Skip to main content

Allergy Reconciliation Section

  1. Last updated
  2. Save as PDF
This section provides a list of active allergies that must be reconciled.  
 
Perform the reconciliation of the CCD imported items and potentially anything already captured in the Care Record in either CWS or OrderConnect. Depending on the source of information for the allergy, different actions will be available. After actions are selected to be applied for the allergies, the selected list of allergies can be reconciled. Perform a final review of allergies and their corresponding actions.

Allergy information can populate from the following sources:

  • CCD allergies - Imported into myAvatar via one of the CCD import methods.
  • CWS allergies - Entries made within the Allergies and Hypersensitivities form.
  • OC Allergies - Entries made in OrderConnect.

The Allergy Reconciliation Grid header contains the following prompts:

  • Reason for Reconciliation - User-defined dictionary that can be defined in Dictionary Update (File: CWS, Data Element #80200) that is used for data collection purposes only.
  • Group Like Items - Group similar items in the Allergies grid. Duplicate allergies will be grouped together and highlighted in yellow. 
  • Known Medication Allergies - Defaults based on the value entered into the Known Medication Allergies field on the Allergies and Hypersensitivities form. This will also be determined by data received from OrderConnect. If a medication allergy is assigned to the patient, then this must be set to Yes in order to submit. A medication allergy is defined with Type equal to "Drug." This information is used for the Meaningful Use Measures reporting.
    • Yes will automatically be selected if there are active medication allergies on record. This is defined based on the Type of allergy equal to "Drug."
    • Select No if no active Medication Allergies.
  • Preview Items for Reconciliation - Selected after all actions you wishes to proceed with are selected. This will present you with a sub-screen that will display all of the items that will be reconciled within the session.
  • View Final Active Allergy List - Launches a view of all active allergies assigned to the client. 

Prerequisites:

The following dictionaries have extended data elements for CCD reporting, and for allergy information inclusion in the Clinical Reconciliation form:

  • Status (Allergy)
    • At least one Status code must be defined as an "Inactive Allergy" in order to enable Clinical Reconciliation. Set the extended dictionary 10038 Active Allergy to "No" for at least one code.
    • At least one Status code must be defined as "Active" in order to view allergies within Clinical Reconciliation. Set the extended dictionary 80410 SNOMED Code-Status to "Active" for at least one code.
  • Reactions​ and Reaction Severity
    • Both dictionaries are pre-populated with values and cross-walked to the appropriate SNOMED code that will be included on the CCD. No setup is required.
CCD Allergies

In the Action column, the following actions are available:

  1. Create New - Create a new client entry in the Allergies and Hypersensitivities form. The RxNorm or SNOMED code received in the CCD should match the corresponding RxNorm or SNOMED code defined in the Allergies and Hypersensitivities form. The ability to map RxNorm or SNOMED codes to allergy codes is only available with the Micromedex catalog.
    • The following information will be pulled from the CCD and saved in the Allergy list:
      • Allergy/reactant code
      • Date recognized
      • Allergy Status - In order to save the allergy status, the code in the CCD has to be matched with any of the codes defined in the Allergy Status dictionary. This is defined in the extended data element, 80410 - SNOMED Code - Status.
    • Creating a CCD problem will also update the CCD record in the CCD SQL table. The following information will be updated:
      • Last Reconciliation ID
      • Reconciliation Action Code
  2. Create New (and Remove from List) - This action is identical to Create New except that the original item that was being used for the reconciliation will be removed from the list when the Clinical Reconciliation screen refreshes.
  3. Defer - Delays acting on the allergy information until the next session. The allergy will display the next time you perform allergy reconciliation.
    • The CCD record will be updated. The CCD record in the CCD SQL table will also have the following information updated:​​​​​​​
      • Last Reconciliation ID
      • Reconciliation Action Code
  4. Remove From List - Permanently deletes the allergy record from the database (CCD temporary storage).
CWS Allergies

In the Action column, the following actions are available:

  1. Continue - Indicates that you want to retain the CWS allergy record. The following information will updated in the record:
    • Last Reconciliation ID
    • System Notes
  2. Discontinue/Inactivate - Automatically discontinues an allergy that was recorded in myAvatar CWS. The existing record will be updated in the client's allergy list, in the Allergies and Hypersensitivities form. The following information will be updated:
    • Allergy Status 
      There should be at least one problem where "Inactive" is selected in Allergy Status dictionary, for the extended dictionary 10038 - Active Allergy.
    • Last Reconciliation ID
  3. ​​​​​​​If no action is selected, this will also result in keeping the allergy record in myAvatar CWS.​
OrderConnect Allergies

In the Action column, the following actions are available:

  1. Continue - Update the client's allergy record in OrderConnect. The following information will be updated:
    • Last Reconciliation ID​​​​​​​
  2. Discontinue/Inactivate - Automatically discontinues an allergy that was recorded in OrderConnect. The following information will be updated:
    • Allergy Status
      There should be at least one problem where "Inactive" is selected in Allergy Status dictionary, for the extended dictionary 10038 - Active Allergy.
    • Last Reconciliation ID
  3. ​​​​​​​If no action is selected, this will also result in keeping the allergy record in OrderConnect.​
Allergy Reconciliation - Preview grid

The Preview Grid is where all of the reconciliation work is determined. You can assign actions and New Allergies to Add within this grid or discontinue existing items. This is the worklist for you until you decide to Preview Items for Reconciliation and complete the process. 

Columns:

  • Action
    • The available actions correspond to the source of information (displayed in the Source column).
    • Select the action to be applied. Depending on the action, specific fields will become enabled and required.
  • Source
    • Displays the source of the information. This could be CCD, myAvatar CWS or OrderConnect.
  • Allergy
    • Displays the allergy description, and associated standard code. If a CCD allergy is displayed and the standard code matches the crosswalk defined for an allergy record in myAvatar CWS, then the allergy will populate in the New Allergy to Add field.
  • New Allergy to Add
    • Enter the allergy code. The available allergies that can be selected depend on the information source. The could be pre-populated with a CWS Allergy if there is a match to a standard code to what is cross walked to the CWS Allergy.
  • Start Date
    • Displays the allergy record date.
  • Last Updated
    • Displays the last date the allergy information was updated.
  • Details
    • Click to display a screen that displays an overview of the allergy information.
  • Practitioner
    • Displays the practitioner who is associated with the allergy information.
  • Reconciliation

Duplicate allergies are highlighted in yellow.

  1. In the Reason for Reconciliation field, select the reason for reconciliation.
  2. Click Group Like Items to sort allergies together, in the Allergy column.
  3. In the Known Medication Allergies field:
    • Select Yes if there are active allergies associated with medication allergies.
    • Select No if no active allergies are associated with medication.
  4. In the Action column, select the action. Depending on the source of the allergy, different actions will be available:
    • Create New – creates a new allergy in the Allergies and Hypersensitivities form.
      New Allergy to Add – enter the allergy record to create.
    • Create New (and Remove from List) - This action is identical to Create New except that the original item that was being used for the reconciliation will be removed from the list when the Clinical Reconciliation screen refreshes.
    • Continue - continues the allergy record in either myAvatar CWS or OrderConnect.
    • Discontinue – discontinues either an myAvatar CWS or OrderConnect allergy.
    • Defer – delays acting on the allergy.
    • Remove from List – removes the CCD allergy from the list.
  5. Click Preview Items for Reconciliation to open the Clinical Reconciliation - Preview screen.
  6. After allergies have been reconciled, click View Final Active Allergy List to display the Final Active Allergy List.