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Version: 3.1

Allergy Intolerance

Definition​

An allergy or intolerance in Care is a substance that causes a reaction in a patient. The substance is a food, a medication, an environmental substance, or a biologic substance. Every allergy belongs to one patient. You record it from an encounter of that patient.

Key Attributes​

ComponentsWhat it captures
SubstanceThe substance that the patient reacts to. You select it from a standard SNOMED CT allergy terminology. There is no default, so you must select one.
CategoryThe type of the substance. The default is Medication.
CriticalityThe risk of a serious reaction. The default is Low.
StatusHow certain the record is. The default is Confirmed.
Clinical StatusThe current clinical state of the allergy. The default is Active.
OccurrenceThe date when the patient last reacted to the substance. Care does not accept a future date. The default is empty.
NoteFree text about the allergy. The default is empty.

Category​

The Category shows the type of the substance. Select one of these values:

  • Food
  • Medication
  • Environment
  • Biologic

Note: You cannot change the Category after you save the allergy.

Criticality​

The Criticality shows the risk of a serious reaction. Select one of these values:

  • Low
  • High
  • Unable to Assess

Status​

The Status column shows how certain the record is. Select one of these values:

StatusDescription
UnconfirmedCare has no confirmation of the allergy.
PresumedThe allergy is likely, but nobody confirmed it.
ConfirmedSomebody confirmed the allergy.
RefutedSomebody ruled out the allergy.
Entered in ErrorSomebody recorded the allergy by mistake.

Note: Care offers Entered in Error only for a saved allergy.

Clinical Status​

The Clinical Status shows the current clinical state of the allergy. Set it from the more-options (⋮) menu of the row.

Clinical StatusDescriptionMenu item
ActiveThe allergy still applies to the patient.Mark Active
InactiveThe allergy no longer applies to the patient.Mark Inactive
ResolvedThe allergy is over.Mark Resolved

Care shows an inactive allergy in a lighter shade. Care strikes through a resolved allergy.

Terminology​

The substances come from a standard SNOMED CT allergy terminology.

Note: Your deployment's administrator can change the available terminology.

Lifecycle​

You record and change allergies from the Overview tab of the encounter. Use the Allergies section, or use the Allergy quick action.

While the encounter is open, you can change the Criticality, the Status, the Clinical Status, the Occurrence, and the Note of a saved allergy. You cannot change the Substance or the Category after you save the allergy.

All add and edit controls are read-only when the encounter status is Completed, Cancelled, Discontinued, or Entered in Error.

Care never deletes a saved allergy. To retract one, set its Status to Entered in Error. Care then leaves the allergy out of the Allergies section and out of the allergy history.

Care links each allergy to the encounter where you last recorded or changed it. If you change an allergy from a later encounter, Care keeps the earlier version with the first encounter.

Allergies stay with the patient. The allergy history of the patient shows them across all encounters.

Permissions​

Your role controls what you can do with an allergy.

PermissionWhat it allows
Can submit questionnaire about patient encountersSubmit the allergy screen of an encounter.
Can Update a Patient's dataRecord a new allergy for the patient.
Update Encounter related clinical dataChange or retract an allergy of an encounter.
Can view clinical data about patientsView the allergies of a patient.
Can Read encounter related clinical dataView the allergies of one encounter.

By default, doctors, nurses, administrators, and facility administrators can record and change allergies. Staff can view patient clinical data, but staff do not have encounter clinical-data access.

FHIR R5 alignment​

Care follows FHIR R5 for allergies. The substance, the category, the criticality, the verification status, the clinical status, the last occurrence, and the note map to the FHIR AllergyIntolerance resource.