HdBe-Alert

Profile	Description	Status	URL
HdBe-Alert	An alert describes a clinical or administrative fact brought to the attention of the users of the clinical systems to be taken into account when shaping diagnostic and therapeutic policy or in dealing with the patient, usually because of a safety risk. Disorders that describe the body’s sensitivity to a substance which results in a specific physiological reaction after being exposed to that substance are referred to as allergies. These are described in a separate information model. Warnings for non-allergic disorders can concern: A disorder, condition or diagnosis which can be considered as a contraindication for undergoing a certain type of therapy, such as pregnancy or long QT syndrome; Impaired functioning of an organ system (heart failure, impaired liver or kidney function, weakened immune system); Risk of spreading certain microorganisms (multi-resistant bacteria, tubercle bacilli, HIV, HBV, Ebola virus); Other risks	draft	https://fhir.healthdata.be/StructureDefinition/HdBe-Alert

Profile

Description

Status

URL

HdBe-Alert

An alert describes a clinical or administrative fact brought to the attention of the users of the clinical systems to be taken into account when shaping diagnostic and therapeutic policy or in dealing with the patient, usually because of a safety risk. Disorders that describe the body’s sensitivity to a substance which results in a specific physiological reaction after being exposed to that substance are referred to as allergies. These are described in a separate information model. Warnings for non-allergic disorders can concern:

A disorder, condition or diagnosis which can be considered as a contraindication for undergoing a certain type of therapy, such as pregnancy or long QT syndrome;
Impaired functioning of an organ system (heart failure, impaired liver or kidney function, weakened immune system);
Risk of spreading certain microorganisms (multi-resistant bacteria, tubercle bacilli, HIV, HBV, Ebola virus);
Other risks

draft

https://fhir.healthdata.be/StructureDefinition/HdBe-Alert

Flag	I		Flag	Element Id Flag Short description Alert Alternate names Barriers to Care, Alert, Warning Definition Prospective warnings of potential issues when providing care to the patient. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Data Type Flag Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` HdBe-Alert-1:One concept from Condition::Concern and AlertName must be selected. If Flag.code contains a code from AlertNameCodelist, Flag.extension:concern SHALL not exist. `code.memberOf('https://fhir.healthdata.be/ValueSet/AlertName') implies extension.where(url = 'http://hl7.org/fhir/StructureDefinition/flag-detail').exists().not()` HdBe-Alert-2:One concept from Condition::Concern and AlertName must be selected. If Flag.extension:concern is filled, Flag.code SHALL contain code 'not-applicable' from system 'http://terminology.hl7.org/CodeSystem/data-absent-reason'. `extension('http://hl7.org/fhir/StructureDefinition/flag-detail').exists() implies code.coding.where($this.system = 'http://terminology.hl7.org/CodeSystem/data-absent-reason' and $this.code = 'not-applicable').exists()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=ISSUE, moodCode=EVN] zib-alert-v4.1-2020EN:NL-CM:8.3.1 HdBe-Alert:Alert
extension	I	0..*	Extension	Element Id Flag.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
concern	I	0..1	Extension(Reference(Resource))	Element Id Flag.extension:concern Short description Resource with details for flag Alternate names extensions, user content Definition Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Reference(Resource)) Extension URL http://hl7.org/fhir/StructureDefinition/flag-detail Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:concern.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/flag-detail Mappings rim:N/A
value[x]		1..1		Element Id Flag.extension:concern.value[x] Short description Condition Alternate names Conditie Definition The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.3 HdBe-Alert:Alert.Condition
valueReference			Reference(Resource \| HdBe Problem)	Data Type Reference(Resource \| HdBe Problem)
comment	I	0..1	Extension(string)	Element Id Flag.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Flag.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Explanatory comments to the alert that can not be expressed in any of the other elements. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.7 HdBe-Alert:Alert.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Flag.identifier Short description Business identifier Definition Business identifiers assigned to this flag by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Flag.status Short description active \| inactive \| entered-in-error Definition Supports basic workflow. Comments Sending systems that don't record an explicit status can use the following guidance to infer a value from the CBB: EndDateTime present and in the past: inactive EndDateTime absent: active EndDateTime present and in the future - goes against both FHIR and CBB definitions, but in a case where this might occur: active Data Type code Binding Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error. FlagStatus (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.status rim:.status zib-alert-v4.1-2020EN:NL-CM:8.3.5 zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime (implicit, main mapping is on Flag.Period.End) HdBe-Alert:Alert.StartDateTime (implicit, main mapping is on Flag.Period.Start)
category	Σ	0..*	CodeableConcept	Element Id Flag.category Short description Clinical, administrative, etc. Definition Allows a flag to be divided into different categories like clinical, administrative etc. Intended to be used as a means of filtering which flags are displayed to particular user or in a given context. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) Binding A general category for flags for filtering/display purposes. FlagCategory (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code
alertType	Σ	0..1	CodeableConceptBinding	Element Id Flag.category:alertType Short description AlertType Alternate names AlertType Definition Indicates the type of alert, meaning a rough description of the cause or origin of the warning. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Binding A general category for flags for filtering/display purposes. AlertType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code zib-alert-v4.1-2020EN:NL-CM:8.3.6 HdBe-Alert:Alert.AlertType
code	Σ	1..1	CodeableConcept	There are no (further) constraints on this element Element Id Flag.code Short description Coded or textual message to display to user Definition The coded value or textual component of the flag to display to the user. Comments If non-coded, use CodeableConcept.text. This element should always be included in the narrative. Data Type CodeableConcept Binding Detail codes identifying specific flagged issues. FlagCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] rim:.value
coding	Σ	1..*	Coding	Element Id Flag.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Sliced: Unordered, Open, by $this(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
alertName	Σ	0..1	CodingBinding	Element Id Flag.code.coding:alertName Short description AlertName Alternate names AlertNaam Definition A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments If this slice is used, slice `:dataAbsentReason` MUST be absent and `Flag.extension:concern` MUST NOT exist. See the guidance on the root. Data Type Coding Binding AlertName (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding zib-alert-v4.1-2020EN:NL-CM:8.3.4 HdBe-Alert:Alert.AlertName
dataAbsentReason	Σ	0..1	Coding	Element Id Flag.code.coding:dataAbsentReason Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments This slice MUST be used when `Flag.extension:concern` is populated. Slice `:alertName` MUST be absent in this case. See the guidance on the root. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason", "code": "not-applicable" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Flag.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ I	1..1	Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient)	Element Id Flag.subject Short description Who/What is flag about? Definition The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] rim:.participation[typeCode=SBJ].role[classCode=PAT \| LOCE \| ASSIGNED] w5:FiveWs.subject
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Flag.period Short description Time period when flag is active Definition The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] w5:FiveWs.context
start	Σ I	0..1	dateTime	Element Id Flag.period.start Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low zib-alert-v4.1-2020EN:NL-CM:8.3.5 HdBe-Alert:Alert.StartDateTime
end	Σ I	0..1	dateTime	Element Id Flag.period.end Short description EndDateTime Alternate names EindDatumTijd Definition The date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime
encounter	Σ I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id Flag.encounter Short description Alert relevant during encounter Definition This alert is only relevant during the encounter. Comments If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context
author	Σ I	0..1	Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id Flag.author Short description Flag creator Definition The person, organization or device that created the flag. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role

Flag	I		Flag	Element Id Flag Short description Alert Alternate names Barriers to Care, Alert, Warning Definition Prospective warnings of potential issues when providing care to the patient. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Data Type Flag Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` HdBe-Alert-1:One concept from Condition::Concern and AlertName must be selected. If Flag.code contains a code from AlertNameCodelist, Flag.extension:concern SHALL not exist. `code.memberOf('https://fhir.healthdata.be/ValueSet/AlertName') implies extension.where(url = 'http://hl7.org/fhir/StructureDefinition/flag-detail').exists().not()` HdBe-Alert-2:One concept from Condition::Concern and AlertName must be selected. If Flag.extension:concern is filled, Flag.code SHALL contain code 'not-applicable' from system 'http://terminology.hl7.org/CodeSystem/data-absent-reason'. `extension('http://hl7.org/fhir/StructureDefinition/flag-detail').exists() implies code.coding.where($this.system = 'http://terminology.hl7.org/CodeSystem/data-absent-reason' and $this.code = 'not-applicable').exists()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=ISSUE, moodCode=EVN] zib-alert-v4.1-2020EN:NL-CM:8.3.1 HdBe-Alert:Alert
extension	I	0..*	Extension	Element Id Flag.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
concern	I	0..1	Extension(Reference(Resource))	Element Id Flag.extension:concern Short description Resource with details for flag Alternate names extensions, user content Definition Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Reference(Resource)) Extension URL http://hl7.org/fhir/StructureDefinition/flag-detail Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:concern.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/flag-detail Mappings rim:N/A
value[x]		1..1		Element Id Flag.extension:concern.value[x] Short description Condition Alternate names Conditie Definition The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.3 HdBe-Alert:Alert.Condition
valueReference			Reference(Resource \| HdBe Problem)	Data Type Reference(Resource \| HdBe Problem)
comment	I	0..1	Extension(string)	Element Id Flag.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Flag.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Explanatory comments to the alert that can not be expressed in any of the other elements. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.7 HdBe-Alert:Alert.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Flag.identifier Short description Business identifier Definition Business identifiers assigned to this flag by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Flag.status Short description active \| inactive \| entered-in-error Definition Supports basic workflow. Comments Sending systems that don't record an explicit status can use the following guidance to infer a value from the CBB: EndDateTime present and in the past: inactive EndDateTime absent: active EndDateTime present and in the future - goes against both FHIR and CBB definitions, but in a case where this might occur: active Data Type code Binding Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error. FlagStatus (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.status rim:.status zib-alert-v4.1-2020EN:NL-CM:8.3.5 zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime (implicit, main mapping is on Flag.Period.End) HdBe-Alert:Alert.StartDateTime (implicit, main mapping is on Flag.Period.Start)
category	Σ	0..*	CodeableConcept	Element Id Flag.category Short description Clinical, administrative, etc. Definition Allows a flag to be divided into different categories like clinical, administrative etc. Intended to be used as a means of filtering which flags are displayed to particular user or in a given context. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) Binding A general category for flags for filtering/display purposes. FlagCategory (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code
alertType	Σ	0..1	CodeableConceptBinding	Element Id Flag.category:alertType Short description AlertType Alternate names AlertType Definition Indicates the type of alert, meaning a rough description of the cause or origin of the warning. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Binding A general category for flags for filtering/display purposes. AlertType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code zib-alert-v4.1-2020EN:NL-CM:8.3.6 HdBe-Alert:Alert.AlertType
code	Σ	1..1	CodeableConcept	There are no (further) constraints on this element Element Id Flag.code Short description Coded or textual message to display to user Definition The coded value or textual component of the flag to display to the user. Comments If non-coded, use CodeableConcept.text. This element should always be included in the narrative. Data Type CodeableConcept Binding Detail codes identifying specific flagged issues. FlagCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] rim:.value
coding	Σ	1..*	Coding	Element Id Flag.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Sliced: Unordered, Open, by $this(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
alertName	Σ	0..1	CodingBinding	Element Id Flag.code.coding:alertName Short description AlertName Alternate names AlertNaam Definition A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments If this slice is used, slice `:dataAbsentReason` MUST be absent and `Flag.extension:concern` MUST NOT exist. See the guidance on the root. Data Type Coding Binding AlertName (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding zib-alert-v4.1-2020EN:NL-CM:8.3.4 HdBe-Alert:Alert.AlertName
dataAbsentReason	Σ	0..1	Coding	Element Id Flag.code.coding:dataAbsentReason Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments This slice MUST be used when `Flag.extension:concern` is populated. Slice `:alertName` MUST be absent in this case. See the guidance on the root. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason", "code": "not-applicable" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Flag.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ I	1..1	Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient)	Element Id Flag.subject Short description Who/What is flag about? Definition The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] rim:.participation[typeCode=SBJ].role[classCode=PAT \| LOCE \| ASSIGNED] w5:FiveWs.subject
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Flag.period Short description Time period when flag is active Definition The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] w5:FiveWs.context
start	Σ I	0..1	dateTime	Element Id Flag.period.start Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low zib-alert-v4.1-2020EN:NL-CM:8.3.5 HdBe-Alert:Alert.StartDateTime
end	Σ I	0..1	dateTime	Element Id Flag.period.end Short description EndDateTime Alternate names EindDatumTijd Definition The date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime
encounter	Σ I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id Flag.encounter Short description Alert relevant during encounter Definition This alert is only relevant during the encounter. Comments If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context
author	Σ I	0..1	Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id Flag.author Short description Flag creator Definition The person, organization or device that created the flag. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role

Flag	I		Flag	Element Id Flag Short description Alert Alternate names Barriers to Care, Alert, Warning Definition Prospective warnings of potential issues when providing care to the patient. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Data Type Flag Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` HdBe-Alert-1:One concept from Condition::Concern and AlertName must be selected. If Flag.code contains a code from AlertNameCodelist, Flag.extension:concern SHALL not exist. `code.memberOf('https://fhir.healthdata.be/ValueSet/AlertName') implies extension.where(url = 'http://hl7.org/fhir/StructureDefinition/flag-detail').exists().not()` HdBe-Alert-2:One concept from Condition::Concern and AlertName must be selected. If Flag.extension:concern is filled, Flag.code SHALL contain code 'not-applicable' from system 'http://terminology.hl7.org/CodeSystem/data-absent-reason'. `extension('http://hl7.org/fhir/StructureDefinition/flag-detail').exists() implies code.coding.where($this.system = 'http://terminology.hl7.org/CodeSystem/data-absent-reason' and $this.code = 'not-applicable').exists()` Mappings rim:Entity. Role, or Act rim:Observation[classCode=ISSUE, moodCode=EVN] zib-alert-v4.1-2020EN:NL-CM:8.3.1 HdBe-Alert:Alert
extension	I	0..*	Extension	Element Id Flag.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension Sliced: Unordered, Open, by url(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
concern	I	0..1	Extension(Reference(Resource))	Element Id Flag.extension:concern Short description Resource with details for flag Alternate names extensions, user content Definition Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(Reference(Resource)) Extension URL http://hl7.org/fhir/StructureDefinition/flag-detail Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:concern.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value http://hl7.org/fhir/StructureDefinition/flag-detail Mappings rim:N/A
value[x]		1..1		Element Id Flag.extension:concern.value[x] Short description Condition Alternate names Conditie Definition The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list. Comments One of the CBB concepts Condition::Concern and AlertName must be selected. If `.code` contains a code from AlertNameCodelist, `.extension:concern` SHALL not exist. On the other hand, if `.extension:concern` is populated, `.code` SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.3 HdBe-Alert:Alert.Condition
valueReference			Reference(Resource \| HdBe Problem)	Data Type Reference(Resource \| HdBe Problem)
comment	I	0..1	Extension(string)	Element Id Flag.extension:comment Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data Type Extension(string) Extension URL https://fhir.healthdata.be/StructureDefinition/ext-Comment Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1:Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim:n/a rim:N/A
url		1..1	System.StringFixed Value	There are no (further) constraints on this element Element Id Flag.extension:comment.url Short description identifies the meaning of the extension Definition Source of the definition for the extension code - a logical name or a URL. Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Data Type System.String Fixed Value https://fhir.healthdata.be/StructureDefinition/ext-Comment Mappings rim:N/A
value[x]		0..1		Element Id Flag.extension:comment.value[x] Short description Comment Alternate names Toelichting Definition Explanatory comments to the alert that can not be expressed in any of the other elements. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:N/A zib-alert-v4.1-2020EN:NL-CM:8.3.7 HdBe-Alert:Alert.Comment
valueString			string	There are no (further) constraints on this element Data Type string
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Flag.identifier Short description Business identifier Definition Business identifiers assigned to this flag by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers. Comments This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier w5:FiveWs.identifier rim:.id
status	Σ ?!	1..1	codeBinding	Element Id Flag.status Short description active \| inactive \| entered-in-error Definition Supports basic workflow. Comments Sending systems that don't record an explicit status can use the following guidance to infer a value from the CBB: EndDateTime present and in the past: inactive EndDateTime absent: active EndDateTime present and in the future - goes against both FHIR and CBB definitions, but in a case where this might occur: active Data Type code Binding Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error. FlagStatus (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a w5:FiveWs.status rim:.status zib-alert-v4.1-2020EN:NL-CM:8.3.5 zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime (implicit, main mapping is on Flag.Period.End) HdBe-Alert:Alert.StartDateTime (implicit, main mapping is on Flag.Period.Start)
category	Σ	0..*	CodeableConcept	Element Id Flag.category Short description Clinical, administrative, etc. Definition Allows a flag to be divided into different categories like clinical, administrative etc. Intended to be used as a means of filtering which flags are displayed to particular user or in a given context. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Sliced: Unordered, Open, by $this(Value) Binding A general category for flags for filtering/display purposes. FlagCategory (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code
alertType	Σ	0..1	CodeableConceptBinding	Element Id Flag.category:alertType Short description AlertType Alternate names AlertType Definition Indicates the type of alert, meaning a rough description of the cause or origin of the warning. Comments The value set will often need to be adjusted based on local business rules and usage context. Data Type CodeableConcept Binding A general category for flags for filtering/display purposes. AlertType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.class rim:.code zib-alert-v4.1-2020EN:NL-CM:8.3.6 HdBe-Alert:Alert.AlertType
code	Σ	1..1	CodeableConcept	There are no (further) constraints on this element Element Id Flag.code Short description Coded or textual message to display to user Definition The coded value or textual component of the flag to display to the user. Comments If non-coded, use CodeableConcept.text. This element should always be included in the narrative. Data Type CodeableConcept Binding Detail codes identifying specific flagged issues. FlagCode (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD w5:FiveWs.what[x] rim:.value
coding	Σ	1..*	Coding	Element Id Flag.code.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data Type Coding Sliced: Unordered, Open, by $this(Value) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
alertName	Σ	0..1	CodingBinding	Element Id Flag.code.coding:alertName Short description AlertName Alternate names AlertNaam Definition A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments If this slice is used, slice `:dataAbsentReason` MUST be absent and `Flag.extension:concern` MUST NOT exist. See the guidance on the root. Data Type Coding Binding AlertName (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding zib-alert-v4.1-2020EN:NL-CM:8.3.4 HdBe-Alert:Alert.AlertName
dataAbsentReason	Σ	0..1	Coding	Element Id Flag.code.coding:dataAbsentReason Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments This slice MUST be used when `Flag.extension:concern` is populated. Slice `:alertName` MUST be absent in this case. See the guidance on the root. Data Type Coding Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Pattern { "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason", "code": "not-applicable" } Mappings rim:n/a v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim:CV orim:fhir:Coding rdfs:subClassOf dt:CDCoding v2:CE.1-8, CE.10-22 rim:union(., ./translation) orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element Id Flag.code.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data Type string Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE.9. But note many systems use CE.2 for this rim:./originalText[mediaType/code="text/plain"]/data orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
subject	Σ I	1..1	Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient)	Element Id Flag.subject Short description Who/What is flag about? Definition The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Patient \| Location \| Group \| Organization \| Practitioner \| PlanDefinition \| Medication \| Procedure \| HdBe Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.subject[x] rim:.participation[typeCode=SBJ].role[classCode=PAT \| LOCE \| ASSIGNED] w5:FiveWs.subject
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Flag.period Short description Time period when flag is active Definition The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] w5:FiveWs.context
start	Σ I	0..1	dateTime	Element Id Flag.period.start Short description StartDateTime Alternate names BeginDatumTijd Definition The date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments If the low element is missing, the meaning is that the low boundary is not known. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.1 rim:./low zib-alert-v4.1-2020EN:NL-CM:8.3.5 HdBe-Alert:Alert.StartDateTime
end	Σ I	0..1	dateTime	Element Id Flag.period.end Short description EndDateTime Alternate names EindDatumTijd Definition The date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year). Comments The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:DR.2 rim:./high zib-alert-v4.1-2020EN:NL-CM:8.3.8 HdBe-Alert:Alert.EndDateTime
encounter	Σ I	0..1	Reference(Encounter)	There are no (further) constraints on this element Element Id Flag.encounter Short description Alert relevant during encounter Definition This alert is only relevant during the encounter. Comments If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end. Data Type Reference(Encounter) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.context
author	Σ I	0..1	Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole)	There are no (further) constraints on this element Element Id Flag.author Short description Flag creator Definition The person, organization or device that created the flag. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5:FiveWs.author rim:.participation[typeCode=AUT].role

Mapping FHIR profile to CBB

Path	map	CBB
Flag	Alert	HdBe-Alert
Flag.extension:concern.value[x]	Alert.Condition	HdBe-Alert
Flag.extension:comment.value[x]	Alert.Comment	HdBe-Alert
Flag.status	Alert.EndDateTime (implicit, main mapping is on Flag.Period.End)	HdBe-Alert
Flag.status	Alert.StartDateTime (implicit, main mapping is on Flag.Period.Start)	HdBe-Alert
Flag.category:alertType	Alert.AlertType	HdBe-Alert
Flag.code.coding:alertName	Alert.AlertName	HdBe-Alert
Flag.period.start	Alert.StartDateTime	HdBe-Alert
Flag.period.end	Alert.EndDateTime	HdBe-Alert

HdBe-Alert-01

zib Alert difference

Concept	Category	Description
`code`	terminology	Replaced NullFlavor Other and Unkown with SNOMED equivelant codes.

Terminology Bindings

Path	Name	Strength	URL	ConceptMap
Flag.category	AlertType	required	https://fhir.healthdata.be/ValueSet/AlertType	No bound ConceptMap
Flag.code.coding	AlertName	required	https://fhir.healthdata.be/ValueSet/AlertName	No bound ConceptMap