2015May core #124 - The movement of sunlight out of this resource directly is different than the design in C-CDA design.

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    • Type: Change Request
    • Resolution: Not Persuasive with Modification
    • Priority: Low
    • FHIR Core (FHIR)
    • DSTU1 [deprecated]
    • Patient Care
    • AllergyIntolerance
    • 4.1
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      Per Russ Leftwich (with edits):

      Most clinicians would not enter sunlight sensitivity on the allergy list but rather on the problem list. Same with other physical stimuli which can produce an adverse reaction, usually hives.

      The allergy list exists to inform decision support, whether human or computer decision support, and is therefore tied to ordering or other clinical behavior; ordering medications or nutrition and use of devices and medical materials. A publication last year showed a drug-allergy override rate of 90%. Cluttering the list with things like sunlight is just going to aggravate the already high risk of alert fatigue.

      A true reaction to sunlight that is not photosensitivity (which is a side effect of some antibiotics and other drugs) is rare. Most of those that do exist are secondary to some other condition, such as porphyria, dietary peculiarity (unusual amounts of certain vegetables or treatment. Not things that belong on the Allergy List, since they are not a property of the individual.

      What is more, most allergies on the list are asserted by the patient. Too many fair complexioned patients are going to assert that they are "allergic to the sun" and this is just more clutter and overhead.

      Will replace the existing sentence with:

      The Allergy/Intolerance List exists as a patient safety tool to inform decision support around ordering of medications and nutrition and to guide clinical treatment. Other reactions triggered by physical stimuli – light, heat, cold, pressure, vibration, which may mimic allergic or intolerance reactions, should be recorded as Conditions on the problem list, not using AllergyIntolerance.

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      Per Russ Leftwich (with edits): Most clinicians would not enter sunlight sensitivity on the allergy list but rather on the problem list. Same with other physical stimuli which can produce an adverse reaction, usually hives. The allergy list exists to inform decision support, whether human or computer decision support, and is therefore tied to ordering or other clinical behavior; ordering medications or nutrition and use of devices and medical materials. A publication last year showed a drug-allergy override rate of 90%. Cluttering the list with things like sunlight is just going to aggravate the already high risk of alert fatigue. A true reaction to sunlight that is not photosensitivity (which is a side effect of some antibiotics and other drugs) is rare. Most of those that do exist are secondary to some other condition, such as porphyria, dietary peculiarity (unusual amounts of certain vegetables or treatment. Not things that belong on the Allergy List, since they are not a property of the individual. What is more, most allergies on the list are asserted by the patient. Too many fair complexioned patients are going to assert that they are "allergic to the sun" and this is just more clutter and overhead. Will replace the existing sentence with: The Allergy/Intolerance List exists as a patient safety tool to inform decision support around ordering of medications and nutrition and to guide clinical treatment. Other reactions triggered by physical stimuli – light, heat, cold, pressure, vibration, which may mimic allergic or intolerance reactions, should be recorded as Conditions on the problem list, not using AllergyIntolerance.
    • Russ/Rob: 7-0-0
    • Clarification
    • Non-substantive
    • DSTU1 [deprecated]

      Existing Wording: Not to be used for recording physiological reactions to physical agents, such as heat, cold, sunlight, vibration, exercise activity, by infectious agents or food contaminants. Use Condition instead

      Proposed Wording: N/A

      Comment:

      The movement of sunlight out of this resource directly is different than the design in C-CDA design.

      How did you decide to make this change? Did you consider where EHRs record this information?

            Assignee:
            Unassigned
            Reporter:
            Brett Marquard
            Brett Marquard
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: