Allergy Intolerance Models

Allergy/Exposure RMIM versions

Notes

Entrance point is a regular Concern Tracking structure.
The Concern has a subject of an allergy observation.
Like other observations, it has a recordTarget, activityTime, effectiveTime, author, informant, location, etc.
The code of the observation is to represent the type of observation. For example "True Allergy", "Intolerance", etc.
The allergy observation is a judgment by someone that an exposure to some substance is related to an adverse reaction.
The allergy observation (again, a judgment) has a uncertaintyCode. It may also be negated to indicate that the patient does note have an allergy to a particular substance.
The allergy observation may be made using formal techniques, or via simple history per the patient (for example -- patient statement "I was told not to take it when I was a child") This distinction may be recorded in the methodCode.

The allergen (the Causative Agent participant to the judgment) is not necessarily the same as the substance that was exposed. For example, the substance exposure may have been to percocet, but the judgment of the allergic material might be oxycodone and excluding the Tylenol since the patient was exposed Tylenol several times without adverse effect.
The reaction is a simple observation. It may have a severity.

The allergy observation may also have a serverity. This may be different than the reaction severity. Is this concern severity, or observation severity?
The observation (judgement) may be supported by test results such as a formal skin testing. This might be represented as an coded allergy test, which implies allergens, but doesn't specify reactions and other observations in this model per say. It may a simple code/value such as "PeanutAllergy:Yes"

Is this really needed, or should the support just be another allergy observation (a recursive link) with a different method code?