Reaction: "A response to a substance, treatment, or other stimulus, such as an antigen-antibody reaction, an allergic reaction, or an adverse pharmacological reaction." - Mosby's Medical Dictionary
This class documents an Observation of an adverse physiological response attributed to the exposure of the Patient to the given substance. Note that the dates may be unspecified, such as when the Patient reports that she breaks out in hives when she eats peanuts.
"Details about each adverse reaction event linked to exposure to the identified substance." - HL7 FHIR, AllergyIntolerance.reaction

Attributes
«CS» Code	certainty	"Statement about the degree of clinical certainty that the Specific Substance was the cause of the Manifestation in this reaction event." - HL7 FHIR, AllergyIntolerance.event.certainty. Note that the latest build of FHIR has removed this concept.
String	description	"Text description about the reaction as a whole, including details of the manifestation if required." - HL7 FHIR, AllergyIntolerance.reaction.description
String	exposureRoute	"Identification of the route by which the subject was exposed to the substance." - HL7 FHIR, AllergyIntolerance.reaction.exposureRoute Note that FHIR uses a code for this concept, but we modeled this as a string, because we currently do not foresee a need for this property. Should the partner agencies require the use of this property, a decision would need to be made regarding whether to use SNOMED codes as FHIR recommends, or FDA codes, which is required by Meaningful Use for other kinds of substance administrations.
Annotation	note	"Additional text about the adverse reaction event not captured in other fields." - HL7 FHIR, AllergyIntolerance.reaction.note
«TS» PointInTime	onsetDateTime	"Record of the date and/or time of the onset of the Reaction." - HL7 FHIR, AllergyIntolerance.reaction.onset "Date of reaction to the immunization." - HL7 FHIR, Immunization.reaction.date
«CS» Code	reaction	Indicates the adverse physiological response which is suspected to have been caused by an exposure to the given substance (i.e., the reactant). "Identifies the specific allergic reaction that was documented." - HL7 Version 2.8, AL1-5 and IAM-5 "Clinical symptoms and/or signs that are observed or associated with the adverse reaction event." - HL7 FHIR, AllergyIntolerance.reaction.manifestation
«CS» Code	severity	"Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations." - HL7 FHIR, AllergyIntolerance.reaction.severity

Attributes inherited from  FHIM::ClinicalObservation::ObservationStatement

basedOn,  bodySite,  category,  componentObservation,  dataAbsentReason,  dateTime,  dateTimeIssued,  deltaFlag,  description,  deviceInstance,  evaluationProcedure,  exceptionValue,  interpretationEvent,  method,  multimedia,  observed,  observedCharacteristic,  referenceRange,  reliability,  resultStatus,  specimen,  value,  derivedFrom,  hasMember,  partOf

Attributes inherited from  FHIM::Common::ClinicalStatement

clinicalDataSource,  contentVersion,  contextCode,  encounter,  note,  recordStatus,  relatedClinicalInformation,  sourceRecordType,  sourceSystem,  subjectGroup,  subjectOfInformation,  subjectOfRecord,  temporalContext,  topicCode,  cosigned,  recorded,  signed,  verified

Attributes inherited from  FHIM::Common::InformationEntry

identifier

 certainty

Public «CS» Code certainty

"Statement about the degree of clinical certainty that the Specific Substance was the cause of the Manifestation in this reaction event." - HL7 FHIR, AllergyIntolerance.event.certainty.
Note that the latest build of FHIR has removed this concept.

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	certainty
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::certainty
Stereotype
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 description

Public String description

"Text description about the reaction as a whole, including details of the manifestation if required." - HL7 FHIR, AllergyIntolerance.reaction.description

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	description
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::description
Stereotype
Template Parameter
Type	String
Upper	1
Upper Value	(1)
Visibility	Public

 exposureRoute

Public String exposureRoute

"Identification of the route by which the subject was exposed to the substance." - HL7 FHIR, AllergyIntolerance.reaction.exposureRoute
Note that FHIR uses a code for this concept, but we modeled this as a string, because we currently do not foresee a need for this property. Should the partner agencies require the use of this property, a decision would need to be made regarding whether to use SNOMED codes as FHIR recommends, or FDA codes, which is required by Meaningful Use for other kinds of substance administrations.

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	exposureRoute
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::exposureRoute
Stereotype
Template Parameter
Type	String
Upper	1
Upper Value	(1)
Visibility	Public

 note

Public Annotation note

"Additional text about the adverse reaction event not captured in other fields." - HL7 FHIR, AllergyIntolerance.reaction.note

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	note
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::note
Stereotype
Template Parameter
Type	Annotation
Upper	*
Upper Value	(*)
Visibility	Public

 onsetDateTime

Public «TS» PointInTime onsetDateTime

"Record of the date and/or time of the onset of the Reaction." - HL7 FHIR, AllergyIntolerance.reaction.onset
"Date of reaction to the immunization." - HL7 FHIR, Immunization.reaction.date

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	onsetDateTime
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::onsetDateTime
Stereotype
Template Parameter
Type	«TS» PointInTime
Upper	1
Upper Value	(1)
Visibility	Public

 reaction

Public «CS» Code reaction

Indicates the adverse physiological response which is suspected to have been caused by an exposure to the given substance (i.e., the reactant).
"Identifies the specific allergic reaction that was documented." - HL7 Version 2.8, AL1-5 and IAM-5
"Clinical symptoms and/or signs that are observed or associated with the adverse reaction event." - HL7 FHIR, AllergyIntolerance.reaction.manifestation

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Terminologies	[ HL7_FHIR_R4 SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings , FHIM_Defined_Content Adverse clinical reaction 2.16.840.1.113883.3.2074.1.1.30 , C-CDA_2.1 Problem 2.16.840.1.113883.3.88.12.3221.7.4 ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1..*
Name	reaction
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::reaction
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	*
Upper Value	(*)
Visibility	Public

 severity

Public «CS» Code severity

"Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations." - HL7 FHIR, AllergyIntolerance.reaction.severity

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	ReactionObservation
Terminologies	[ HL7_FHIR_R4 AllergyIntoleranceSeverity http://hl7.org/fhir/ValueSet/reaction-event-severity , FHIM_Defined_Content Reaction severity 2.16.840.1.113883.3.2074.1.1.64 , C-CDA_2.1 Reaction severity 2.16.840.1.113883.3.88.12.3221.6.8 ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	severity
Name Expression
Namespace	ReactionObservation
Opposite
Owner	ReactionObservation
Owning Association
Owning Template Parameter
Qualified Name	FHIM::Allergies::ReactionObservation::severity
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public