This page is part of the HL7 Belgium FHIR Implementation Guide - Allergy profiles (v1.1.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Guidance

Identifier

For exchange purposes the allergy record SHALL be provided with an UUID based identifier from the BeNSAllergy namespace.

Causes of the Allergy or Intolerance

The allergy or intolerance causes are divided in two categories

• medication related (see www.samportal.be)
• not medication related

The first group SHALL be indicated by using one of the following namespaces from the medication project:

• CNK code https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem-be-ns-cnk-codes
• ATC code http://whocc.no/atc
• CTI extended code https://www.ehealth.fgov.be/standards/fhir/medication/NamingSystem-be-ns-cti-extended-code

The second group SHALL be indicated by using a value from the BeAllergyIntoleranceCode

Allergy and intolerance types

The type of allergy or intolerance is expressed in the extension BeExtAllergyType and not in AllergyIntolerance.type. The AllergyIntolerance.type only allows two values, allergy or intolerance. Currently we recognize non allergic hypersensitivity. To avoid the use of duplicate or misaligned information, there shall be no value in AllergyIntolerance.type, so it is forbidden.
The Value Set for Allergy / Intolerance type is extensible, like in other value sets where SNOMED CT is used. This means that if an allergy type can be expressed using the provided SNOMED CT values, then these codes shall be used. Other codes may be used but only if the allergy type is not matching those provided.

Recorder

The recorder SHALL always be identified by at least a SSIN (SSIN bis) number. Additionally, in a contained resource, you can provide extra information, such as name or NIHDI number. BePatient is added to allow a patient to record his/her own allergies. For GDPR reasons, when this information is used for clinical studies, or other secondary purposes, the SSIN will not be made available.

If you want to use an Organization as a recorder, you can do that using a PractitionerRole, and add the Organization to PractitionerRole.organization. However, you SHALL add a Practitioner to the PractitionerRole. This will be the person that ultimately bears the medical responsibility for this record on behalf of the Organization.

Dates

AllergyIntolerance.onset

The .onset field is used when there are no reactions known, or when the date of the reactions is uncertain (e.g. in childhood, some years ago,…).

AllergyIntolerance.reactions.onset

If a reaction (and manifestation) is known, and it can be dated sufficiently accurately, then a (partial) date on the reaction level is used.

Role of the Registrar

The verification status of the allergy or intolerance depends on the role of the person that registers the allergy or intolerance, and the information that is available at the time of the registration.

Description	Role	VerificationStatus
Patient self-service	Patient	Unconfirmed
Doctor in posession of a positive test result	Doctor	Confirmed
Doctor in posession of a negative test result	Doctor	Refuted
Patient tells a caregiver (KB/AR 78) that he/she suffers from an allergy	Caregiver (KB/AR 78)	Unconfirmed