Representing Patient Allergic Reactions

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard for observations
Final
Production
Rating 3
No
Free
N/A
Standard for observation values
Final
Production
Rating 4
No
Free
N/A
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • SNOMED CT® may not be sufficient to differentiate between an allergy or adverse reaction, or the level of severity
  • For use of SNOMED CT®, codes should generally be chosen from the Clinical finding axis
  • See LOINC projects in the Interoperability Proving Ground.
  • For more information about observations and observation values, see Appendix II for an informational resource developed by the Health IT Standards Committee. 

 

Comment

Links to value sets

Links to value sets in VSAC, PHINVADS or elsewhere would be very helpful.  A URN or OID means NOTHING to about 98% of the affected parties.

The value sets are a start, but the first represents about 1/3 of all SNOMED CT codes. This is not a useful reduction to something that represents value to the community.

The second appears to be useful, but without a way to understand the process by which the codes were selected, it is difficult to validate it. That would require a rather deep analysis.  It would be helpful if VSAC value sets included something more than a one line description of the value set.  Without further information about the value set, and considering its source from a federal group rather than a standards organization, it is hard to judge whether this valueset is viable.

 

ONC response to comments

"Problem" VS extremely broad, recommend removal and suggest using "Adverse Clinical Reaction" and "Allergic and Intolerance Type" VSs as starter set.  Links added to VSAC.  Validation of comprehensiveness is difficult, although second VS is stewarded by HL7 Terminology workgroup.