Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512

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    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • FHIR Core (FHIR)
    • DSTU2
    • Patient Care
    • AllergyIntolerance
    • (profiles)
    • AllergyIntolerance.r
    • Hide

      1) Add the same note to both AllergyIntolerance.code and AllergyIntolerance.reaction.substance as follows:

      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.

      2) In AllergyIntolerance.code, fix UNII misspelling and remove "CPT" reference from the definition.

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      1) Add the same note to both AllergyIntolerance.code and AllergyIntolerance.reaction.substance as follows: 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. 2) In AllergyIntolerance.code, fix UNII misspelling and remove "CPT" reference from the definition.
    • Rob M/Stephen: 6-0-1
    • Correction
    • Non-substantive
    • DSTU2

      Existing Wording: AllergyIntolerance.code and AllergyIntolerance.reaction.substance overlap significantly.

      Comment:

      While I understand the difficulty in forcing seperation of a clinical condition from the substance involved in that condition, it must be done I think. If a condition concept (finding) that includes the substance is used, then the model must enforce that substance also coded is = or a subtype. If the model can not enforce this then I question the value of allowing the substance to be identified in both places. Consider restricting the condition concept allowed in AllergyIntolerance.code to those without a substance embedded and then represent the substance in AllergyIntolerance.reaction.substance.

      Summary:

      Substance identified in both AllergyIntolerance.code and reaction.substance is problematic

            Assignee:
            Unassigned
            Reporter:
            Rob McClure
            Rob McClure
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: