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The capture and exchange of adverse sensitivity data varies across EHRs. As an effect, much of this data is not interoperable across electronic systems. Confusion regarding the representation and definition of adverse sensitivity data within the EHR presents challenges to organizations that are trying to implement SNOMED CT for electronic data sharing. Further, this uncertainty limits the use of adverse sensitivity data for clinical decision support and longitudinal patient care records. The capture of allergy data must be clearly defined to support patient safety and a comprehensive health record.

Objective

This implementation guide is intended to accelerate consistent implementation of vocabulary with an emphasis on the use of SNOMED CT within the domain of adverse sensitivity and adverse reactions by:

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• Fill the knowledge gap in the community of practice by providing authoritative guidance and reference sets that can be used consistently for the representation of:
• an allergy, non-allergic hypersensitivity and intolerance 
• propensities and reactions
• the criticality of the allergic condition (i.e. the potential seriousness of a future reaction)
• the severity of a reaction 
• Provide guidance for the aggregation & analysis of reported adverse drug reactions (ADR) and sharing/interoperability of ADR reports

Scope

Our scope and approach was the following:

1. Review definitions and reference standard publications
2. Analyze relevant information models
   1. Review existing information models that are in scope, with special emphasis on HL7® FHIR® that has gained considerable momentum in recent years
   2. Create an inclusive model to harmonize the key data elements in the reviewed information models
3. Create exemplar use cases
   1. Describe the most common and important scenarios for capturing or exchanging adverse sensitivity information
   2. Illustrate how the information can be represented by using FHIR® and SNOMED CT concepts
4. Identify SNOMED CT reference sets
   1. Identify starter sets for large domains – most commonly used SNOMED CT concepts in clinical settings e.g., food allergens, adverse sensitivity reactions
   2. Identify value sets for specific data elements e.g., adverse sensitivity types, certainty, criticality, severity
5. Provide practical guidance of the use of SNOMED CT in
   1. Allergy list
   2. Problem list
   3. Clinical decision support

Audience

Attribution

Guide overview

Review