Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

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.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

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.

Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.

An Extension

The date or estimated date that the allergy or intolerance resolved. This is called abatement because of the many overloaded connotations associated with resolution.

Hier wird angegeben, bis wann der/die Patient:in die Allergie/Unverträglichkeit hatte. Bei einer fortbestehenden Diagnose/Erkrankung ist diese Angabe nicht zu übermitteln.

Begründung MS: Das Enddatum der Allergie/Unverträglichkeit ist für die klinische Bewertung der aktuellen Relevanz und die Priorisierung von Warnhinweisen essenziell. Es ermöglicht die Unterscheidung zwischen aktiven und zurückliegenden Allergien, was insbesondere in Medikations- und Entscheidungsunterstützungsprozessen von großer Bedeutung ist.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Diese Variante erlaubt es, das klinisch relevante Enddatum als exakten Zeitstempel zu übertragen, wie er in Primärsystemen üblich dokumentiert wird. Ein präzises Datum ist die belastbarste Grundlage für die Bewertung, ob eine Allergie/Unverträglichkeit noch aktuell relevant ist.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Für lang zurückliegende oder anamnestisch erhobene Allergien/Unverträglichkeiten ist das Ende häufig nur als Lebensalter der/des Patient:in dokumentiert. Diese Variante verhindert Informationsverlust, wenn kein exaktes Enddatum vorliegt.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Ist das Ende zeitlich nicht exakt eingrenzbar, ermöglicht die Angabe einer Altersspanne dennoch eine medizinisch verwertbare zeitliche Einordnung der zurückliegenden Allergie/Unverträglichkeit.

Lebensphase als kodierte Information angegeben, bis zu der der/die Patient:in die Allergie/Unverträglichkeit hatte.

Begründung MS: Ist auch eine Altersspanne nicht bezifferbar, erlaubt die kodierte Lebensphase (z. B. Kindheit, Erwachsenenalter) eine grobe, aber klinisch nachvollziehbare Einordnung des Endes der Allergie/Unverträglichkeit.

The low limit. The boundary is inclusive.

Begründung MS: Die Untergrenze grenzt den frühesten Zeitpunkt ein, ab dem die Allergie/Unverträglichkeit nicht mehr bestand, und ist für die Interpretation der Altersspanne unverzichtbar.

The high limit. The boundary is inclusive.

Begründung MS: Die Obergrenze grenzt den spätesten Zeitpunkt ein, bis zu dem die Allergie/Unverträglichkeit noch relevant gewesen sein kann, und ist für die Interpretation der Altersspanne unverzichtbar.

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).

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.

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.

The clinical status of the allergy or intolerance.

Begründung MS: Der klinische Status ist notwendig, um aktive gegenüber zurückliegenden Allergien unterscheiden und in Medikations- sowie Entscheidungsunterstützungsprozessen korrekt berücksichtigen zu können.

The clinical status of the allergy or intolerance.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

Begründung MS: Der Verifizierungsstatus macht transparent, ob eine Meldung bestätigt, widerlegt oder noch im Verdacht ist und ist Voraussetzung für belastbare AMTS-Prüfungen.

Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

Identification of the underlying physiological mechanism for the reaction risk.

Begründung MS: Gibt die Unterscheidung zwischen Allergie und Unverträglichkeit an.

Identification of the underlying physiological mechanism for a Reaction Risk.

Category of the identified substance.

Begründung MS: Die Kategorie erlaubt das Filtern, z. B. nach Arzneimittel-, Lebensmittel- oder Umweltallergien, und unterstützt zielgerichtete Warn- und Recherchefunktionen.

Category of an identified substance associated with allergies or intolerances.

Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.

Begründung MS: Die Kritikalität beschreibt das erwartete Risiko bei erneuter Exposition und dient der Priorisierung von Warnhinweisen.

Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

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.

Begründung Pflichtfeld: Nur mit einer codierten oder textuell benannten Auslösersubstanz lässt sich die Allergie klinisch interpretieren und für Interaktionsprüfungen nutzen.

Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

The patient who has the allergy or intolerance.

Begründung Must-Support: Ein Patientenbezug der AllergieUnverträglichkeit MUSS stets zum Zwecke der Nachvollziehbarkeit und Datenintegrität vorliegen.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

The encounter when the allergy or intolerance was asserted.

Begründung Must-Support: Ein Aufenthaltsbezug der Allergie MUSS zum Zwecke der Nachvollziehbarkeit und Datenintegrität exponiert und empfangen werden können.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

Estimated or actual date, date-time, or age when allergy or intolerance was identified.

Begründung MS: Der dokumentierte Beginn unterstützt die medizinische Bewertung, ob eine Allergie aktuell relevant ist, und wird in CapabilityStatements als Suchparameter gefordert.

Estimated or actual date, date-time, or age when allergy or intolerance was identified.

Begründung MS: Diese Variante erlaubt es, den Beginn als exakten Zeitstempel zu übertragen, wie er in Primärsystemen üblich ist.

Estimated or actual date, date-time, or age when allergy or intolerance was identified.

Begründung MS: Für lang zurückliegende Ereignisse wird der Beginn häufig nur als Alter dokumentiert

Estimated or actual date, date-time, or age when allergy or intolerance was identified.

Begründung MS: Steht keine strukturierte Angabe zur Verfügung, verhindert eine Freitextbeschreibung des Beginns Informationsverlust.

The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.

Begründung MS: Der Dokumentationszeitpunkt ist wichtig für Verlauf, Audits und Suchfunktionen nach frisch erfassten Allergien.

Individual who recorded the record and takes responsibility for its content.

Begründung MS: Die dokumentierende Person ermöglicht fachliche Rückfragen und unterstützt nachvollziehbare Verantwortungsketten.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The source of the information about the allergy that is recorded.

Begründung MS: Die feststellende Person oder Rolle macht die klinische Verantwortlichkeit transparent.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

Begründung MS: Anmerkungen transportieren kontextuelle Details (z. B. individuelle Auslöser oder Maßnahmen), die in Codes nicht erfasst werden können.

The individual responsible for making the annotation.

Organization is used when there's no need for specific attribution as to who made the comment.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Indicates when this particular annotation was made.

The text of the annotation in markdown format.

Details about each adverse reaction event linked to exposure to the identified substance.

Begründung MS: Die beobachtete Reaktion ist für die klinische Bewertung der Gefährdung essenziell und Grundlage für Entscheidungshilfen.

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).

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.

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.

Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

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.

Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

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.

Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

Identification of the route by which the subject was exposed to the substance.

Coding of the route of exposure with a terminology should be used wherever possible.

A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.

Hier wird angegeben, bis wann der/die Patient:in die Allergie/Unverträglichkeit hatte. Bei einer fortbestehenden Diagnose/Erkrankung ist diese Angabe nicht zu übermitteln.

Begründung MS: Das Enddatum der Allergie/Unverträglichkeit ist für die klinische Bewertung der aktuellen Relevanz und die Priorisierung von Warnhinweisen essenziell. Es ermöglicht die Unterscheidung zwischen aktiven und zurückliegenden Allergien, was insbesondere in Medikations- und Entscheidungsunterstützungsprozessen von großer Bedeutung ist.

Begründung MS: Diese Variante erlaubt es, das klinisch relevante Enddatum als exakten Zeitstempel zu übertragen, wie er in Primärsystemen üblich dokumentiert wird. Ein präzises Datum ist die belastbarste Grundlage für die Bewertung, ob eine Allergie/Unverträglichkeit noch aktuell relevant ist.

Begründung MS: Für lang zurückliegende oder anamnestisch erhobene Allergien/Unverträglichkeiten ist das Ende häufig nur als Lebensalter der/des Patient:in dokumentiert. Diese Variante verhindert Informationsverlust, wenn kein exaktes Enddatum vorliegt.

Begründung MS: Ist das Ende zeitlich nicht exakt eingrenzbar, ermöglicht die Angabe einer Altersspanne dennoch eine medizinisch verwertbare zeitliche Einordnung der zurückliegenden Allergie/Unverträglichkeit.

Lebensphase als kodierte Information angegeben, bis zu der der/die Patient:in die Allergie/Unverträglichkeit hatte.

Begründung MS: Ist auch eine Altersspanne nicht bezifferbar, erlaubt die kodierte Lebensphase (z. B. Kindheit, Erwachsenenalter) eine grobe, aber klinisch nachvollziehbare Einordnung des Endes der Allergie/Unverträglichkeit.

Begründung MS: Die Untergrenze grenzt den frühesten Zeitpunkt ein, ab dem die Allergie/Unverträglichkeit nicht mehr bestand, und ist für die Interpretation der Altersspanne unverzichtbar.

Begründung MS: Die Obergrenze grenzt den spätesten Zeitpunkt ein, bis zu dem die Allergie/Unverträglichkeit noch relevant gewesen sein kann, und ist für die Interpretation der Altersspanne unverzichtbar.

Begründung MS: Der klinische Status ist notwendig, um aktive gegenüber zurückliegenden Allergien unterscheiden und in Medikations- sowie Entscheidungsunterstützungsprozessen korrekt berücksichtigen zu können.

Begründung MS: Der Verifizierungsstatus macht transparent, ob eine Meldung bestätigt, widerlegt oder noch im Verdacht ist und ist Voraussetzung für belastbare AMTS-Prüfungen.

Begründung MS: Gibt die Unterscheidung zwischen Allergie und Unverträglichkeit an.

Begründung MS: Die Kategorie erlaubt das Filtern, z. B. nach Arzneimittel-, Lebensmittel- oder Umweltallergien, und unterstützt zielgerichtete Warn- und Recherchefunktionen.

Begründung MS: Die Kritikalität beschreibt das erwartete Risiko bei erneuter Exposition und dient der Priorisierung von Warnhinweisen.

Begründung Pflichtfeld: Nur mit einer codierten oder textuell benannten Auslösersubstanz lässt sich die Allergie klinisch interpretieren und für Interaktionsprüfungen nutzen.

Begründung Must-Support: Ein Patientenbezug der AllergieUnverträglichkeit MUSS stets zum Zwecke der Nachvollziehbarkeit und Datenintegrität vorliegen.

Begründung MS: Die Verlinkung auf eine Patienten-Ressource dient der technischen Zuordnung der Dokumentation zu einem Patienten und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKPatient sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

Begründung Must-Support: Ein Aufenthaltsbezug der Allergie MUSS zum Zwecke der Nachvollziehbarkeit und Datenintegrität exponiert und empfangen werden können.

Begründung MS: Die Verlinkung auf eine Encounter-Ressource dient der technischen Zuordnung der Dokumentation zu einem Aufenthalt und ermöglicht wichtige API-Funktionen wie verkettete Suche, (Reverse-)Include etc. Im ISik Kontext MUSS die referenzierte Ressource konform zu ISiKKontaktGesundheitseinrichtung sein. Jenseits von ISiK KÖNNEN weitere Instanzen mit anderen Profilen referenziert werden.

Begründung MS: Der dokumentierte Beginn unterstützt die medizinische Bewertung, ob eine Allergie aktuell relevant ist, und wird in CapabilityStatements als Suchparameter gefordert.

Begründung MS: Diese Variante erlaubt es, den Beginn als exakten Zeitstempel zu übertragen, wie er in Primärsystemen üblich ist.

Begründung MS: Für lang zurückliegende Ereignisse wird der Beginn häufig nur als Alter dokumentiert

Begründung MS: Steht keine strukturierte Angabe zur Verfügung, verhindert eine Freitextbeschreibung des Beginns Informationsverlust.

Begründung MS: Der Dokumentationszeitpunkt ist wichtig für Verlauf, Audits und Suchfunktionen nach frisch erfassten Allergien.

Begründung MS: Die dokumentierende Person ermöglicht fachliche Rückfragen und unterstützt nachvollziehbare Verantwortungsketten.

Begründung MS: Die feststellende Person oder Rolle macht die klinische Verantwortlichkeit transparent.

Begründung MS: Anmerkungen transportieren kontextuelle Details (z. B. individuelle Auslöser oder Maßnahmen), die in Codes nicht erfasst werden können.

Begründung MS: Die beobachtete Reaktion ist für die klinische Bewertung der Gefährdung essenziell und Grundlage für Entscheidungshilfen.

Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

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.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

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.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

When the resource last changed - e.g. when the version changed.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

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.

Begründung Constraint: In ISiK existiert kein Use-Case für dieses Element. Da es sich um ein Modifying Element handelt, wird es daher ausgeschlossen. Darüber hinaus werden die Regeln als URI vorgehalten. Dies führt dazu, dass sich hinter der URI eine beliebige Menge an Regeln befinden kann; wodurch nicht sichergestellt werden kann, dass alle Clients die Regeln korrekt interpretieren können.

The base language in which the resource is written.

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).

A human language.

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.

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.

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.

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.

An Extension

The date or estimated date that the allergy or intolerance resolved. This is called abatement because of the many overloaded connotations associated with resolution.

Hier wird angegeben, bis wann der/die Patient:in die Allergie/Unverträglichkeit hatte. Bei einer fortbestehenden Diagnose/Erkrankung ist diese Angabe nicht zu übermitteln.

Begründung MS: Das Enddatum der Allergie/Unverträglichkeit ist für die klinische Bewertung der aktuellen Relevanz und die Priorisierung von Warnhinweisen essenziell. Es ermöglicht die Unterscheidung zwischen aktiven und zurückliegenden Allergien, was insbesondere in Medikations- und Entscheidungsunterstützungsprozessen von großer Bedeutung ist.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Diese Variante erlaubt es, das klinisch relevante Enddatum als exakten Zeitstempel zu übertragen, wie er in Primärsystemen üblich dokumentiert wird. Ein präzises Datum ist die belastbarste Grundlage für die Bewertung, ob eine Allergie/Unverträglichkeit noch aktuell relevant ist.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Für lang zurückliegende oder anamnestisch erhobene Allergien/Unverträglichkeiten ist das Ende häufig nur als Lebensalter der/des Patient:in dokumentiert. Diese Variante verhindert Informationsverlust, wenn kein exaktes Enddatum vorliegt.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Begründung MS: Ist das Ende zeitlich nicht exakt eingrenzbar, ermöglicht die Angabe einer Altersspanne dennoch eine medizinisch verwertbare zeitliche Einordnung der zurückliegenden Allergie/Unverträglichkeit.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

Lebensphase als kodierte Information angegeben, bis zu der der/die Patient:in die Allergie/Unverträglichkeit hatte.

Begründung MS: Ist auch eine Altersspanne nicht bezifferbar, erlaubt die kodierte Lebensphase (z. B. Kindheit, Erwachsenenalter) eine grobe, aber klinisch nachvollziehbare Einordnung des Endes der Allergie/Unverträglichkeit.

The low limit. The boundary is inclusive.

Begründung MS: Die Untergrenze grenzt den frühesten Zeitpunkt ein, ab dem die Allergie/Unverträglichkeit nicht mehr bestand, und ist für die Interpretation der Altersspanne unverzichtbar.

The high limit. The boundary is inclusive.

Begründung MS: Die Obergrenze grenzt den spätesten Zeitpunkt ein, bis zu dem die Allergie/Unverträglichkeit noch relevant gewesen sein kann, und ist für die Interpretation der Altersspanne unverzichtbar.

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).

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.

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.

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.

This is a business identifier, not a resource identifier (see discussion). 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.

Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

The clinical status of the allergy or intolerance.

Begründung MS: Der klinische Status ist notwendig, um aktive gegenüber zurückliegenden Allergien unterscheiden und in Medikations- sowie Entscheidungsunterstützungsprozessen korrekt berücksichtigen zu können.

The clinical status of the allergy or intolerance.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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.

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.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.