Allergies & Safety¶
Record patient allergies once, and the system shows them everywhere it matters — and stops a drug the patient is allergic to from being dispensed unless a clinician overrides with a documented reason. Maps to HL7 FHIR AllergyIntolerance.
Screenshot: Allergy register — TODO
Allergy register¶
Medical → Allergies (/medical/allergies) — record each allergy/intolerance:
- Allergen (e.g. Penicillin, Peanuts, Iodinated contrast)
- Category — Drug / Food / Environment / Biologic / Other
- Severity — Mild · Moderate · Severe · Life‑threatening (each a distinct colour)
- Status — Active · Inactive · Resolved
- Verification — Reported · Confirmed · Refuted (self‑reported vs clinically confirmed)
- Recorded by — the clinician who asserted it
- Reaction + optional reaction code (SNOMED/ICD), onset date, notes
Search by patient or allergen, and filter by Severity and Status.
The safety band¶
Active allergies appear as a red band at the top of the patient profile and the encounter
screen, with a severity‑coloured chip per allergen (e.g. Penicillin · Severe). When a patient has
none, a green "No known allergies" band with an Add action shows instead — so a blank is never
mistaken for unchecked.
Drug allergy checking (cross‑sensitivity)¶
Checks match a drug against the patient's active drug/biologic allergies two ways:
- Direct — the drug name matches the allergen.
- Cross‑sensitivity — same or related drug class via a built‑in, ATC‑coded class map (e.g. a penicillin allergy flags amoxicillin, a cephalosporin, or a carbapenem; a sulfa allergy flags cotrimoxazole; one NSAID flags another).
Conservative by design
The class map is curated (not a full RxNorm/ATC feed) and errs toward flagging: a false alert costs one documented override, a missed allergy could harm a patient.
At prescribing (advisory)¶
Medical → Orders & Rx (/medical/emr/orders) — saving a medication order whose drug matches
the patient's allergies shows a yellow warning to the prescriber. Prescribing only flags; the
hard stop is at dispense.
At dispensing (hard block)¶
Medical → Pharmacy → Dispenses — confirming a dispense for a matching drug is blocked. The screen shows a red alert (with a cross‑sensitivity tag where relevant); the normal Dispense button is replaced by an override‑reason form. Dispensing requires a non‑blank clinical reason, which is appended to the dispense remarks and written to the override audit.
Override audit¶
Medical → Allergy Overrides (/medical/allergy-overrides) — a read‑only register of every drug
dispensed against a recorded allergy: when, patient, drug, matched allergen(s), cross‑sensitivity flag,
reason, and the acting user. The accountable trail for the safety override.
Overrides are permanent
An override record cannot be edited or deleted — it is a clinical‑safety fact.
Dashboard¶
The medical board carries KPI cards for Active allergies, Severe / life‑threatening allergies, and Allergy overrides.