
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
  name:
    v: RIM Mapping
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: v2
  uri:
    v: http://hl7.org/v2
  name:
    v: HL7 v2 Mapping
kind:
  v: resource
abstract:
  v: false
type:
  v: AllergyIntolerance
base definition:
  v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-allergyintolerance
  link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-allergyintolerance
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
    value: string
      v: 6.0.0-ballot
  element:
    id:
      v: AllergyIntolerance
    path:
      v: AllergyIntolerance
    short:
      v: CH IPS AllergyIntolerance
    definition:
      v: Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.
    comment:
      v: Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.
    alias:
      v: Allergy
    alias:
      v: Intolerance
    alias:
      v: Adverse Reaction
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: AllergyIntolerance
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: ait-1
      severity:
        v: error
      human:
        v: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
      expression:
        v: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
      xpath:
        v: f:verificationStatus/f:coding/f:code/@value='entered-in-error' or exists(f:clinicalStatus)
      source:
        v: http://hl7.org/fhir/StructureDefinition/AllergyIntolerance
        link: http://hl7.org/fhir/StructureDefinition/AllergyIntolerance
    constraint:
      key:
        v: ait-2
      severity:
        v: error
      human:
        v: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
      expression:
        v: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
      xpath:
        v: not(f:verificationStatus/f:coding/f:code/@value='entered-in-error') or not(exists(f:clinicalStatus))
      source:
        v: http://hl7.org/fhir/StructureDefinition/AllergyIntolerance
        link: http://hl7.org/fhir/StructureDefinition/AllergyIntolerance
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
      expression:
        v: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()

v: not(exists(f:contained/*/f:meta/f:security))

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice
  value: boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation
  value: markdown
    v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
key:
  v: dom-6
severity:
  v: warning
human:
  v: A resource should have narrative for robust management
expression:
  v: text.`div`.exists()
xpath:
  v: exists(f:text/h:div)
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource
  link: http://hl7.org/fhir/StructureDefinition/DomainResource

v: false

v: false

identity:
  v: rim
map:
  v: Entity. Role, or Act

identity:
  v: rim
map:
  v: Observation[classCode=OBS, moodCode=EVN]

id:
  v: AllergyIntolerance.id
path:
  v: AllergyIntolerance.id
short:
  v: Logical id of this artifact
definition:
  v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
comment:
  v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: id
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: true

id:
  v: AllergyIntolerance.meta
path:
  v: AllergyIntolerance.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: AllergyIntolerance.implicitRules
path:
  v: AllergyIntolerance.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: AllergyIntolerance.language
path:
  v: AllergyIntolerance.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
    value: canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      link: http://hl7.org/fhir/ValueSet/all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages
    link: http://hl7.org/fhir/ValueSet/languages

id:
  v: AllergyIntolerance.text
path:
  v: AllergyIntolerance.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: AllergyIntolerance.contained
path:
  v: AllergyIntolerance.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: AllergyIntolerance.extension
path:
  v: AllergyIntolerance.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: AllergyIntolerance.modifierExtension
path:
  v: AllergyIntolerance.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: AllergyIntolerance.identifier
path:
  v: AllergyIntolerance.identifier
short:
  v: External ids for this item
definition:
  v: Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
comment:
  v: This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
requirements:
  v: Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.
min:
  v: 0
max:
  v: *
base:
  path:
    v: AllergyIntolerance.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier
mapping:
  identity:
    v: v2
  map:
    v: IAM-7
mapping:
  identity:
    v: rim
  map:
    v: id

id:
  v: AllergyIntolerance.clinicalStatus
path:
  v: AllergyIntolerance.clinicalStatus
short:
  v: active | inactive | resolved
definition:
  v: The clinical status of the allergy or intolerance.
comment:
  v: Refer to [discussion](http://hl7.org/fhir/R4/extensibility.html#Special-Case) if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.clinicalStatus
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
condition:
  v: ait-1
condition:
  v: ait-2
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceClinicalStatus
  strength:
    v: required
  description:
    v: The clinical status of the allergy or intolerance.
  value set:
    v: http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status
mapping:
  identity:
    v: rim
  map:
    v: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value

id:
  v: AllergyIntolerance.verificationStatus
path:
  v: AllergyIntolerance.verificationStatus
short:
  v: unconfirmed | confirmed | refuted | entered-in-error
definition:
  v: Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).
comment:
  v: The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.verificationStatus
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
condition:
  v: ait-1
condition:
  v: ait-2
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceVerificationStatus
  strength:
    v: required
  description:
    v: Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
  value set:
    v: http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status
mapping:
  identity:
    v: rim
  map:
    v: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value

id:
  v: AllergyIntolerance.type
path:
  v: AllergyIntolerance.type
short:
  v: allergy | intolerance - Underlying mechanism (if known)
definition:
  v: Identification of the underlying physiological mechanism for the reaction risk.
comment:
  v: Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.
alias:
  v: Category
alias:
  v: Class
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceType
  strength:
    v: required
  description:
    v: Identification of the underlying physiological mechanism for a Reaction Risk.
  value set:
    v: http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: v2
  map:
    v: IAM-9
mapping:
  identity:
    v: rim
  map:
    v: code

id:
  v: AllergyIntolerance.category
path:
  v: AllergyIntolerance.category
short:
  v: food | medication | environment | biologic
definition:
  v: Category of the identified substance.
comment:
  v: This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to [search](http://hl7.org/fhir/R4/search.html) for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.
alias:
  v: Category
alias:
  v: Type
alias:
  v: Reaction Type
alias:
  v: Class
min:
  v: 0
max:
  v: *
base:
  path:
    v: AllergyIntolerance.category
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceCategory
  strength:
    v: required
  description:
    v: Category of an identified substance associated with allergies or intolerances.
  value set:
    v: http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class
mapping:
  identity:
    v: v2
  map:
    v: AL1-2
mapping:
  identity:
    v: rim
  map:
    v: value < IntoleranceValue (Agent)

id:
  v: AllergyIntolerance.criticality
path:
  v: AllergyIntolerance.criticality
short:
  v: low | high | unable-to-assess
definition:
  v: Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.
comment:
  v: The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.
alias:
  v: Severity
alias:
  v: Seriousness
alias:
  v: Contra-indication
alias:
  v: Risk
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.criticality
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceCriticality
  strength:
    v: required
  description:
    v: Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
  value set:
    v: http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.grade
mapping:
  identity:
    v: v2
  map:
    v: AL1-4
mapping:
  identity:
    v: rim
  map:
    v: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]

id:
  v: AllergyIntolerance.code
path:
  v: AllergyIntolerance.code
short:
  v: Code that identifies the allergy or intolerance
definition:
  v: Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.
comment:
  v: It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.
alias:
  v: Code
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.code
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  strength:
    v: preferred
  value set:
    v: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceValueSet
    link: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceValueSet
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.what[x]
mapping:
  identity:
    v: v2
  map:
    v: AL1-3 / IAM-3
mapping:
  identity:
    v: rim
  map:
    v: substance/product: .participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] negated/excluded substance/product: .participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType] positive or negated/excluded condition/situation: Observation.code=ASSERTION; Observation.value

id:
  v: AllergyIntolerance.patient
path:
  v: AllergyIntolerance.patient
short:
  v: Who the sensitivity is for
definition:
  v: The patient who has the allergy or intolerance.
alias:
  v: Patient
min:
  v: 1
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.patient
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://fhir.ch/ig/ch-ips/StructureDefinition/ch-ips-patient
    link: http://fhir.ch/ig/ch-ips/StructureDefinition/ch-ips-patient
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: v2
  map:
    v: (PID-3)
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=SBJ].role[classCode=PAT]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: AllergyIntolerance.encounter
path:
  v: AllergyIntolerance.encounter
short:
  v: Encounter when the allergy or intolerance was asserted
definition:
  v: The encounter when the allergy or intolerance was asserted.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.encounter
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Encounter
    link: http://hl7.org/fhir/StructureDefinition/Encounter
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.context
mapping:
  identity:
    v: rim
  map:
    v: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

id:
  v: AllergyIntolerance.onset[x]
path:
  v: AllergyIntolerance.onset[x]
short:
  v: When allergy or intolerance was identified
definition:
  v: Estimated or actual date, date-time, or age when allergy or intolerance was identified.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.onset[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
type:
  code:
    v: Age
type:
  code:
    v: Period
type:
  code:
    v: Range
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.init
mapping:
  identity:
    v: rim
  map:
    v: effectiveTime.low

id:
  v: AllergyIntolerance.recordedDate
path:
  v: AllergyIntolerance.recordedDate
short:
  v: Date first version of the resource instance was recorded
definition:
  v: The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.recordedDate
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded
mapping:
  identity:
    v: v2
  map:
    v: IAM-13
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=AUT].time

id:
  v: AllergyIntolerance.recorder
path:
  v: AllergyIntolerance.recorder
short:
  v: Who recorded the sensitivity
definition:
  v: Individual who recorded the record and takes responsibility for its content.
alias:
  v: Author
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.recorder
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-relatedperson
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-relatedperson
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.author
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=AUT].role

id:
  v: AllergyIntolerance.asserter
path:
  v: AllergyIntolerance.asserter
short:
  v: Source of the information about the allergy
definition:
  v: The source of the information about the allergy that is recorded.
comment:
  v: The recorder takes responsibility for the content, but can reference the source from where they got it.
alias:
  v: Source
alias:
  v: Informant
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.asserter
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient
  target profile:
    v: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-relatedperson
    link: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-relatedperson
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source
mapping:
  identity:
    v: v2
  map:
    v: IAM-14 (if patient) / IAM-18 (if practitioner)
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=INF].role

id:
  v: AllergyIntolerance.lastOccurrence
path:
  v: AllergyIntolerance.lastOccurrence
short:
  v: Date(/time) of last known occurrence of a reaction
definition:
  v: Represents the date and/or time of the last known occurrence of a reaction event.
comment:
  v: This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.lastOccurrence
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime

id:
  v: AllergyIntolerance.note
path:
  v: AllergyIntolerance.note
short:
  v: Additional text not captured in other fields
definition:
  v: Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.
comment:
  v: For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.
min:
  v: 0
max:
  v: *
base:
  path:
    v: AllergyIntolerance.note
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Annotation
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: subjectOf.observationEvent[code="annotation"].value

id:
  v: AllergyIntolerance.reaction
path:
  v: AllergyIntolerance.reaction
short:
  v: Adverse Reaction Events linked to exposure to substance
definition:
  v: Details about each adverse reaction event linked to exposure to the identified substance.
min:
  v: 0
max:
  v: *
base:
  path:
    v: AllergyIntolerance.reaction
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]

id:
  v: AllergyIntolerance.reaction.id
path:
  v: AllergyIntolerance.reaction.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value: url
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: AllergyIntolerance.reaction.extension
path:
  v: AllergyIntolerance.reaction.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:certainty
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: certainty
short:
  v: Certainty that the substance was the cause of the manifestation
definition:
  v: Statement about the degree of clinical certainty that the specific substance was the cause of the manifestation in this reaction event.
comment:
  v: When certainty is missing, it means no information exists (although it could be in narrative). By contrast, the unknown code is used when there is an explicit assertion that certainty is not known, such as when a patient eats a meal and it is unknown which food caused the reaction.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/allergyintolerance-certainty|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: uncertaintyCode

id:
  v: AllergyIntolerance.reaction.extension:duration
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: duration
short:
  v: How long Manifestations persisted
definition:
  v: The amount of time that the Adverse Reaction persisted.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/allergyintolerance-duration|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:location
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: location
short:
  v: Body site of manifestations
definition:
  v: The anatomical location / body site(s) where the symptoms manifested.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/openEHR-location|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:exposureDate
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: exposureDate
short:
  v: Date(/time) of first exposure to Substance
definition:
  v: Record of the date and/or time of the first exposure to the Substance for this Reaction Event.
comment:
  v: Exposure can be more complicated by more than one exposure events leading to a reaction. Further details about the nature of the exposure can be provided in additional extensions, or as text in the Exposure Description extension.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/openEHR-exposureDate|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:exposureDuration
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: exposureDuration
short:
  v: Amount of time individual was exposed to Substance
definition:
  v: The amount of time the individual was exposed to the Substance.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/openEHR-exposureDuration|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:exposureDescription
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: exposureDescription
short:
  v: Text description about exposure to the Substance
definition:
  v: Text description about exposure to the Substance.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/openEHR-exposureDescription|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.extension:management
path:
  v: AllergyIntolerance.reaction.extension
slice name:
  v: management
short:
  v: Clinical Management Description
definition:
  v: Text description about the clinical management provided.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: http://hl7.org/fhir/StructureDefinition/openEHR-management|5.2.0
    link: 5.2
    link: .0
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: AllergyIntolerance.reaction.modifierExtension
path:
  v: AllergyIntolerance.reaction.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: AllergyIntolerance.reaction.substance
path:
  v: AllergyIntolerance.reaction.substance
short:
  v: Specific substance or pharmaceutical product considered to be responsible for event
definition:
  v: Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.
comment:
  v: Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.reaction.substance
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: preferred
  value set:
    v: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceReactionSubstanceValueSet
    link: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceReactionSubstanceValueSet
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]

id:
  v: AllergyIntolerance.reaction.manifestation
path:
  v: AllergyIntolerance.reaction.manifestation
short:
  v: Clinical symptoms/signs associated with the Event
definition:
  v: Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.
comment:
  v: Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.
alias:
  v: Symptoms
alias:
  v: Signs
min:
  v: 1
max:
  v: *
base:
  path:
    v: AllergyIntolerance.reaction.manifestation
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  strength:
    v: preferred
  value set:
    v: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceReactionManifestationValueSet
    link: http://fhir.ch/ig/ch-allergyintolerance/ValueSet/CHAllergyIntoleranceReactionManifestationValueSet
mapping:
  identity:
    v: v2
  map:
    v: AL1-5
mapping:
  identity:
    v: rim
  map:
    v: code

id:
  v: AllergyIntolerance.reaction.description
path:
  v: AllergyIntolerance.reaction.description
short:
  v: Description of the event as a whole
definition:
  v: Text description about the reaction as a whole, including details of the manifestation if required.
comment:
  v: Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.
alias:
  v: Narrative
alias:
  v: Text
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.reaction.description
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: text

id:
  v: AllergyIntolerance.reaction.onset
path:
  v: AllergyIntolerance.reaction.onset
short:
  v: Date(/time) when manifestations showed
definition:
  v: Record of the date and/or time of the onset of the Reaction.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.reaction.onset
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: v2
  map:
    v: AL1-6
mapping:
  identity:
    v: rim
  map:
    v: effectiveTime.low

id:
  v: AllergyIntolerance.reaction.severity
path:
  v: AllergyIntolerance.reaction.severity
short:
  v: mild | moderate | severe (of event as a whole)
definition:
  v: Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.
comment:
  v: It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.reaction.severity
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: AllergyIntoleranceSeverity
  strength:
    v: required
  description:
    v: Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
  value set:
    v: http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: rim
  map:
    v: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]

id:
  v: AllergyIntolerance.reaction.exposureRoute
path:
  v: AllergyIntolerance.reaction.exposureRoute
short:
  v: How the subject was exposed to the substance
definition:
  v: Identification of the route by which the subject was exposed to the substance.
comment:
  v: Coding of the route of exposure with a terminology should be used wherever possible.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: AllergyIntolerance.reaction.exposureRoute
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value: string
      v: RouteOfAdministration
  strength:
    v: example
  description:
    v: A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
  value set:
    v: http://hl7.org/fhir/ValueSet/route-codes
    link: http://hl7.org/fhir/ValueSet/route-codes
mapping:
  identity:
    v: rim
  map:
    v: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode

id:
  v: AllergyIntolerance.reaction.note
path:
  v: AllergyIntolerance.reaction.note
short:
  v: Text about event not captured in other fields
definition:
  v: Additional text about the adverse reaction event not captured in other fields.
comment:
  v: Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.
min:
  v: 0
max:
  v: *
base:
  path:
    v: AllergyIntolerance.reaction.note
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Annotation
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: subjectOf.observationEvent[code="annotation"].value

element:
  id:
    v: AllergyIntolerance
  path:
    v: AllergyIntolerance
  short:
    v: CH IPS AllergyIntolerance
element:
  id:
    v: AllergyIntolerance.patient
  path:
    v: AllergyIntolerance.patient
  type:
    code:
      v: Reference
    target profile:
      v: http://fhir.ch/ig/ch-ips/StructureDefinition/ch-ips-patient
      link: http://fhir.ch/ig/ch-ips/StructureDefinition/ch-ips-patient