The FHIR profiles used for the Allergies and Adverse Reactions Event Message Bundle
FHIR Profiles
The following FHIR profiles are used to form the Allergies and Adverse Reactions Event Message Bundle:
Bundle Structure
Specifies referencing within the Event Message Bundle.
Allergies and Adverse Reactions Event data item mapping to FHIR profiles
This Mapping table defines the FHIR elements that SHALL be used to encode the Healthy Child Event Specification data items for each DCH Event Message payload.
Some common data item mappings, such as patient, publisher or Date/Time of event information, are defined within the Header mapping table and SHALL be considered in parallel with the payload mapping.
The Child Health Event data items are fulfilled by elements within the FHIR resources listed below:
| DCH Data Item | FHIR resource element | Mandatory/
Required/
Optional | Notes |
|---|
| Date/Time Recorded | CareConnect-AllergyIntolerance-1.assertedDate | Mandatory | |
| Causative Agent | CareConnect-AllergyIntolerance-1.code | Required | Where a SNOMED CT code for a Causative Agent is not available, then code.text should be used to contain a text representation of the Causative Agent |
| Description of Reaction | CareConnect-AllergyIntolerance-1.reaction.manifestation.coding | Optional | When no code manifestation coded value is available, a description of the manifestation should be entered in manifestation.code.text |
| Type Of Reaction | CareConnect-AllergyIntolerance-1.type | Optional | |
| Certainty | CareConnect-AllergyIntolerance-1.verificationStatus | Optional | Use the mapping defined in the verificationStatus valueSet (http://hl7.org/fhir/ValueSet/allergy-verification-status) to find the actual values to flow). When no code for Certainty is available (or a more detailed certainty description is needed), a free text representation in CareConnect-AllergyIntolerance-1.note should be sent* |
| Severity | CareConnect-AllergyIntolerance-1.reaction.severity | Optional | Use the mapping defined in the CareConnect-ReactionEventSeverity-1 valueSet (https://fhir.hl7.org.uk/STU3/ValueSet/CareConnect-ReactionEventSeverity-1) to find the actual values to flow. When no code for Severity is available (or a more detailed severity description is needed), a free text representation in CareConnect-AllergyIntolerance-1.note should be sent* |
| Evidence | CareConnect-AllergyIntolerance-1.note* | Optional | |
| Date First Experienced | CareConnect-AllergyIntolerance-1.onset | Optional | |
| Comment | CareConnect-AllergyIntolerance-1.note* | Optional | |
*Rather than split descriptive and user entered text across a number of note fields the AllergyIntolerance.note element is used as the single notes field to convey all qualifiers and user-entered text associated with the allergy or intolerance in a single place. Qualifiers and values expressed as text MUST be appropriately labelled and formatted and where user notes have been entered against explicit fields such as certainty then appropriate labels MUST be used.
Resource Population Requirements and Guidance
The following requirements and resource population guidance should be followed in addition to the requirements and guidance outlined in the data item mapping above and in the Event Header requirements page.
| Resource Cardinality |
1..1 |
| Element |
Cardinality |
Additional Guidance |
| type |
1..1 |
Fixed value: message |
The Event-MessageHeader-1 resource included as part of the event message SHALL conform to the Event-MessageHeader-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 |
| Element |
Cardinality |
Additional Guidance |
| extension(messageEventType) |
1..1 |
|
| event |
1..1 |
Fixed Value: ‘allergies-and-adverse-reactions-1 | Allergies and Adverse Reactions’ |
| responsible |
1..1 |
This will reference the responsible Organization resource |
| focus |
1..1 |
This will reference the CareConnect-Encounter-1 resource which contains information relating to the event message. |
The CareConnect-Organization-1 resource included as part of the event message SHALL conform to the CareConnect-Organization-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..* |
| Element |
Cardinality |
Additional Guidance |
| identifier.system |
1..1 |
Fixed value: https://fhir.nhs.uk/Id/ods-organization-code |
| identifier.value |
1..1 |
Organisation’s ODS Organization Code |
| name |
1..1 |
Organisation’s Name |
The CareConnect-HealthcareService-1 resource included as part of the event message SHALL conform to the CareConnect-HealthcareService-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 |
| Element |
Cardinality |
Additional Guidance |
| providedBy |
1..1 |
This will reference the ‘sender’ organization of the event message. |
| type |
1..1 |
This will represent the type of service responsible for the event message. This will have a fixed value from the ValueSet CareConnect-CareSettingType-1 |
| specialty |
1..1 |
HealthcareService.specialty SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-Specialty-1 |
The CareConnect-Patient-1 resource included as part of the event message SHALL conform to the CareConnect-Patient-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 |
| Element |
Cardinality |
Additional Guidance |
| identifier |
1..1 |
Patient NHS Number SHALL be included within the nhsNumber identifier slice |
| name (official) |
1..1 |
Patients name as registered on PDS, included within the resource as the official name element slice |
| birthDate |
1..1 |
The patient birth date shall be included in the patient resource |
The CareConnect-Encounter-1 resource included as part of the event message SHALL conform to the CareConnect-Encounter-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..1 |
| Element |
Cardinality |
Additional Guidance |
| Encounter.type.coding(childHealthEncounterType) |
1..1 |
Encounter.type.coding(childHealthEncounterType) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-ChildHealthEncounterType-1 |
| Encounter.reason.coding(snomedCT) |
1..1 |
Encounter.reason.coding(snomedCT) SHALL use a value from https://fhir.nhs.uk/STU3/ValueSet/DCH-AdmissionReason-1 |
| serviceProvider |
1..1 |
This will reference the Organisation resource hosting the Encounter |
| location |
1..1 |
This will reference the Encounter’s Location |
| subject |
1..1 |
This will reference the patient resource representing the subject of this event |
The CareConnect-Location-1 resource included as part of the event message SHALL conform to the CareConnect-Location-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
0..1 |
The CareConnect-AllergyIntolerance-1 resource included as part of the event message SHALL conform to the CareConnect-AllergyIntolerance-1 constrained FHIR profile and the additional population guidance as per the table below:
| Resource Cardinality |
1..* |
| Element |
Cardinality |
Additional Guidance |
| patient |
1..1 |
This will reference the patient resource representing the subject of this event |
Allergies and Adverse Reactions Example
Profile Change Mappings for Allergies and Adverse Reactions
Profiles used in Demographics Update Event Messages 1.2.1-Release Candidate are replaced with:
| Demographic-Event-Messages |
Demographic-Event-Messages-CareConnect |
| DCH-Bundle-1 |
Bundle |
| DCH-MessageHeader-1 |
Event-MessageHeader-1 |
| CareConnect-Organization-1 |
CareConnect-Organization-1 |
| DCH-HealthcareService-1 |
CareConnect-HealthcareService-1 |
| CareConnect-DCH-Patient-1 |
CareConnect-Patient-1 |
| CareConnect-DCH-Encounter-1 |
CareConnect-Encounter-1 |
| CareConnect-Location-1 |
CareConnect-Location-1 |
| CareConnect-DCH-AllergyIntolerance-2 |
CareConnect-AllergyIntolerance-1 |
