Representing Patient Allergies and Intolerances; Medications

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Standard
Final
Production
Rating 4
Yes
Free
N/A
Standard
Final
Production
Rating 3
No
Free
N/A
Limitations, Dependencies, and Preconditions for Consideration
Applicable Value Set(s) and Starter Set(s)
  • When a medication allergy necessitates capture by medication class, SNOMED CT® should be used.
  • RxNorm: Refers to the RxNorm source specifically (and not to other sources that are included with the RxNorm download).

Comment

Links and descriptions are lacking.

You link to RX Norm, but not to the value set.  How hard would it be to include https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1010.7/expansion

Similarly, for SNOMED CT.  You've identified 327,000 codes, but not much else.  At the very least you could identify the appropriate heirarchies.

Need to include appropriate SNOMED specifics

The Consideration: "When a medication allergy necessitates capture by medication class, SNOMED CT® should be used." would mean the use of a specific SNOMED CT subset that are descendants of  Pharmaceutical / biologic product (product) [373873005]. As a change from NDFRT this recommendation should also have specifications regarding the concern about consistency among the members of a drug class concept.

Also, it is VERY confusing that the SNOMED CT consideration noted above does not align with the SNOMED CT "starter Set" noted on the right - this set of "disorders" is a completely different thing than the substance-type recommendations every where else in this part of the ISA. This is extremely problematic and as a condition-type concept should not be used here at all. That is not to say that implementers should not consider using disorders to also represent allergies, but the ISA has consistently appropriately said that the best way to represent an allergy/intolerance reactant is using a concept that is a substance, not a condition. Don't change this.