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rBackground

The capture and exchange of adverse sensitivity data (which encompasses allergy, non-allergic hypersensitivity and intolerance) vary 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.

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This implementation guide is intended to accelerate the consistent implementation of SNOMED CT within the domain of adverse sensitivity and adverse reactions byallergy, hypersensitivity and intolerance:

• Extending previous SNOMED International work on definitions of adverse sensitivity
• Surveying and summarizing the relevant interoperability standards, 
• Advising the SNOMED International community regarding best practice deployment of allergy data within the EHR and identifying the SNOMED CT content that would constitute best practice for use in electronic health records.
• Addressing issues using SNOMED in day-to-day clinical practice
• Provide guidance in reconciling substances as allergens with clinical findings representing diseases and propensities as used in problem lists
• Leverage products and substances hierarchy for allergy decision support 

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1. Review definitions and reference standard publicationsstandards
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
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 setssubset
   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 on the use of SNOMED CT in
   1. Allergy list
   2. Problem list
   3. Clinical decision support

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