Allergy & Intolerance
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Contents
Allergy/Intolerance Project Meeting Minutes
Allergy/Intolerance Project Conference Calls and Meeting Minutes
Allergy/Intolerance and Adverse Reaction Projects
The Allergy/Intolerance and Adverse Reaction topic comprises a number of phases:
- Allergy and Intolerance Substance Value Set(s)Definition Informative Document
- HL7 FHIR Allergy and Intolerance Resource: http://www.hl7.org/fhir/allergyintolerance.html
- Allergy/Intolerance Domain Analysis phase, which aimed at producing a Domain Analysis Model (DAM)
- Allergy/Intolerance and Adverse Reaction clinical model development phase, which aims at producing of a set of HL7 clinical models DSTU to support exchanges of allergy/intolerance and adverse reaction information
- Implementation guide - project scope yet to be defined
- Harmonization of Allergy and Intolerance concepts in V3, C-CDA R1.1, C-CDA R2.0 and FHIR
Food substance sub-project
Food Substances Sub Group Project
Drug substance sub-project
Allergy & Intolerance Drug Sub-project
Leadership (project co-leads)
Elaine Ayres
Russ Leftwich
Stephen Chu
Allergy/Intolerance Topic Scope Statements
Current work: Create an Allergy and Intolerance Domain Analysis Model and Clinical Models (DSTU).
Project 881 (Domain Analysis Model) and Project 1004 (Clinical Models) This is a work in progress. See HL7 Ballot site for existing specification.
This topic covers all interactions related to clinically recorded adverse reactions, including:
- Recording adverse reactions
- Revising existing adverse reaction records
- Retrieving a patient's adverse reaction records
These transactions are not intended for reporting adverse reactions (as managed by Individual Case Safety Reports). Rather, these transactions are intended to be recorded as part of a patient's electronic health record. They supplement allergy and intolerance records for circumstances where it is not clear whether an allergy or intolerance exists. These interactions are crafted to support a 'request-based' architecture in which messages are sent from a point of service (POS) such as a clinic, pharmacy, etc. to a central drug information system (DIS). These messages are phrased as requests because the DIS reserves the right to refuse all requests. Reasons might include the presence of contraindications such as drug-drug interactions or duplicate therapy, as well as more mundane issues such as lack of permission, lack of recorded patient consent, etc.
Allergy/Intolerance Topic DSTU
The current "Allergy/Intolerance" topic DSTU expires in June 2012. The "Allergy/Intolerance" project group after some discussion recommends that application to HL7 publishing committee for a 12-month extension of the current DSTU should be considered as the best option forward. The 12-month extension will allow the group with time to perform proper DAM development and to determine how best the current DSTU may be modified and/or extended to meet updated, new requirements.
The following is DSTU extension guidance provided by HL7 HQ:
DSTU extension guidance is offered at the TSC wiki page under TSC Process Guidance, at: http://hl7t3f.org/wiki/index.php?title=DSTU_Publishing_Guidance, where requesting extensions to DSTU should use criteria determined in the TSC’s conference call 2009-03-09:
“Sufficient justification should be provided to describe effort in progress to move the standard towards a normative ballot, such as evidence of current trial activity, if they have a credible expectation that a normative document will be produced within a requested timeframe, given that trials are currently underway. The request must include the length of time required to extend the DSTU, including conclusion of the pilot and subsequent balloting activity...If you send the completed form to me (LynnL) I can put it on the TSC agenda.”
Domain Analysis Model (DAM)
Allergy/Intolerance DAM project is completed.
This is the artefact produced by the project:
Ballot reconciliation is complete for this DAM as of May 8, 2013. Final Domain Analysis Model will be published with changes.
To help with harmonization with FHIR resources, a recent (2014-10-30) discussion thread regarding Adverse Event v Adverse Reaction (to substance) v Propensity to Adverse Reaction (to substance) has emerged.
Ballot Reconciliation January 2013
Harmonization Activities and Related Materials
Allergy/Intolerance and Adverse Reaction Projects: Document Collection
The Allergy/Intolerance and Adverse Reaction projects produced a number of artefacts which can be accessed through the following links:
C-CDA Terminology Analysis for DAM and C-CDA r1.1 Harmonization Project:Terminology Analysis - Elaine Ayres June 2014
Presentations
- Proposal To Address Medications, Allergies Disparities In Final Rule MU Stage 2 (2012-10-03) Powerpoint.
- Allergy/Intolerance Concept Model Slides - Andre Boudreau (2012-02-03) updated 2012-01-03 Powerpoint.
- Allergy/Intolerance Concept Discussion Slides - Andre Boudreau (2011-12-20) updated 2012-01-03 Powerpoint.
- Allergy/Intolerance Topic Slides from Russ Leftwich, MD (2011-12-20) Powerpoint in PDF format.
- Canadian model on Allergy & Intolerance (2011-07-19) Powerpoint in PDF format.
2012 Use Cases and Storyboards
- Reported Food Intolerance (2012-4-17)
- Allergy List (2012-5-8)
- Allergy Not Asked (2012-7-11)
- Immunizations (2012-7-26)
- Allergy to Latex (2012-7-26)
- Medication Reaction (2012-7-11)
- Misattribution of Allergy to Nickel Knee Implant (2012-7-26)
- New Food Allergy (2012-4-17)
- No Known History of Allergy (2012-7-11)
- Unable to Determine Triggering Agent (2012-7-11)
- Patient PHR List (2012-10-9)
- Reported Preference(2012-10-9)
2013 Use Cases and Storyboards
Updated Allergy and Intolerance Glossary
Past Use Cases and Storyboards
- Allergy/Intolerance Topic Use Cases and Storyboard Summary (2011-08-30)
- From the old Ballot??
- Revised Draft 2007-May-23
Models
- Patient Care RMIM as of Jan 2007
- Patient Care RMIM as of May 2, 2007
- Updated Model as of May 22, 2007
Links to Other Relevant Projects
Structured Document WG: CDA Implementation Guilde Project on Clinical Oncology Treatment Plan and Summary:
http://wiki.hl7.org/index.php?title=Clinical_Oncology_Treatment_Plan_and_Summary