Uppmärksamhetsinformation

eHN Guideline

Data	Description	Preferred Code Systems	Arbetsgruppens ("Svensk") tolkning av informationselementet	Utvärderingsparametrar
* ** A.2 Patient summary body data elements	Ur uppdraget: • Socialstyrelsens arbete med förvaltningen och vidareutvecklingenav informationsspecifikationen för den nationellaUppmärksamhetsinformation (UMI) •systemleverantörernas stöd för Socialstyrelsensinformationsspecifikation, där bl.a. Cambio redan implementeratstöd •pågående diskussioner hos Socialstyrelsen om att lägga tillvarningar för specifika tillstånd, som pacemakerimplantat ochblodprover, vilket är en del av Socialstyrelsensuppmärksamhetsinformation för att minimera risker.
A.2.1 Alerts
A.2.1.1 Allergy
A.2.1.1.1 Allergy description	Textual description of the allergy or intolerance			Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.3 Type of propensity	This element describes whether this condition refers to an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance)	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.3 Allergy manifestation	Description of the clinical manifestation of the allergic reaction. Example: anaphylactic shock, angioedema (the clinical manifestation also gives nformation about the severity of the observed reaction)	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.4 Severity	Severity of the clinical manifestation of the allergic reaction.	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.5 Criticality	Potential risk for future life-threatening adverse reactions when exposed to a substance known to cause an adverse reaction.	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.6 Onset date	Date of the observation of the reaction	ISO 8601		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.7 End Date	Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)	ISO 8601		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.8 Status	Current status of the allergy or intolerance, for example, whether it is active, in remission, resolved, etc.	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.9 Certainty	Assertion about the certainty associated with a propensity, or potential risk, of a reaction to the identified substance. Diagnostic and/or clinical evidence of condition.	SNOMED CT GPS		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.1.10 Agent or Allergen	A specific allergen or other agent/substance (drug, food, chemical agent, etc.) to which the patient has an adverse reaction propensity.	SNOMED CT GPS (for non-drug allergy) or ATC* (for drug allergy) (IDMP, when available)		Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen
A.2.1.2 Medical alert information (other alerts not included in allergies)
A.2.1.2.1 Healthcare alert description	Description of medical alerts in textual format: any clinical information that is imperative to know so that the life or health of the patient does not come under threat. - Example 1: intolerance to aspirin due to gastrointestinal bleeding. Example 2: intolerance to captopril because of cough (the patient is not allergic but can't tolerate it because of persistent cough) Example 3: the patient has a rare disease that requires special treatment Example 4: Airway Alert / Difficult Intubation Example 5: Diagnoses such as malignant hyperthermia, porphyria, and bleeding disorders; special treatments like anticoagulants or immunosuppressants; implanted devices. Example 6: transplanted organs illustrate other information that has to be taken into account in a healthcare contact. Example 7: participation in a clinical trial that has to be taken into account in a healthcare contact.			Beskrivning av hur lösningen möter EDHS krav
				Bedömning
				Täckningsgrad
				Kvalité på informationen

* In a foreseeable future, the suggested preferred vocabularies might be superseded or
complemented, as mentioned in Guidelines Article 11(2).
** The Preferred code system(s) has been selected based on adequacy to convey the
information using the methodology of the Subgroup on Semantics. When more alternative
international code systems are available, all are listed when it is assumed to be unlikely that
agreement can be reached short term. Mapping between code systems could be proposed for
specific use cases.

Xt-EHR Logical model

Short	Definition	Min	Max	Type(s)	Binding Strength	Binding Description
B.1.1 - Alerts	Alert section includes information about allergies, intolerances and other substantial alerts or warnings that health professionals should be aware of.	1	1	Base
B.1.1.1 - Section narative	Narative content of the section. This narative shell containing either narative description of both allergy and alerts, or similar narative sub-section elements shell be provided.	0	1	string
B.1.1.2 - Allergy	A record of allergies and intolerances.	1	*	https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSAllergyIntolerance
B.1.1.3 - Medical alert	Medical alert information (other alerts not included in allergies).	0	*	https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSAlertFlag

Short	Definition	Min	Max	Type(s)	Binding Strength	Binding Description
Allergy intolerance model	C.21 - EHDS refined base model for Allergy Intolerance	0	*
C.21.1 - Identifier	Appointment identifier	0	*	Identifier
C.21.2 - Allergy description	Textual description of the allergy or intolerance	0	1	string
C.21.3 - Type of propensity	This element describes whether this condition refers to an allergy, non-allergy intolerance, or unknown class of intolerance (not known to be allergy or intolerance)	0	1	CodeableConcept	preferred	SNOMED CT
C.21.4 - Allergy manifestation	Description of the clinical manifestation of the allergic reaction including date of manifestation and severity. Example: anaphylactic shock, angioedema (the clinical manifestation also gives information about the severity of the observed reaction). Multiple manifestations could be provided.	0	*	Base
C.21.4.1 - Date	Date and time of allergy manifestation	0	1	dateTime
C.21.4.2 - Severity	Severity of the clinical manifestation of the allergic reaction.	0	1	CodeableConcept	preferred	SNOMED CT
C.21.4.3 - Description	Description of the event as a whole	0	1	string
C.21.4.4 - Manifestation	Clinical symptoms/signs associated with the Event	0	*	CodeableConcept	preferred	SNOMED CT
C.21.5 - Criticality	Potential risk for future life-threatening adverse reactions when exposed to a substance known to cause an adverse reaction.	0	1	CodeableConcept	preferred	SNOMED CT
C.21.6 - Onset date	Date of onset of allergy, e.g., date of the first observation of the reaction. Partial date could be used. or life period (childhood, adolescence).	0	1	dateTime
C.21.7 - Onset life period	Date of onset of allergy, e.g., date of the first observation of the reaction expressed usingor life period (childhood, adolescence, etc.).	0	1	CodeableConcept	preferred	SNOMED CT
C.21.8 - End date	Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition)	0	1	dateTime
C.21.9 - End date life period	Date of resolution of the allergy (e.g. when the clinician deemed there is no longer any need to track the underlying condition) exprssed using life period (childhood, … )	0	1	CodeableConcept	preferred	SNOMED CT
C.21.10 - Status	Current status of the allergy or intolerance, for example, whether it is active, in remission, resolved, and so on …	0	1	CodeableConcept	preferred	SNOMED CT
C.21.11 - Certainty	Assertion about the certainty associated with a propensity, or potential risk, of a reaction to the identified substance. Diagnostic and/or clinical evidence of condition.	0	1	CodeableConcept	preferred	SNOMED CT
C.21.12 - Agent or Allergen	A specific allergen or other agent/substance (drug, food, chemical agent, etc.) to which the patient has an adverse reaction propensity.	1	1	CodeableConcept	preferred	SNOMED CT, ATC, (IDMP / EMA SPOR SMS)
C.21.13 - Subject	The patient who has the allergy or intolerance.	1	1	Reference(https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSPatient)

Short	Definition	Min	Max	Type(s)	Binding Strength	Binding Description
Alert flag model	C.22 - EHDS refined base model for Alert flag	0	*
C.22.1 - Identifier	Flag identifier (Business identifiers assigned to this flag).	0	*	Identifier
C.22.2 - Text	A human-readable narrative that contains a summary of the flag and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Example 1: intolerance to aspirin due to gastrointestinal bleeding. Example 2: intolerance to captopril because of cough (the patient is not allergic but can't tolerate it because of persistent cough) Example 3: the patient has a rare disease that requires special treatment Example 4: Airway Alert / Difficult Intubation Example 5: Diagnoses such as malignant hyperthermia, porphyria, and bleeding disorders; special treatments like anticoagulants or immunosuppressants; implanted devices. Example 6: transplanted organs illustrate other information that has to be taken into account in a healthcare contact. Example 7: participation in a clinical trial that has to be taken into account in a healthcare contact.	0	1	Narrative
C.22.3 - Priority	A code that identifies the priority of the alert.	0	*	CodeableConcept	preferred	hl7:Flag-priority-code
C.22.4 - Status	Current status of the flag, Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error.	0	1	CodeableConcept	preferred	hl7:Flag-status
C.22.5 - Code	A coded or textual representation of the flag.	1	1	CodeableConcept	preferred	SNOMED CT
C.22.6 - Subject	Who/What this flag is a record of	1	1	Reference(Patient)
C.22.7 - Period	Time period when flag is active. The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified.	0	1	Period
C.22.8 - Encounter	This alert is only relevant during the encounter.	0	1	Reference(Encounter)
C.22.9 - Author	The person, organization or device that created the flag.	0	1	Reference(https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSHealthProfessional\|https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSOrganization\|https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSDevice)

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