StructureDefinition - Statements of Allergy or Intolerance to support exchange of digital health in Australia

[dtr-agency]

Prerequisites

• [X] I have searched open and closed issues to make sure it isn't already requested or reported
• [X] I have written a descriptive issue title

The issue / feature

Change description

Design and develop a set of materials that define a Clinical Information Object for Allergy or Intolerance for the electronic exchange of allergy and intolerance information between patients, healthcare providers, and between healthcare providers and the My Health Record system infrastructure in Australia.

What are the use cases we want to support?

• We want to be able to record that an allergy - which individual is this allergy information associated with, who recorded this, when was this recorded, allergy to what, manifestations and so forth
• We want to be able find out what allergies a specific individual has. This will just be a list of the allergies
• We should be able to supply the standard protocol in some computable format

Forming part of wider use cases

• This profile should also serve the purpose of providing a summary statement of an allergy or intolerance in general and may be a standalone statement for an individual, be an entry in an allergy list, be used in a Shared Medicines List or form part of an entirely different specification.
• This profile should support broad set of authoring roles including patient-entered data and provider-entered data.
• This profile should serve the purpose of all Continuity of Care specification use cases, e.g. Shared Health Summary, Event Summary, Discharge Summary, Specialist Letter, eReferral.

The key design aspects are that:

• the key information is captured with must supports / cardinality
• it can be standalone (doesn't' require a document wrapper or section to understand its context such as who is the patient etc.)
• not too much detail aka don't put must support everywhere as every item with must support on it requires a vendor to build in the capability to process
• support all known use cases
• is based on an AU Base profile that provides the common definition of concepts, extensions, terminology
• is as R5-proof as possible
• serves the following operations
  • Add (Create) an allergy for a patient
  • Update an allergy for a patient
  • Add (Create) allergies for a patient
  • Update an allergy(s) for a patient
  • Delete an allergy for a patient
  • Retrieve (Search) a patient's allergies, potentially extended by:
    • Allergy Type: latex, Labetalol allergy, ...
    • Allergy Category: food | medication | environment | biologic
    • Status of Allergy: active, resolved, ...
    • Clinical verification of Allergy: refuted, confirmed, unconfirmed, ...
    • Manifestations

Mockups

N/A

How awesome would it be?

Fundamentally awesome - this is the basis of the Agency concept of an allergy or intolernce in R4 FHIR in clinical data exchange including terminology, etc. This contributes to the basic foundation for interoperability, re-use, and optimisation.

Workarounds

N/A

Additional context

AU Base Allergy Intolerance

As part of the development of this profile we need to ensure:

• the R4 HL7 AU Base content used complete and correct - profile | extensions | terminology | namespaces
  • only necessary and sufficient content is present and it is all correct - is everything we need present; is there anything included that we DO NOT want in HL7 AU Base
  • issues that cannot be resolved quickly are raised in HL7 AU GitHub
  • QA for spelling and grammar,
  • ok against HL7 AU metadata conventions
  • tested invariant FHIRPath and tested the profile with examples
• design page(s) for R4 AllergyIntolerance profile(s) are established
• R4 AllergyIntolerance profile is included in the applicable existing FHIR IGs in ci-fhir-r4 (currently only Event Summary)
  • the profile(s) conform to the metadata conventions
• R4 AllergyIntolerance profile has at least 5 examples that conform to the profile
  • the examples conform to the contentions and principles for examples
  • the examples are linked to on the Examples tab for the applicable profiles in the FHIR IG(s)

Backlog story: https://jira.digitalhealth.gov.au/browse/CIFMM-2575

[dtr-agency]

ADHA Core AllergyIntolerance in progress.