@motorcycle_guy: How do you say "no med allergies but allergic to latex" in CCDA?No Drug Allergy
— Arien Malec (@amalec) March 27, 2012
The answer for no drug allergy is below. It uses the model for negation and unknown that I talked about previously here in How to say No.
<act classCode='ACT' moodCode='EVN'>
<templateId root='2.16.840.1.113883.5.6'/>
<id root='55092E13-32D5-4e54-A4B2-B61B58901DD2'/>
<code code='48765-2' displayName='Allergies, adverse reactions, alerts'
codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
<statusCode code='active'/>
<effectiveTime>
<low value='20120216'/>
</effectiveTime>
<entryRelationship typeCode='SUBJ'>
<observation classCode='OBS' moodCode='EVN' negationInd='true'>
<templateId root='2.16.840.1.113883.10.20.22.4.7'/>
<id root='654AB113-EAD6-43fd-8ABC-E55228690AB3'/>
<code code='ASSERTION' codeSystem='2.16.840.1.113883.5.4'/>
<statusCode code='completed'/>
<effectiveTime>
<low value='1972'/>
</effectiveTime>
<value xsi:type='CD' code='416098002' displayName='Drug Allergy'
codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'>
<originalText><reference value='#Allergy-1'/></originalText>
</value>
<participant classCode='MANU'>
<playingEntity classCode='MMAT'>
<code code='410942007' displayName='drug or medication'
codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'>
<originalText><reference value='#Allergen-1'/></originalText>
</code>
</playingEntity>
</particpant>
</observation>
</entryRelationship>
</act>
- One for a specific medication (RxNORM)
- Another for class of medications (NDF-RT)
- A final one for non-medication substances (UNII)
This isn't a specific medication, so RxNORM doesn't work. It is not a non-medication, so UNII isn't right either. So I should use a code for class of medications (that is a the superset), but I cannot find a code in NDF-RT for the class of all medications (if you can, USE IT instead and let me know what it is), so I used the SNOMED code for drug or medication.
Latex Allergy
For recording a Latex allergy, I'll take the same XML, and modify it thus:
- Remove negationInd since I want to record the presence rather than the absence of an allergy
- Change the value element code to the SNOMED CT allergy to substance code:
- Replace the SNOMED CT code for "drug or medication" with the UNII code for Latex
<act classCode='ACT' moodCode='EVN'>
<templateId root='2.16.840.1.113883.5.6'/>
<id root='55092E13-32D5-4e54-A4B2-B61B58901DD3'/>
<code code='48765-2' displayName='Allergies, adverse reactions, alerts'
codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
<statusCode code='active'/>
<effectiveTime>
<low value='20120216'/>
</effectiveTime>
<entryRelationship typeCode='SUBJ'>
<observation classCode='OBS' moodCode='EVN'>
<templateId root='2.16.840.1.113883.10.20.22.4.7'/>
<id root='654AB113-EAD6-43fd-8ABC-E55228690AB4'/>
<code code='ASSERTION' codeSystem='2.16.840.1.113883.5.4'/>
<statusCode code='completed'/>
<effectiveTime>
<low value='1972'/>
</effectiveTime>
<value xsi:type='CD' code='419199007' displayName='Allergy to Substance'
codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'>
<originalText><reference value='#Allergy-2'/></originalText>
</value>
<participant classCode='MANU'>
<playingEntity classCode='MMAT'>
<code code='2LQ0UUW8IN' displayName='Natural Latex Rubber'
codeSystem='2.16.840.1.113883.4.9' codeSystemName='UNII'>
<originalText><reference value='#Allergen-2'/></originalText>
</code>
</playingEntity>
</particpant>
</observation>
</entryRelationship>
</act>
<templateId root='2.16.840.1.113883.5.6'/>
<id root='55092E13-32D5-4e54-A4B2-B61B58901DD3'/>
<code code='48765-2' displayName='Allergies, adverse reactions, alerts'
codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
<statusCode code='active'/>
<effectiveTime>
<low value='20120216'/>
</effectiveTime>
<entryRelationship typeCode='SUBJ'>
<observation classCode='OBS' moodCode='EVN'>
<templateId root='2.16.840.1.113883.10.20.22.4.7'/>
<id root='654AB113-EAD6-43fd-8ABC-E55228690AB4'/>
<code code='ASSERTION' codeSystem='2.16.840.1.113883.5.4'/>
<statusCode code='completed'/>
<effectiveTime>
<low value='1972'/>
</effectiveTime>
<value xsi:type='CD' code='419199007' displayName='Allergy to Substance'
codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'>
<originalText><reference value='#Allergy-2'/></originalText>
</value>
<participant classCode='MANU'>
<playingEntity classCode='MMAT'>
<code code='2LQ0UUW8IN' displayName='Natural Latex Rubber'
codeSystem='2.16.840.1.113883.4.9' codeSystemName='UNII'>
<originalText><reference value='#Allergen-2'/></originalText>
</code>
</playingEntity>
</particpant>
</observation>
</entryRelationship>
</act>
1530 bytes, lot of data, we need to simplify, especially for a mobile environment
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