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General information
Name: nl.zorg.Reaction
Version: 1.0
HCIM Status:Final
Release: 2021
Release status: Prepublished
Release date: 01-12-2021
Metadata
DCM::CoderList |
Werkgroep Overgevoeligheid
|
DCM::ContactInformation.Address |
*
|
DCM::ContactInformation.Name |
*
|
DCM::ContactInformation.Telecom |
*
|
DCM::ContentAuthorList |
Werkgroep Overgevoelighed
|
DCM::CreationDate |
4-11-2021
|
DCM::DeprecatedDate |
|
DCM::DescriptionLanguage |
nl
|
DCM::EndorsingAuthority.Address |
|
DCM::EndorsingAuthority.Name |
PM
|
DCM::EndorsingAuthority.Telecom |
|
DCM::Id |
2.16.840.1.113883.2.4.3.11.60.40.3.5.3
|
DCM::KeywordList |
Reactie
|
DCM::LifecycleStatus |
Final
|
DCM::ModelerList |
Werkgroep overgevoeligheid
|
DCM::Name |
nl.zorg.Reactie
|
DCM::PublicationDate |
01-12-2021
|
DCM::PublicationStatus |
Prepublished
|
DCM::ReviewerList |
|
DCM::RevisionDate |
16-11-2021
|
DCM::Supersedes |
|
DCM::Version |
1.0
|
HCIM::PublicationLanguage |
EN
|
Revision History
Only available in Dutch
Publicatieversie 1.0 (01-12-2021)
.
Concept
An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction.
The substances can be categorized as follows:
- Medicine
- Medicine category
- Ingredient/addition
- Nutrition
- Environmental factor
- Animal
- Plants
- Chemicals
- Inhaled allergenic
Purpose
Documenting and communicating allergies and intolerances is an important part of medical registration. It concerns the core of patient safety in general and medication safety in particular. In the execution of research, treatment and care, these patient characteristics constantly have to be taken into account.
In principle, allergies and intolerances are also disorders and also could be entered as a problem. Nevertheless, these are usually entered separately.
Allergies/Intolerances have a lot in common with warnings (Alert). An important difference is that with allergies and intolerances, a lot of detailed information is recorded on things such as the reactions to the causative substance. Furthermore, not every warning is a problem or medical condition. Every allergy/intolerance is, however, while not every allergy or intolerance implies a warning.
Evidence Base
For all allergies in the Netherlands, the codes available in the G standard are used to register and complete medicinal allergies in the work process of prescribers and pharmacists (in medication monitoring). This is outlined in the document “Allergies and unwanted substances IR V-2-3-1”.
This code is insufficient when it comes to reactions to exposure to food products, items (such as bandages and band-aids), plants and animals. For these items, the standard allows the use of free text or the use of SNOMED CT code. However, no validated value set is currently available for this purpose for SNOMED CT.
Information Model
Type |
Id |
Concept |
Card. |
Definition |
DefinitionCode |
Reference
|
|
NL-CM:5.3.1
|
Reaction
|
|
Root concept of the Reaction information model. This root concept contains all data elements of the Reaction information model.
|
|
|
|
NL-CM:5.3.7
|
|
ReactionPhenomenon
|
0..*
|
The substantive specification of the reaction (symptoms) that occurs when the patient is exposed to the substance.
|
|
|
|
NL-CM:5.3.6
|
|
CausativeAagent
|
0..*
|
Container of the CausativeAagent concept.This container contains all data elements of the CausativeAagent concept.
|
|
|
|
NL-CM:5.3.5
|
|
|
Radiation
|
0..1
|
Indicates whether it is (presumably) a reaction to radiation.
|
|
|
|
NL-CM:5.3.8
|
|
|
CausativeSubstance
|
0..1
|
The substance that (presumably) caused the reaction.
|
|
|
|
NL-CM:5.3.9
|
|
ReactionDescription
|
0..1
|
Textual description of the reaction as a whole including the reaction phenomena (symptoms).
|
|
|
|
NL-CM:5.3.10
|
|
Severity
|
0..1
|
The severity of the reaction as a result of exposure to the substance.
|
|
|
|
NL-CM:5.3.11
|
|
RouteOfExposure
|
0..1
|
Way in which the patient came into contact with the causative agent or the way in which the agent was administered.
|
|
|
|
NL-CM:5.3.4
|
|
SpecificationExposure
|
0..*
|
Container of the SpecificationExposure concept.This container contains all data elements of the SpecificationExposure concept. This is a reference to a procedure, vaccination or a medication HCIM
|
|
|
|
NL-CM:5.3.12
|
|
ReactionPeriod
|
0..1
|
Start Date: Date and time the response started. This may also only be a date or a partial date, if not known more precisely. TimeDuration: Duration of the reaction. End date: Date and time when the response stopped occurring. This may also only be a date or a partial date, if this is not known more precisely.
|
|
|
|
NL-CM:5.3.3
|
|
DateTimeCommit
|
1
|
The date the reaction was recorded.
|
|
|
|
NL-CM:5.3.2
|
|
Author::HealthProfessional
|
1
|
Person who records the reaction, this can be a healthcare professional, patient or contact person.
|
|
|
Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page
Example Instances
Only available in Dutch
Reactie
|
ReactieErnst
|
Ernstig
|
Matig
|
ReactieTijdstip
|
12-10-2020
|
02-06-2021
|
ReactieSymptomen
|
Trombocytopenie
|
Jeuk
|
Veroorzakendestof
|
Fragmin
|
Amoxicilline
|
DatumTijdVastlegging
|
13-10-2020 13:15
|
03-06-2021 12:00
|
Auteur::Zorgverlener
|
Mevr. Zaal
|
Dhr. Jacobs
|
EersteAuteur::Zorgverlener
|
Naam
|
Mevr. Zaal
|
Mevr. Zaal
|
Specialisme
|
SEH-arts
|
SEH-arts
|
|
ReactieBeschrijving
|
-
|
Over het hele lichaam.
|
Issues
No known allergies
The question is whether to offer a code for "No known allergies (SNOMED CT 160244002)" and subdirectories in this information model that fall under this code, or to determine that, where applicable, the document should outline when the information model is to be applied.
Value set for the ‘Causative substance’ concept
Currently, no defined code list is yet available for allergenic substances other than medication. Entering SNOMED CT must therefore suffice to code allergenic substances for the time-being. The G standard is used to code medical products.
References
1. Z-INDEX. (2011) Allergieën en ongewenste middelen [Online] v. R V-2-3-1 Beschikbaar op: http://www.z-index.nl/g-standaard/beschrijvingen/functioneel/wijzigingen/mb/bewaking-op-allergie/IR%20Allergieen%20V%202-1-1.pdf [Geraadpleegd: 15 oktober 2014]
2. HL7 FHIR Resource AllergyIntolerance. [Online] Continuous Build. Beschikbaar op: http://hl7-fhir.github.io/allergyintolerance.html [Geraadpleegd: 12 maart 2014]
Valuesets
CausativeSubstanceAllergicAgentCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.1
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
SNOMED CT: ^98061000146100|Dutch total non-drug allergen simple reference set|
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
CausativeSubstanceHPKCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.2
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
Alle waarden
|
G-Standaard Handels Product Kode (HPK)
|
2.16.840.1.113883.2.4.4.7
|
CausativeSubstanceSNKCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.3
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
Alle waarden
|
G-standaard Stofnaamcode (SNK)
|
2.16.840.1.113883.2.4.4.1.750
|
CausativeSubstanceSSKCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.4
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
Alle waarden
|
G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK)
|
2.16.840.1.113883.2.4.4.1.725
|
CausativeSubstanceThesaurus122Codelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.5
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
Alle waarden
|
G-standaard Ongewenste medicatiegroepen
|
2.16.840.1.113883.2.4.4.1.902.122
|
ReactionPhenomenonCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.7
|
Binding: Extensible
|
Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
Anaphylaxis
|
39579001
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Anafylaxie
|
Angioedema
|
41291007
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Angio-oedeem
|
Upper respiratory tract hypersensitivity reaction
|
490008
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Overgevoeligheidsreactie van de bovenste luchtwegen
|
Dyspnea
|
267036007
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Kortademigheid
|
Bronchospasm
|
4386001
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Bronchospasme
|
Urticaria
|
126485001
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Urticaria
|
Contact dermatitis
|
40275004
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Contactdermatitis
|
Itching of skin
|
418363000
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Jeuk
|
Eruption
|
271807003
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Exantheem
|
Allergic conjunctivitis
|
473460002
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Allergische conjunctivitis
|
Lyell syndrome
|
768962006
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Syndroom van Lyle
|
Nausea and vomiting
|
16932000
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Misselijk en braken
|
Diarrhea
|
62315008
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Diarree
|
Drug-induced erythema multiforme
|
297942002
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Door medicatie veroorzaakte erythema multiforme
|
Fever
|
386661006
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Koorts
|
Overig
|
OTH
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Overig
|
RouteOfExposureCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.6
|
Binding: Required
|
Conceptname
|
Codesystem name |
Codesystem OID
|
SNOMED CT: <284009009|Route of administration value|
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
SeverityCodelist
Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.8
|
Binding: Required
|
Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
Mild
|
255604002
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Licht
|
Moderate
|
6736007
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Matig
|
Severe
|
24484000
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
Ernstig
|
This information model in other releases
Information model references
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Technical specifications in HL7v3 CDA and HL7 FHIR
To exchange information based on health and care information models, additional, more technical specifications are required.
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:
- HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment
- HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR
Downloads
This information model is also available as pdf file or as spreadsheet
About this information
The information in this wikipage is based on Pre-release 2021-2
SNOMED CT and LOINC codes are based on:
- SNOMED Clinical Terms version: 20210731 [R] (July 2021 Release)
- LOINC version 2.67
Conditions for use are located on the mainpage
This page is generated on 30/11/2021 09:45:22 with ZibExtraction v. 6.4.8004.1652