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The Allergy section details any allergies, adverse relations, and intolerances to medication, food and other substances. There is a separate Entry section for each allergy or intolerance.

This topic details the data elements that must be present in the Allergy section of a Continuity of Care Document (CCD) for it to be processed in the Clinical:AllergyCcda data space (hosted in Data Engine).

(R) - Required elements for the Allergy section and its sub-sections to be processed correctly in the Clinical:AllergyCcda data space.

(O) - Optional elements that are processed if provided in correct format.

Required (R) elements that are children of an Optional (O) element are only required for the immediate parent element to be processed.

Allergies Section Details

Allergy Section Template ID

component/section/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<templateID root="2.16.840.1.113883.10.20.22.2.6.1"/>
	</section>
</component>
...
SectionElementAttributeValueNotes
AllergytemplateIdrootMust be 2.16.840.1.113883.10.20.22.2.6.1

The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure for the entire Allergy section in Continuity of Care Documents (CCDs).

Allergy Section Code

component/section/code

Labels this section as 'Allergies and adverse reactions Document'.

...
<component>
	<section>
		<templateID root="2.16.840.1.113883.10.20.22.6.1"/>
		<code code="48765-2" codeSystem=”2.16.840.1.113883.6.1"/> 
	</section>
</component>
...
SectionElementAttributeValueNotes
AllergycodecodeMust be 48765-2In the Logical Observation Identifiers Names and Codes (LOINC) coding system this alphanumeric string (or 'code') represents Allergies and adverse reactions Document.
codeSystemMust be 2.16.840.1.113883.6.1The unique numerical identifier for the Logical Observation Identifiers Names and Codes (LOINC) coding system. This system will be used to resolve the value in the code attribute (48765-2). 

Allergies Concern Act

component/section/entry/act

Specifies an ongoing concern on behalf of the provider that placed the allergy on a patient’s allergy list.

...
<component>
	<section> 
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				...
			</act>
		</entry>
	</section>
<component>
...
SubsectionElementAttributeValueNotes
Allergy Concern ActactclassCodeMust be ACTSpecifies the general nature of the entry, which in this case is an act (ACT).
moodCodeMust be EVNIndicates that this entry is an event (EVN) that actually happens, has happened or is an ongoing act, or was documented from a past act.

Allergies Concern Act Template ID

component/section/entry/act/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<templateID root="2.16.840.1.113883.10.20.22.4.30"/>
			</act>
		</entry>
	</section>
<component>
...
SubsectionElementAttributeValueNotes
Allergy Concern ActtemplateIdrootMust be 2.16.840.1.113883.10.20.22.2.4.30The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure of the Allergies Concern Act subsection in Continuity of Care Documents (CCDs).

Allergy Concern Act Status Code

component/section/entry/act/statusCode

Indicates the current status of the allergy or intolerance detailed in this entry. 

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<templateID root="2.16.840.1.113883.10.20.22.4.30"/>
				<statusCode code="active"/>
			</act> 
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes

Allergy Concern Act

statusCode

code

Must be one of the following values:

  • completed
  • aborted
  • active
  • suspended

Allergy-Intolerance Observation

component/section/entry/act/entryRelationship

Indicates whether the information being provided relates to the allergy itself (the 'Subject') or to the observed reaction (the 'Manifestation').

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
    				<observation classCode="OBS" moodCode="EVN" negationInd="true">
        				...
    				</observation>
				</entryRelationship>
			</act>
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Allergy-Intolerance ObservationentryRelationshiptypeCodeMust be SUBJ Indicates the information being provided relates to the allergy itself (the 'Subject').
  • entryRelationship
    • observation
classCodeMust be OBSSpecifies the general nature of the entry, which in this case is an observation (OBS).
moodCodeMust be EVNIndicates that this entry is an event (EVN) that has happened or is an ongoing activity, or was documented from a past activity.
negationInd

Must be one of the following:

  • true
  • false
This attribute is optional. If true, the patient has no known observed allergies.

Allergy-Intolerance Observation Template ID

component/section/entry/act/entryRelationship/observation/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
    				<observation classCode="OBS" moodCode="EVN">
        				<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
    				</observation>
				</entryRelationship>
			</act>
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Allergy-Intolerance ObservationtemplateIdrootMust be 2.16.840.1.113883.10.20.22.4.7

The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure of Allergy-Intolerance Observations in Continuity of Care Documents (CCDs). 

Allergy-Intolerance Observation Effective Time

component/section/entry/act/entryRelationship/observation/effectiveTime

Specifies the onset date, duration, and resolution date (if known) of an allergy or intolerance. Refer to How Effective Time values are processed for details on the different ways effectiveTime information can be processed.

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
    				<observation classCode="OBS" moodCode="EVN">
        				<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<effectiveTime xsi:type="IVL_TS">
							<low value="199803"/>
							<high value="20110103"/>
						</effectiveTime>
					</observation>
				</entryRelationship>
			</act>
		</entry>
	</section>
</component>
...

Allergy-Intolerance Observation Value

component/section/entry/act/entryRelationship/observation/value

Specifies the category of allergen or substance of intolerance.

...
<component>
	<section>
 		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
    				<observation classCode="OBS" moodCode="EVN">
       					<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
        				<value xsi:type="CD" code="416098002" displayName="drug allergy" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
   		 			</observation>
				</entryRelationship>
			</act>
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Allergy-Intolerance Observation  Value  xsi:typeMust be CD.

Indicates this is a 'coded value'.

'Coded values' provide a code (an alphanumeric string that represents a name or description) and the unique identifier for the code system that specifies that the alphanumeric string represents a specific name or description.

For example, in the SNOMED CT code system, the code 419199007 represents Allergy to substance.

code

Must be one of the following Allergy-Intolerance Observation codes specified by the SNOMED CT coding system:

  • 235719002 - Food intolerance
  • 414285001 - Food allergy
  • 416908002 - Drug allergy
  • 418038007 - Propensity to adverse reactions to substance
  • 418471000 - Propensity to adverse reactions to food
  • 419199007 - Allergy to substance
  • 41951103 - Propensity to adverse reactions to a drug
  • 420134006 - Propensity to adverse reactions
  • 59037007 - Drug intolerance

During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.

IIf a nullFlavor attribute is present the Allergy-Intolerance Observation coded value will not be mapped.

codeSystemMust be 2.16.840.1.113883.6.96This is the unique identifier for the SNOMED CT coding system. This system will be used to resolve the value in the code attribute.

Allergy-Intolerance Observation Author

component/section/entry/act/entryRelationship/observation/author

Indicates information of person observing the allergy or intolerance, or the person adding notes to the document about the allergy detailed in this entry. Refer to Assigned Author Element for more details on what information can be available for the author section.

...
	<component>
		<section>
			<entry typeCode="DRIV">
				<act classCode="ACT" moodCode="EVN"> 
					<entryRelationship typeCode="SUBJ">
						<observation classCode="OBS" moodCode="EVN">
							<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
							<author>
								<assignedAuthor>
									...
								</assignedAuthor>
							</author>
						</observation>
					</entryRelationship>
				</act>
			</entry> 
		</section>
	</component>
...

Playing Entity

component/section/entry/act/entryRelationship/observation/participant/participantRole/playingEntity

Specifies the agent or substance which caused the allergic or adverse reaction.

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
					<observation classCode="OBS" moodCode="EVN">
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<participant typeCode="CSM">
							<participantRole classCode="MANU">
								<playingEntity classCode="MMAT">
									<code code="314422" displayName="ALLERGENIC EXTRACT, PENICILLIN" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/>
								</playingEntity>
							</participantRole>
						</participant>
					</observation>
				</entryRelationship> 
			</act>
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Allergy-Intolerance Observation
  • participant
    • participantRole
      • playingEntity
        • code
code

Alphanumeric string that represents the name or description of the agent or substance the caused the allergic or adverse reaction.

Each Coding System assigns a unique alphanumeric string (or 'code') to represent each agent or substance. For example, the RxNorm Coding System uses 314422 as the unique alphanumeric string (or 'code') to represent Penicillin.


During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.


codeSystem

The unique identifier for the Coding System that should be used to resolve the value specified in Code attribute.

Typically, agents or substances are determined by one of the following code systems:

  • RxNorm - 2.16.840.1.11388.3.6.88
  • National Drug File - Reference Terminology (NDF-RT) - 2.16.840.1.113883.3.26.1.5
  • Unique ingredient identifiers (UNII) - 2.16.840.1.113883.4.9
This system will be used to resolve the value in the code attribute.

Reaction Observation

component/section/entry/act/entryRelationship/observation/entryRelationship

Indicates whether the information being provided relates to the allergy itself (the 'Subject') or to the observed reaction (the 'Manifestation').

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="MFST">
							...
						</entryRelationship>
					</observation>
				</entryRelationship>
			</act> 
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes

Reaction Observation

entryRelationship

typeCode

Must be MFST

Indicates that the information in this subsection relates to the observed reaction (the 'Manifestation').

Reaction Observation Template ID

component/section/entry/act/entryRelationship/observation/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>					
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship> 
			</act> 
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes

Observation

templateId

root

Must be 2.16.840.1.113883.10.20.22.4.9

The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure of Reaction Observations in Continuity of Care Documents (CCDs).

Reaction Observation Value

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/value

Specifies the type of allergic or adverse reaction for the allergy detailed in this entry.

 ...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
								<value xsi:type="CD" code="247472004" codeSystem="2.16.840.1.113883.6.96" displayName="Hives"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry>  
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Reaction Observationvaluexsi:typeMust be CD.

Indicates this is a 'Coded Value'.

'Coded values' provide a code (an alphanumeric string that represents a name or description) and the unique identifier for the code system that specifies that the alphanumeric string represents a specific name or description.

For example, in the SNOMED CT code system, the code 247472004 represents Hives.

code

Must be one of the Reaction Observation codes specified by the SNOMED CT coding system. For example:

  • 247472004 - Hives
  • 39579001 - Anaphylaxis
  • 129851009 - Alteration in comfort: pain

During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.

If a nullFlavor attribute is set with a value of OTH or UNK, then the coded values from the translation sub-element of the Reaction Observation Value element will be used instead.

codeSystem

Must be 2.16.840.1.113883.6.96

This is the unique identifier for the SNOMED CT Coding System. This system will be used to resolve the value in the code attribute.

Reaction Observation Effective Time

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/effectiveTime

Indicates the date and time that the reaction was observed. Refer to How Effective Time values are processed for details on the different ways effectiveTime information can be processed.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
								<effectiveTime value="199803"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry>  
	</section>
</component>
...

Reaction Severity Observation

component/ section/entry/act/entryRelationship/observation/entryRelationship/observation/entryRelationship

Indicates whether the information being provided relates to the allergy itself (the 'Subject') or to the observed reaction (the 'Manifestation').

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>					
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
								<entryRelationship typeCode="SUBJ">
									<observation classCode="OBS" moodCode="EVN">
										...
									</observation>
								</entryRelationship>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship> 
			</act> 
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Reaction Severity ObservationentryRelationshiptypeCodeMust be SUBJIndicates that the information in this subsection relates to the allergy itself (the 'Subject').
  • entryRelationship
    • observation
classCodeMust be OBSSpecifies the general nature of the entry, which in this case is an observation (OBS).
moodCodeMust be EVNIndicates that this entry is an event (EVN) that has happened or is an ongoing activity, or was documented from a past activity.

Reaction Severity Observation Template ID

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/entryRelationship/observation/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV">
			<act classCode="ACT" moodCode="EVN">
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>					
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
								<entryRelationship typeCode="SUBJ"
									<observation>
										<templateId root="2.16.840.1.113883.10.20.22.4.8" />
									</observation>
								</entryRelationship>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship> 
			</act> 
		</entry>
	</section>
</component>
...

Reaction Severity Observation Value

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/entryRelationship/observation/value

Specifies the level of severity of the observed allergy reaction.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>					
						<entryRelationship typeCode="MFST">
							<observation>
								<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
								<entryRelationship typeCode="SUBJ">
									<observation>
										<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
										<value xsi:type="CD" code="255604002" codeSystem="2.16.840.1.113883.6.96" displayName="Mild"/>
									</observation>
								</entryRelationship>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship> 
			</act> 
		</entry>
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Reaction Severity Observationvaluexsi:typeMust be CD.

Indicates this is a 'Coded Value'.

'Coded values' provide a code (an alphanumeric string that represents a name or description) and the unique identifier for the code system that specifies that the alphanumeric string represents a specific name or description.

For example, in the SNOMED CT code system, the code 247472004 represents Hives.

code

Must be one of the Problem Severity codes specified by the SNOMED CT coding system. For example:

  • 255604002 - Mild
  • 371923003 - Mild to Moderate
  • 6736007 - Moderate
  • 371924009 - Moderate to Severe
  • 24484000 - Severe
  • 399166001 - Fatal

During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.

If a nullFlavor attribute is present the Reaction Severity Observation coded value will not be mapped.

codeSystem

Must be 2.16.840.1.113883.6.96

This is the unique identifier for the SNOMED CT Coding System. This system will be used to resolve the value in the code attribute.
displayNameCan be an alphanumerical string of any lengthThis attribute is optional. A human readable display name for the template section.

Severity Observation

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/entryRelationship

Indicates whether the information being provided relates to the allergy itself (the 'Subject') or to the observed reaction (the 'Manifestation').

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="SUBJ">
							<observation classCode="OBS" moodCode="EVN">
								...
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry>
	</section>
</component>
... 
SubsectionElementAttributeValueNotes

Severity Observation

entryRelationship

typeCode

Must be SUBJ

Indicates that the information in this subsection relates to the allergy itself (the 'Subject').

  • entryRelationship
    • observation
classCodeMust be OBSSpecifies the general nature of the entry, which in this case is an observation (OBS).
moodCodeMust be EVNIndicates that this entry is an event (EVN) that has happened or is an ongoing activity, or was documented from a past activity.

Severity Observation Template ID

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="SUBJ">
							<observation classCode="OBS" moodCode="EVN">
								<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>
			</act>
		</entry>
	</section>
</component>
... 
SubsectionElementAttributeValueNotes
Severity ObservationtemplateIdrootMust be 2.16.840.1.113883.10.20.22.4.8The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure of Severity Observations in Continuity of Care Documents (CCDs).

Severity Observation Value

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/value

Specifies the level of severity of the allergic or adverse reaction.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="SUBJ">
							<observation classCode="OBS" moodCode="EVN">
								<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
								<value xsi:type="CD" code="255604002" codeSystem="2.16.840.1.113883.6.96" displayName="Mild"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry>
	</section>
</component>
... 

 

SubsectionElementAttributeValueNotes
Severity Observationvaluexsi:typeMust be CD

Indicates this is a "Coded Value".

'Coded values' provide a code (an alphanumeric string that represents a name or description) and the unique identifier for the code system that specifies that the alphanumeric string represents a specific name or description.

For example, in the SNOMED CT code system, the code 371924009 represents Moderate to severe.

code

Must be a Severity code specified in the SNOMED CT coding system:

  • 255604002 - Mild
  • 371923003 - Mild to Moderate
  • 6736007 - Moderate
  • 371924009 - Moderate to Severe
  • 24484000 - Severe
  • 399166001 - Fatal

During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.

If a nullFlavor attribute is present the Severity Observation coded value will not be mapped.

codeSystemMust be 2.16.840.1.113883.6.96This is the unique identifier for the SNOMED CT coding system. This system will be used to resolve the value in the code attribute.

Criticality Observation

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/entryRelationship

Indicates whether the information being provided relates to the allergy itself (the 'Subject') or to the observed reaction (the 'Manifestation').

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="SUBJ">
							<observation classCode="OBS" moodCode="EVN">
								...
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry> 
	</section>
</component>
... 
SubsectionElementAttributeValueNotes

Criticality Observation

entryRelationship

typeCode

Must be SUBJ

Indicates that the information in this subsection relates to the allergy itself (the 'Subject').

  • entryRelationship
    • observation
classCodeMust be OBSSpecifies the general nature of the entry, which in this case is an observation (OBS).
moodCodeMust be EVNIndicates that this entry is an event (EVN) that has happened or is an ongoing activity, or was documented from a past activity.

Criticality Observation Template ID

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/templateId

Specifies which CCDA R2.1 template is being used to determine the requirements, format and structure of the information this subsection.

...
<component>
	<section>
		<entry typeCode="DRIV"> 
			<act classCode="ACT" moodCode="EVN"> 
				<entryRelationship typeCode="SUBJ">
					<observation>
						<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
						<entryRelationship typeCode="SUBJ">
							<observation classCode="OBS" moodCode="EVN">
								<templateId root="2.16.840.1.113883.10.20.22.4.145"/>
							</observation>
						</entryRelationship>
					</observation>
				</entryRelationship>	
			</act> 
		</entry> 
	</section>
</component>
...
SubsectionElementAttributeValueNotes
Criticality ObservationtemplateIdrootMust be 2.16.840.1.113883.10.20.22.4.145The unique identifier for the CCDA R2.1 template that defines the requirements, format and structure of Criticality Observations in Continuity of Care Documents (CCDs).

Criticality Observation Value

component/section/entry/act/entryRelationship/observation/entryRelationship/observation/value

Specifies the level of criticality of the allergy or intolerance.

 ...
	<component>
		<section>
			<entry typeCode="DRIV"> 
				<act classCode="ACT" moodCode="EVN"> 
					<entryRelationship typeCode="SUBJ">
						<observation>
							<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
							<entryRelationship typeCode="SUBJ">
								<observation classCode="OBS" moodCode="EVN">
									<templateId root="2.16.840.1.113883.10.20.22.4.145"/>
									<value xsi:type="CD" code="CRITH" displayName="High Criticality" codeSystem="2.16.840.1.11388 3.5.1063" codeSystemName="LOINC"/>
								</observation>
							</entryRelationship>
						</observation>
					</entryRelationship>	
				</act> 
			</entry> 
		</section>
	</component>
...
SubsectionElementAttributeValueNotes
Criticality Observationvaluexsi:typeMust be CD.

Indicates this is a 'Coded Value'

'Coded values' provide a code (an alphanumeric string that represents a name or description) and the unique identifier for the code system that specifies that the alphanumeric string represents a specific name or description.

For example, in the Observation Value code system, the code CRITL represents Low Criticality.

code

Must be one of the Criticality Observation codes specified by the Observation Value coding system:

  • CRITL - Low criticality
  • CRITH - High criticality
  • CRITU - Unable to assess criticality

During message processing, the Clinical:AllergyCcda data space takes the alphanumeric string provided. It does not check whether the code or codeSystem values are valid.

If an invalid code is provided, an error may occur when this data is retrieved from Data Engine's Model Store. Errors can occur when the Allergy-Allergy Intolerance CDR8 FHIR Converter, which transforms data after retrieval, cannot resolve a code.

If a nullFlavor attribute is present the Criticality Observation coded value will not be mapped.

displayNameCan be an alphanumerical string of any lengthThis attribute is optional. A human readable display name for the template section.
codeSystemMust be 2.16.840.1.113883.5.1063This is the unique identifier for the Observation Value coding system. This system will be used to resolve the value in the code attribute.
codeSystemNameCan be an alphanumerical string of any lengthThis attribute is optional. A human readable display name for the code system.
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