InterweaveFlag

FHIR Profile

The Notts Care Record will use the following Interweave Profiles, as published in the Interweave Implementation Guide:

Definition: Active information or a warning, about a patient or their situation, which may affect how their care or support is delivered.

Notts Guidance

Flags vs AllergyIntolerance

Whilst the FHIR Flag can be used to model generic alerts and risks, for Known/Suspected Allergies or Intolerances there is dedicated FHIR Resource that should be used instead

Mandatory fields

The following fields are mandatory:

  • status only flags which are currently active against a person should be shared. Therefore the value in this field will always be 'active'.
    Data Providers will need to develop a mechanism to remove flags when they are no longer 'active'.

  • category this provides a level of categorisation, i.e. Risk to others, Risk to self, safeguarding concern and other. This should always be known and is vital for meaningful display purposes. Here We have defined a custom code list for the most common categories of flags used by Social Care. We fully expect that this list will need to be extended for use by healthcare providers. If you need further categories considering, please get in touch.

  • code code is used to record the type of flag assigned to a patient. Here we specify a preferred list which was developed for Social Care. Again we expect that this list will need to expand to cater for healthcare providers. Please get in touch should you required further 'flag types' adding.
    code.text SHOULD be populated with the local name of the flag, this is not a repeat of the code.display, and this field MUST be populated to further describe the flag when ‘Other’ is selected as the type.

  • subject.patient The patient to which the flag is assigned.

Must Support fields

In addition, the following fields are "Must Support" - i.e. they must be populated if relevant and known:

  • period.start period.start should be populated with the date that the flag was placed against the patient.

Use Cases

Mental Health Act Status

The following elements MUST be populated on a FHIR Flag relating to the Mental Health Act Status of a Patinet:

FHIR Element RIO Notes
Flag.id Unique ID for the status record Rio Used to update or delete a specific record in the future
Flag.status active|inactive will be 'inactive' if end date in past
Flag.category Fixed Value = http://snomed.info/sct\|980131000000101
Flag.code Status on Rio From SNOMED CT Refset 999003071000000100
Flag.period Start DateTime MUST be provided
End date must be provided if recorded on source system (note data provider may choose to remove ended statuses if deemed more appropriate)
Flag.subject Patient ID Local Rio id for the Patient which the Flag is for

Note: Leave Periods (e.g. Section 17 leave with/without restrictions) will be shared as a seperate flag, hence a patient could have an active MHA Status Flag to show they are deatined (e.g. S47) and a MHA Status Flag for the leave period

Example and Mappings

Click here to see an example of an Mental Health Act Status Flag