IAM - Patient Adverse Reaction Information Segment

The IAM segment contains person/patient adverse reaction information of various types. Most of this information will be derived from user-defined tables. Each IAM segment describes a single person/patient adverse reaction. This segment is used in lieu of the AL1 - Patient Allergy Information Segment to support action code/unique identifier mode update definition of repeating segments as defined in 2.10.4.2 in chapter 2, section 2.4.10, "Protocol for interpreting repeating segments or segment groups in an update Message." The AL1 segment is used to support Snapshot mode update definition as defined in 2.10.4.1.

HL7 Attribute Table - IAM - Patient Adverse Reaction Information Segment

Seq#	Data Element Name	DataType	Usage	Vocabulary	Cardinality	Item #	Length	C.LEN	Flags
IAM
1	Set ID - IAM	SI	R		[1..1]	01612	[1..4]
2	Allergen Type Code	CWE	O	0127 Allergen Type	[0..1]	00204
3	Allergen Code/Mnemonic/Description	CWE	R		[1..1]	00205
4	Allergy Severity Code	CWE	O	0128 Allergy Severity	[0..1]	00206
5	Allergy Reaction Code	ST	O		[0..*]	00207		15	#
6	Allergy Action Code	CNE	R	0206(R) Segment Action Code(Required)	[1..1]	01551
7	Allergy Unique Identifier	EI	C		[0..1]	01552
8	Action Reason	ST	O		[0..1]	01553		60	#
9	Sensitivity to Causative Agent Code	CWE	O	0436 Sensitivity to Causative Agent Code	[0..1]	01554
10	Allergen Group Code/Mnemonic/Description	CWE	O		[0..1]	01555
11	Onset Date	DT	O		[0..1]	01556
12	Onset Date Text	ST	O		[0..1]	01557		60	#
13	Reported Date/Time	DTM	O		[0..1]	01558
14	Reported By	XPN	O		[0..1]	01559
15	Relationship to Patient Code	CWE	O	0063 Relationship	[0..1]	01560
16	Alert Device Code	CWE	O	0437 Alert Device Code	[0..1]	01561
17	Allergy Clinical Status Code	CWE	O	0438 Allergy Clinical Status	[0..1]	01562
18	Statused by Person	XCN	O		[0..1]	01563
19	Statused by Organization	XON	O		[0..1]	01564
20	Statused at Date/Time	DTM	O		[0..1]	01565
21	Inactivated by Person	XCN	O		[0..1]	02294
22	Inactivated Date/Time	DTM	O		[0..1]	02295
23	Initially Recorded by Person	XCN	O		[0..1]	02296
24	Initially Recorded Date/Time	DTM	O		[0..1]	02297
25	Modified by Person	XCN	O		[0..1]	02298
26	Modified Date/Time	DTM	O		[0..1]	02299
27	Clinician-Identified Allergen Code	CWE	O		[0..1]	02300
28	Initially Recorded by Organization	XON	O		[0..1]	03293
29	Modified by Organization	XON	O		[0..1]	03294
30	Inactivated by Organization	XON	O		[0..1]	03295

IAM-1: Set ID - IAM (SI) 01612

Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc.

IAM-2: Allergen Type Code (CWE) 00204

Definition: This field indicates a general allergy category (drug, food, pollen, etc.). Refer to User-defined Table 0127 - Allergen Type in Chapter 2C, Code Tables, for suggested values.

IAM-3: Allergen Code/Mnemonic/Description (CWE) 00205

Definition: This field uniquely identifies a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

If a system maintains allergen codes as its unique identifier for a particular allergy, and two systems have agreed to process the IAM using update mode, then this field can be used as the unique identifier instead of IAM-8 - Allergy Unique Identifier. This does not preclude using allergen codes for unique identifiers for snapshot processing.

IAM-4: Allergy Severity Code (CWE) 00206

Definition: This field indicates the general severity of the allergy. Refer to User-defined Table 0128 - Allergy Severity Code in Chapter 2C, Code Tables, for suggested values.

IAM-5: Allergy Reaction Code (ST) 00207

Definition: This field identifies the specific allergic reaction that was documented. This element may conform to some external, standard coding system, or it may conform to local, largely textual or mnemonic descriptions (e.g., convulsions, sneeze, rash, etc.).

IAM-6: Allergy Action Code (CNE) 01551

Definition: This field contains a code defining the status of the record. It allows allergy messages to be sent to delete or update previously sent allergy messages. Refer to HL7 Table 0206 - Segment Action Code in Chapter 2C, Code Tables, for suggested values.

IAM-7: Allergy Unique Identifier (EI) 01552

Definition: This field contains a value that uniquely identifies a single allergy for a person.

This field is conditionally required. The surrogate field to use is IAM-3 - Allergen Code/Mnemonic/Description if that field can uniquely identify the allergy on the receiving system.

IAM-8: Action Reason (ST) 01553

Definition: This field contains the reason for the action indicated in the IAM-6 - Allergy Action Code field.

IAM-9: Sensitivity to Causative Agent Code (CWE) 01554

Definition: This field contains the reason why the patient should not be exposed to a substance. Refer to User-defined Table 0436 - Sensitivity to Causative Agent Code in Chapter 2C, Code Tables, for suggested values.

IAM-10: Allergen Group Code/Mnemonic/Description (CWE) 01555

Definition: This field contains the code, mnemonic, or description used to uniquely identify an allergen group when both a detailed allergy (IAM-3 - Allergen Code/Mnemonic/Description) and group level (IAM-10 - Allergen Group Code/Mnemonic/Description) need to be communicated. In cases where systems want to communicate both a specific drug allergy and the group of drugs to which the specific drug belongs (i.e., Bactrim and Sulfa drugs; Ceclor and Penicillins/Cephalosporins) then the specific drug allergy is sent in IAM-3 - Allergen Code/Mnemonic/Description and the group level is sent in IAM-10 - Allergen Group Code/Mnemonic/Description. However, if only a group level is being communicated, then it can be sent in IAM-3 as the primary identifier of the allergy.

IAM-11: Onset Date (DT) 01556

Definition: This field contains the actual date of the first reaction.

IAM-12: Onset Date Text (ST) 01557

Definition: This field contains a text description of the time period of the first reaction when an exact date is not known (e.g., adolescence, childhood, spring 1990).

IAM-13: Reported Date/Time (DTM) 01558

Definition: This field contains the date/time the allergy was reported to a caregiver.

IAM-14: Reported By (XPN) 01559

Definition: This field contains the name of the person reporting the allergy to a caregiver at the time reported in IAM-14 - Reported Date/Time.

IAM-15: Relationship to Patient Code (CWE) 01560

Definition: This field contains the personal relationship that the person reporting the allergy has to the patient. It uses the same table as that used by NK1-3. Refer to User-defined Table 0063 - Relationship in Chapter 2C, Code Tables, for suggested values. Examples include: brother, sister, mother, father, friend, spouse, etc.

IAM-16: Alert Device Code (CWE) 01561

Definition: This field describes any type of allergy alert device the patient may be carrying or wearing. Refer to User-defined Table 0437 - Alert Device in Chapter 2C, Code Tables, for suggested values.

IAM-17: Allergy Clinical Status Code (CWE) 01562

Definition: This field indicates the verification status for the allergy. Refer to User-defined Table 0438 - Allergy Clinical Status in Chapter 2C, Code Tables, for suggested values.

IAM-18: Statused by Person (XCN) 01563

Definition: This field identifies the provider who assigned the clinical status to the allergy (e.g., ...| S12345^EVERYMAN^ADAM^J^III^DR^MD|...).

IAM-19: Statused by Organization (XON) 01564

Definition: This field contains the name of the organization providing the update to the allergy (e.g., Good Health Hospital).

IAM-20: Statused at Date/Time (DTM) 01565

Definition: The date and time that this allergy was last statused by the IAM-18 - Statused by Person in the IAM-19 - Statused by Organization.

IAM-21: Inactivated by Person (XCN) 02294

Definition: This field identifies the user that inactivated the record entry about the patient’s allergy

(e.g. ...| S12345^Smith^John^J^III^DR^MD|...).

IAM-22: Inactivated Date/Time (DTM) 02295

Definition: The date and time that this allergy was inactivated by the IAM-21 Inactivated by Person.

IAM-23: Initially Recorded by Person (XCN) 02296

Definition: This field identifies the user that created the entry in the record stating the allergy (e.g. ...| S12345^Smith^John^J^III^DR^MD|...).

IAM-24: Initially Recorded Date/Time (DTM) 02297

Definition: The date and time that this allergy entry was created by the IAM-23 Created by Person.

IAM-25: Modified by Person (XCN) 02298

Definition: This field identifies the user that modified the allergy (e.g. ...|S12345^Smith^John^J^III^DR^MD|...).

IAM-26: Modified Date/Time (DTM) 02299

Definition: The date and time that this allergy was modified by the IAM-25 Modified by Person.

IAM-27: Clinician-Identified Allergen Code (CWE) 02300

Definition: This field identifies the clinician entered description associated to a particular allergen. This element may conform to some external, standard coding system (that must be identified), or it may conform to local, largely textual or mnemonic descriptions.

IAM-28: Initially Recorded by Organization (XON) 03293

Definition: This field contains the name of the organization that initially recorded the allergy (e.g., a General Hospital).

IAM-29: Modified by Organization (XON) 03294

Definition: This field contains the name of the organization that modified the allergy (e.g., a General Hospital).

IAM-30: Inactivated by Organization (XON) 03295

Definition: This field contains the name of the organization that inactivated the allergy (e.g., a General Hospital).