KjAllergyIntolerance

The KjAllergyIntolerance is used for registration of allergies or other reactions that are critical in an emergency medical context.

Adverse drug reactions can be reported on:

  • ATC (Anatomical Therapeutic Chemical Classification System)

  • Drug brand/trademark name

  • Excipent (inactive substance) in the drug

  • Active ingredient in the drug

Profile elements

https://simplifier.net/kjernejournalr4/kjallergyintolerance

Element Description Comment
id Record id id + meta.versionId is the unique identifier
meta.versionId Record version id
clinicalStatus active | inactive Inactive if refuted or entered-in-error, otherwise active
verificationStatus Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.
verificationStatus.extension.Presumed Boolean extension to set verification status to “presumed” Presumed will in R5 be added to the valueset for verificationStatus
category food | medication | environment| biologic ‘medication’ shall be used for medication allergies, and typically ´environment´ is used for other allergies
criticality low | high
code.coding Code for allergy. Additional coding may be used for extra information. I.e. the ATC code for drug trade name (not userSelected).
code.coding.userSelected If this coding was chosen directly by the user If more than one coding, userSelected shall indicate the main coding. See code example below.
code.extension.inactiveIngredient Boolean extension if inactive ingredient (hjelpestoffreaksjon)
code.text Other allergy if no proper code is found
patient Who the sensitivity is for
onset Estimated or actual date, date-time, or age when allergy or intolerance was identified.
recordedDate Date when first version of the resource instance was recorded
recorder Who recorded the sensitivity first Use contained reference
note Additional text not captured in other fields
reaction.manifestation.coding Type of reaction
extension.sourceOfInformation Source of information
extension.updater Who changed this version of the resource Use contained reference
extension.updatedDateTime When this version of the resource was changed

Examples

Category medication, coding ATC

{
  "resourceType": "AllergyIntolerance",
  "id": "be3e0de3-d4f1-4df7-b0c1-e723bc2cee7d",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-03-14T12:01:03.633+01:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Fos Perez, Jack"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "100100223"
      },
      "display": "Andeby Legevakt"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "2",
      "display": "Observert av registrerende helsepersonell"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ "medication" ],
  "criticality": "high",
  "code": {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/ATC",
      "code": "J01CA",
      "display": "Penicilliner med utvidet spekter"
    } ]
  },
  "patient": {
    "reference": "Patient/13116900216"
  },
  "onsetDateTime": "2021-03-11T00:00:00+01:00",
  "recordedDate": "2021-03-14T12:01:03+01:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "note": [ {
    "text": "Akutt hevelse i tunge og svelg, tiltagende pusteproblemer, kvalme og abdominale smerter."
  } ],
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "1",
        "display": "Anafylaktisk reaksjon"
      } ]
    } ]
  } ]
}

Categori medication, coding DrugTradeName with ATC code

{
  "resourceType": "AllergyIntolerance",
  "id": "d1fa603b-f62b-4f22-b7fa-da2a7aba852d",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-04-06T15:19:01.355+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "5",
      "display": "Hentet fra tidligere journal"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "unconfirmed",
      "display": "Unconfirmed"
    } ]
  },
  "category": [ "medication" ],
  "criticality": "high",
  "code": {
    "extension": [ {
      "url": "http://nhn.no/kj/fhir/StructureDefinition/KjInactiveIngredient",
      "valueBoolean": true
    } ],
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/DrugTradeName",
      "code": "ID_D31A34B4-705F-44D6-8232-92A89CA921B1",
      "display": "Apocillin Tab",
      "userSelected": true
    }, {
      "system": "http://nhn.no/kj/fhir/CodeSystem/ATC",
      "code": "J01CE02",
      "display": "Fenoksymetylpenicillin",
      "userSelected": false
    } ]
  },
  "patient": {
    "reference": "Patient/01035500126"
  },
  "onsetDateTime": "2021-04-01T00:00:00+02:00",
  "recordedDate": "2021-04-06T15:19:01+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "note": [ {
    "text": "Fikk eksematøse reaksjoner som ble behandlet med lokale glukokortikoider pluss antihistaminer for behandling av urtikarielle reaksjoner."
  } ],
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "10",
        "display": "Alvorlig hudreaksjon"
      } ]
    } ]
  } ]
}

Category medication, coding DrugtradeName and reaction on inactive ingredient

{
  "resourceType": "AllergyIntolerance",
  "id": "d1fa603b-f62b-4f22-b7fa-da2a7aba852d",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-04-06T15:19:01.355+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "5",
      "display": "Hentet fra tidligere journal"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "unconfirmed",
      "display": "Unconfirmed"
    } ]
  },
  "category": [ "medication" ],
  "criticality": "high",
  "code": {
    "extension": [ {
      "url": "http://nhn.no/kj/fhir/StructureDefinition/KjInactiveIngredient",
      "valueBoolean": true
    } ],
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/DrugTradeName",
      "code": "ID_D31A34B4-705F-44D6-8232-92A89CA921B1",
      "display": "Apocillin Tab 660 mg"
    } ]
  },
  "patient": {
    "reference": "Patient/01035500126"
  },
  "onsetDateTime": "2021-04-01T00:00:00+02:00",
  "recordedDate": "2021-04-06T15:19:01+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "note": [ {
    "text": "Fikk eksematøse reaksjoner som ble behandlet med lokale glukokortikoider pluss antihistaminer for behandling av urtikarielle reaksjoner."
  } ],
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "10",
        "display": "Alvorlig hudreaksjon"
      } ]
    } ]
  } ]
}

Category medication, coding ActiveSubstance

{
  "resourceType": "AllergyIntolerance",
  "id": "b61a2de9-dc38-40ea-94ee-634c2e206706",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-04-06T15:09:19.583+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "1",
      "display": "Resultat av tester / analyser"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ "medication" ],
  "criticality": "high",
  "code": {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/ActiveSubstance",
      "code": "ID_ECA56300-5E51-4152-913D-A2EA6E83AD72",
      "display": "Ibuprofen"
    } ]
  },
  "patient": {
    "reference": "Patient/01035500126"
  },
  "onsetAge": {
    "value": 50,
    "system": "http://unitsofmeasure.org",
    "code": "a"
  },
  "recordedDate": "2021-04-06T15:09:19+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "note": [ {
    "text": "Etter en hypersensivitetsreaksjon på et NSAID av immunologisk natur, bør pasienten aldri bruke et annet preparat som har en lignende kjemisk struktur. I dette tilfellet betyr det at pasienten skal unngå alle propionsyrederivater. Dersom man velger et preparat fra en annen gruppe, er det holdepunkter for at de mest COX-II spesifikke gir minst risiko for reaksjoner."
  } ],
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "1",
        "display": "Anafylaktisk reaksjon"
      } ]
    } ]
  } ]
}

Categori environment, coding OtherAllergen

{
  "resourceType": "AllergyIntolerance",
  "id": "5dfa2ca1-27cd-4c89-be74-bc7d1dffb006",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2021-04-06T15:20:24.117+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "7",
      "display": "Opplyst av ansvarlig behandler"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ "environment" ],
  "criticality": "high",
  "code": {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/OtherAllergen",
      "code": "5",
      "display": "Fisk"
    } ]
  },
  "patient": {
    "reference": "Patient/01035500126"
  },
  "onsetAge": {
    "value": 2,
    "system": "http://unitsofmeasure.org",
    "code": "a"
  },
  "recordedDate": "2021-04-06T15:20:24+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "1",
        "display": "Anafylaktisk reaksjon"
      } ]
    } ]
  } ]
}
{
  "resourceType": "AllergyIntolerance",
  "id": "ed89cb10-5415-4676-bbd1-665019c5cdeb",
  "meta": {
    "versionId": "2",
    "lastUpdated": "2021-04-22T17:04:47.552+02:00",
    "profile": [ "http://nhn.no/kj/fhir/StructureDefinition/KjAllergyIntolerance" ]
  },
  "contained": [ {
    "resourceType": "PractitionerRole",
    "id": "updaterRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "986664203"
      },
      "display": "Sjøsiden Legesenter"
    },
    "code": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/CategoriesOfHealthProfessionals",
        "code": "LE",
        "display": "Lege"
      } ]
    } ]
  }, {
    "resourceType": "PractitionerRole",
    "id": "recorderRef",
    "practitioner": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.4.4",
        "value": "222200063"
      },
      "display": "Tandberg, Gard"
    },
    "organization": {
      "identifier": {
        "system": "urn:oid:2.16.578.1.12.4.1.2.101",
        "value": "998570328"
      },
      "display": "Munkholmen Legesenter"
    }
  } ],
  "extension": [ {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdater",
    "valueReference": {
      "reference": "#updaterRef"
    }
  }, {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjUpdatedDateTime",
    "valueDateTime": "2021-04-22T17:04:47+02:00"
  }, {
    "url": "http://nhn.no/kj/fhir/StructureDefinition/KjSourceOfInformation",
    "valueCoding": {
      "system": "http://nhn.no/kj/fhir/CodeSystem/SourceOfInformation",
      "code": "3",
      "display": "Pasientens egne opplysninger"
    }
  } ],
  "clinicalStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
      "code": "active",
      "display": "Active"
    } ]
  },
  "verificationStatus": {
    "coding": [ {
      "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
      "code": "confirmed",
      "display": "Confirmed"
    } ]
  },
  "category": [ "environment" ],
  "criticality": "low",
  "code": {
    "coding": [ {
      "system": "http://nhn.no/kj/fhir/CodeSystem/OtherAllergen",
      "code": "15",
      "display": "Sellerirot- og pastinakk allergi "
    } ]
  },
  "patient": {
    "reference": "Patient/01035500126"
  },
  "onsetDateTime": "2021-04-07T00:00:00+02:00",
  "recordedDate": "2021-04-06T15:26:27+02:00",
  "recorder": {
    "reference": "#recorderRef"
  },
  "note": [ {
    "text": "Pasienten reagerer med kløe i munn og svelg ved inntak av sellerirot, samt magesmerter og diare. "
  } ],
  "reaction": [ {
    "manifestation": [ {
      "coding": [ {
        "system": "http://nhn.no/kj/fhir/CodeSystem/TypeOfReaction",
        "code": "13",
        "display": "Oppkast,  diaré, magesmerter"
      } ]
    } ]
  } ]
}