KjAllergyIntolerance
The KjAllergyIntolerance is used for registration of allergies or other reactions that are critical in an emergency medical context.
Adverse drug reactions can be reported on:
ATC (Anatomical Therapeutic Chemical Classification System)
Drug brand/trademark name
Excipent (inactive substance) in the drug
Active ingredient in the drug
Profile elements
https://simplifier.net/kjernejournalr4/kjallergyintolerance
| Element | Description | Comment |
|---|---|---|
| id | Record id | id + meta.versionId is the unique identifier |
| meta.versionId | Record version id | |
| clinicalStatus | active | inactive | Inactive if refuted or entered-in-error, otherwise active |
| verificationStatus | Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. | |
| verificationStatus.extension.Presumed | Boolean extension to set verification status to “presumed” | Presumed will in R5 be added to the valueset for verificationStatus |
| category | food | medication | environment| biologic | ‘medication’ shall be used for medication allergies, and typically ´environment´ is used for other allergies |
| criticality | low | high | |
| code.coding | Code for allergy. | Additional coding may be used for extra information. I.e. the ATC code for drug trade name (not userSelected). |
| code.coding.userSelected | If this coding was chosen directly by the user | If more than one coding, userSelected shall indicate the main coding. See code example below. |
| code.extension.inactiveIngredient | Boolean extension if inactive ingredient (hjelpestoffreaksjon) | |
| code.text | Other allergy if no proper code is found | |
| patient | Who the sensitivity is for | |
| onset | Estimated or actual date, date-time, or age when allergy or intolerance was identified. | |
| recordedDate | Date when first version of the resource instance was recorded | |
| recorder | Who recorded the sensitivity first. Must always reference the original recorder of the resource. | Use contained reference. The recorder reference id must not be named 'updaterRef'. |
| note | Additional text not captured in other fields | |
| reaction.manifestation.coding | Type of reaction | |
| extension.sourceOfInformation | Source of information | |
| extension.updater | Who changed this version of the resource | Use contained reference |
| extension.updatedDateTime | When this version of the resource was changed |
Examples
Category medication, coding ATC
{
"resourceType": "AllergyIntolerance",
"id": "be3e0de3-d4f1-4df7-b0c1-e723bc2cee7d",
"meta": {
"versionId": "1",
"lastUpdated": "2021-03-14T12:01:03.633+01:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Fos Perez, Jack"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "100100223"
},
"display": "Andeby Legevakt"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "2",
"display": "Observert av registrerende helsepersonell"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed",
"display": "Confirmed"
} ]
},
"category": [ "medication" ],
"criticality": "high",
"code": {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/ATC",
"code": "J01CA",
"display": "Penicilliner med utvidet spekter"
} ]
},
"patient": {
"reference": "Patient/13116900216"
},
"onsetDateTime": "2021-03-11T00:00:00+01:00",
"recordedDate": "2021-03-14T12:01:03+01:00",
"recorder": {
"reference": "#recorderRef"
},
"note": [ {
"text": "Akutt hevelse i tunge og svelg, tiltagende pusteproblemer, kvalme og abdominale smerter."
} ],
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "1",
"display": "Anafylaktisk reaksjon"
} ]
} ]
} ]
}
Categori medication, coding DrugTradeName with ATC code
{
"resourceType": "AllergyIntolerance",
"id": "d1fa603b-f62b-4f22-b7fa-da2a7aba852d",
"meta": {
"versionId": "1",
"lastUpdated": "2021-04-06T15:19:01.355+02:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "998570328"
},
"display": "Munkholmen Legesenter"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "5",
"display": "Hentet fra tidligere journal"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "unconfirmed",
"display": "Unconfirmed"
} ]
},
"category": [ "medication" ],
"criticality": "high",
"code": {
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjInactiveIngredient",
"valueBoolean": true
} ],
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/DrugTradeName",
"code": "ID_D31A34B4-705F-44D6-8232-92A89CA921B1",
"display": "Apocillin Tab",
"userSelected": true
}, {
"system": "http://nhn.no/kj/fhir/CodeSystem/ATC",
"code": "J01CE02",
"display": "Fenoksymetylpenicillin",
"userSelected": false
} ]
},
"patient": {
"reference": "Patient/01035500126"
},
"onsetDateTime": "2021-04-01T00:00:00+02:00",
"recordedDate": "2021-04-06T15:19:01+02:00",
"recorder": {
"reference": "#recorderRef"
},
"note": [ {
"text": "Fikk eksematøse reaksjoner som ble behandlet med lokale glukokortikoider pluss antihistaminer for behandling av urtikarielle reaksjoner."
} ],
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "10",
"display": "Alvorlig hudreaksjon"
} ]
} ]
} ]
}
Category medication, coding DrugtradeName and reaction on inactive ingredient
{
"resourceType": "AllergyIntolerance",
"id": "d1fa603b-f62b-4f22-b7fa-da2a7aba852d",
"meta": {
"versionId": "1",
"lastUpdated": "2021-04-06T15:19:01.355+02:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "998570328"
},
"display": "Munkholmen Legesenter"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "5",
"display": "Hentet fra tidligere journal"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "unconfirmed",
"display": "Unconfirmed"
} ]
},
"category": [ "medication" ],
"criticality": "high",
"code": {
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjInactiveIngredient",
"valueBoolean": true
} ],
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/DrugTradeName",
"code": "ID_D31A34B4-705F-44D6-8232-92A89CA921B1",
"display": "Apocillin Tab 660 mg"
} ]
},
"patient": {
"reference": "Patient/01035500126"
},
"onsetDateTime": "2021-04-01T00:00:00+02:00",
"recordedDate": "2021-04-06T15:19:01+02:00",
"recorder": {
"reference": "#recorderRef"
},
"note": [ {
"text": "Fikk eksematøse reaksjoner som ble behandlet med lokale glukokortikoider pluss antihistaminer for behandling av urtikarielle reaksjoner."
} ],
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "10",
"display": "Alvorlig hudreaksjon"
} ]
} ]
} ]
}
Category medication, coding ActiveSubstance
{
"resourceType": "AllergyIntolerance",
"id": "b61a2de9-dc38-40ea-94ee-634c2e206706",
"meta": {
"versionId": "1",
"lastUpdated": "2021-04-06T15:09:19.583+02:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "998570328"
},
"display": "Munkholmen Legesenter"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "1",
"display": "Resultat av tester / analyser"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed",
"display": "Confirmed"
} ]
},
"category": [ "medication" ],
"criticality": "high",
"code": {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/ActiveSubstance",
"code": "ID_ECA56300-5E51-4152-913D-A2EA6E83AD72",
"display": "Ibuprofen"
} ]
},
"patient": {
"reference": "Patient/01035500126"
},
"onsetAge": {
"value": 50,
"system": "http://unitsofmeasure.org",
"code": "a"
},
"recordedDate": "2021-04-06T15:09:19+02:00",
"recorder": {
"reference": "#recorderRef"
},
"note": [ {
"text": "Etter en hypersensivitetsreaksjon på et NSAID av immunologisk natur, bør pasienten aldri bruke et annet preparat som har en lignende kjemisk struktur. I dette tilfellet betyr det at pasienten skal unngå alle propionsyrederivater. Dersom man velger et preparat fra en annen gruppe, er det holdepunkter for at de mest COX-II spesifikke gir minst risiko for reaksjoner."
} ],
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "1",
"display": "Anafylaktisk reaksjon"
} ]
} ]
} ]
}
Categori environment, coding OtherAllergen
{
"resourceType": "AllergyIntolerance",
"id": "5dfa2ca1-27cd-4c89-be74-bc7d1dffb006",
"meta": {
"versionId": "1",
"lastUpdated": "2021-04-06T15:20:24.117+02:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "998570328"
},
"display": "Munkholmen Legesenter"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "7",
"display": "Opplyst av ansvarlig behandler"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed",
"display": "Confirmed"
} ]
},
"category": [ "environment" ],
"criticality": "high",
"code": {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/OtherAllergen",
"code": "5",
"display": "Fisk"
} ]
},
"patient": {
"reference": "Patient/01035500126"
},
"onsetAge": {
"value": 2,
"system": "http://unitsofmeasure.org",
"code": "a"
},
"recordedDate": "2021-04-06T15:20:24+02:00",
"recorder": {
"reference": "#recorderRef"
},
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "1",
"display": "Anafylaktisk reaksjon"
} ]
} ]
} ]
}
{
"resourceType": "AllergyIntolerance",
"id": "ed89cb10-5415-4676-bbd1-665019c5cdeb",
"meta": {
"versionId": "2",
"lastUpdated": "2021-04-22T17:04:47.552+02:00",
"profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
},
"contained": [ {
"resourceType": "PractitionerRole",
"id": "updaterRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "986664203"
},
"display": "Sjøsiden Legesenter"
},
"code": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
"code": "LE",
"display": "Lege"
} ]
} ]
}, {
"resourceType": "PractitionerRole",
"id": "recorderRef",
"practitioner": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.4",
"value": "222200063"
},
"display": "Tandberg, Gard"
},
"organization": {
"identifier": {
"system": "urn:oid:2.16.578.1.12.4.1.4.101",
"value": "998570328"
},
"display": "Munkholmen Legesenter"
}
} ],
"extension": [ {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdater",
"valueReference": {
"reference": "#updaterRef"
}
}, {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdatedDateTime",
"valueDateTime": "2021-04-22T17:04:47+02:00"
}, {
"url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
"valueCoding": {
"system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
"code": "3",
"display": "Pasientens egne opplysninger"
}
} ],
"clinicalStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
"code": "active",
"display": "Active"
} ]
},
"verificationStatus": {
"coding": [ {
"system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
"code": "confirmed",
"display": "Confirmed"
} ]
},
"category": [ "environment" ],
"criticality": "low",
"code": {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/OtherAllergen",
"code": "15",
"display": "Sellerirot- og pastinakk allergi "
} ]
},
"patient": {
"reference": "Patient/01035500126"
},
"onsetDateTime": "2021-04-07T00:00:00+02:00",
"recordedDate": "2021-04-06T15:26:27+02:00",
"recorder": {
"reference": "#recorderRef"
},
"note": [ {
"text": "Pasienten reagerer med kløe i munn og svelg ved inntak av sellerirot, samt magesmerter og diare. "
} ],
"reaction": [ {
"manifestation": [ {
"coding": [ {
"system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
"code": "13",
"display": "Oppkast, diaré, magesmerter"
} ]
} ]
} ]
}