Gentu's own New Adverse Reaction form, kept as it is (Tam, 27 Oct). Agent and Manifestation are searches, Severity is required. The check can only work on what MIMS can recognise from this record.
KEEPPatient file › Adverse Reactions › +. Four states: empty, agent search, manifestation search, filled.
ANSWEREDQ1 and Q2 of the 22 Oct map: the MIMS allergen search is not brought into recording. Gentu's agent list stays (the list itself is PRD-008's).
THE FACTGentu records a severity on every reaction (Mild to Fatal, or Unknown). MIMS gives none. This may be what the alert's weight hangs on, see Q6 and Q10.
KEEPThe Adverse Reactions card in the sidebar, the flags, and "2 Flagged Adverse Reactions" in the patient header (Tam, 27 Oct).
ADDThe severity recorded on the reaction, as a Vitality StatusBadge on a second line under the agent and manifestation. The one change to the card (Tam, 27 Oct).
CODEThe sidebar has three widths (ClinicalShell.styles.ts): 270px up to a 1440px screen, 380px up to 1919px, 440px from 1920px. The long agent fits on one line at 380px and 440px and wraps at 270px, so the badge goes on its own line at every width. Vitality's Badge is a number or a dot only; a text label is StatusBadge.
Q3Which of these can MIMS check? "Sulpha" is free text. Who matches free-text records to a coded agent, and when: the doctor at the next consult, reception in bulk, or a one-off migration? Baseline today: 20.5% of patients with an allergy have it coded.
Q4Where does the uncoded notice sit against this card (frame 6)?
GENTUSeverity is required on the New Adverse Reaction form, so every reaction carries one and every row gets a badge. Records made before the field was required may have none.
Q13Which badge colour per level: Mild, Moderate, High, Life Threatening, Fatal, Unknown? Drawn for now: High critical, Moderate warning, Mild info.
One call: the patient's coded allergens against every medicine on the script. Three kinds of match come back, plus a list of anything MIMS could not check. There is no severity. MIMS says so itself.
Each element is shown twice: what the user sees, and beside it the field each part of it comes from (Brendan, 29 Oct).
allergies[].allergyType from the MIMS responseGentu from Gentu, never sent to MIMSPlain text is Gentu's own copyinput.nameallergens[].name × input.nameallergyTypeinput.name contains input.moleculeName[], which is documented as this patient's allergen.moleculeName[] · allergyClass · references[]
MIMSallergyType = same ingredient · summaryStatement · MoleculeName · references.
PRD-006Prescribing is never blocked, so this is drawn passive, with the red of the strongest match.
Q5The PRD's Q6, Rory with Daryl: which alerts need acknowledgement, and is an override reason captured. With no severity, acknowledgement would apply to every alert, which may be too much friction.
input.nameallergens[].name × input.nameallergyTypeinput.name contains input.moleculeName[], a input.allergyClass. The patient's documented allergy is to the allergens[].allergyClass class.moleculeName[] · allergyClass · references[]
MIMSallergyType = same allergy class.
Q6Is "same class" weaker than "same ingredient"? Clinically a class allergy is often the more cautious record, so this may deserve the same weight as 3. The ladder is a design call, not a MIMS one.
input.nameallergens[].name × input.nameallergyTypeinput.moleculeName[] is a input.allergyClass. Cross-reaction with allergens[].allergyClass allergy is reported in the literature.references[]
MIMSallergyType = cross sensitivity · references[].
Q7This is the one that will fire most often and annoy most. Penicillin to cephalosporin cross-reaction is low in practice. Passive inline, like Michael's Moderate, or quieter still?
input.nameallergies[] is empty, because no coded allergen was sent.free-text agent, or when unrecognized[] is not empty. Copy is Gentu's (Daryl, 22 Oct).agentseverityagent manifestation⚑severityGENTU-SIDEA free-text allergy is never sent. MIMS unrecognized[] covers bad ids and inactive SNOMED codes.
PRD-006 Q8The notice lives in the sidebar, shown when the check finds no conflict and the patient has uncoded allergies. Copy chosen by Daryl, 22 Oct.
Q8The PRD's Q11, yours: when exactly it shows, whether alongside a conflict alert too, and whether it also covers coded allergies MIMS did not recognise. Drawn here at the top of the Adverse Reactions card.
input.nameallergies[] is empty and unrecognized[] is empty, so nothing shows. noAllergyDisclaimer is not shown here (Q9).MIMSnoAllergyDisclaimer, required by MIMS. PRD-006 Q13, Brendan: where does it show if a clean check shows nothing.
Q9The PRD's Q13. MIMS requires its absence disclaimer, and the PRD shows nothing on a clean check. Once per session, in MIMS settings, behind an info icon, or does the DDI precedent already answer it? The tension with "not-checked must never look like clean" is carried by frame 6's sidebar notice, not by this screen.
THE FACTDrug-drug alerts arrive tiered (severe, moderate, minor, with documentation levels). Drug-allergy alerts do not. The only differentiation MIMS gives is the kind of match. Reusing the drug-drug severity ladder here has nothing to feed it, so the ladder, if there is one, is ours to decide and to defend.
NOT COVEREDExcipients and delivery systems. Non-drug allergies (shellfish, latex) never go to the check.
input.namecount of allergies[] of count of allergens sent allergens match input.nameallergens[].name allergyTypeallergens[].name allergyTypeallergens[].name allergyTypemoleculeName[] · allergyClass · references[] · allergens with no match
MIMSallergies[] holds one entry per allergen and medicine pair. The grouping is Gentu's.
WHY GROUPEDInline alerts stack one per allergen. Six allergens would be six callouts for one decision, and the Prescribe button leaves the screen. 38% of patients with an allergy have two or more.
Q10The group takes the colour of its strongest match (red, from the same-ingredient row). Prescribing is never blocked, per the PRD. Right?
Q11Strongest first, or in the order the allergies are on file?
Q12On a script with several medicines, one group per medicine, or one group for the script?
The same medicine can raise drug-drug alerts and allergy alerts at once. Drug-drug alerts are drawn as Michael's alert surface does them (INTOP-4409, on platform staging): Severe blocks with labelled actions, Moderate is passive inline, Minor collapses. Allergy alerts never block (PRD-006).
REUSEBoth are passive inline Callouts with the same ✕ and ✓, so they read as one family. Both sit in Michael's Zone 1, clinical safety, above any PBS notice.
ILLUSTRATIVEThe interaction text is a stand-in, not MIMS output.
Q14Which goes first when the weight looks the same: allergy before drug-drug, or the order MIMS returns them? Drawn: allergy first, because it is about this patient, not the combination.
Q15Does the title need to say which kind it is ("Allergy ·" against "Moderate ·"), or does the pill do that? Today the drug-drug title leads with severity and the allergy title cannot.
D3The Severe interaction blocks: labelled actions, Prescribe disabled until acknowledged. The allergy alert under it stays passive, because PRD-006 says an allergy alert never blocks.
ILLUSTRATIVEThe allergy match is drawn to show the case. Whether MIMS returns erythromycin to clarithromycin as same class has not been checked.
Q16Is it right that a drug-drug interaction can block and an allergy to the medicine cannot? A prescriber may read the louder alert as the more dangerous one.
Q17Does "Acknowledge & prescribe…" also clear the allergy alert, or does each need its own action?
D4Michael's rule for many drug-drug alerts: anything you must act on stays open, Moderate and Minor collapse behind counts tinted by their own severity.
STACKINGThe allergy group stays open above the collapsed interactions. The uncoded notice stays in the sidebar, so the panel still says what was not checked.
Q18Does the allergy group ever collapse like a Moderate, for example when its strongest match is only cross-sensitivity? Drawn: it always stays open.
Q19Does the recorded severity on the allergy (Mild to Fatal, frame 2) decide where it sits among the drug-drug alerts? A Fatal reaction on file next to a Minor interaction is not the same as a Mild one.