- This is an Implementation Guide for UK Core FHIR Assets in Development.
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StructureDefinition-UKCore-Flag
Canonical_URL | Status | Current_Version | Last_Updated | Description |
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https://fhir.hl7.org.uk/StructureDefinition/UKCore-Flag | draft | 1.2.0 | 2023-12-12 | This profile defines the UK constraints and extensions on the International FHIR resource Flag. |
Profile_Purpose |
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A flag is a warning or notification of some sort presented to the user - who may be a clinician or some other person involve in patient care. It usually represents something of sufficient significance to warrant a special display of some sort - rather than just a note in the resource. A flag has a subject representing the resource that will trigger its display. This subject can be of different types, as described in the examples below:
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Detailed Descriptions
Flag | |
Definition | Prospective warnings of potential issues when providing care to the patient. |
Cardinality | 0...* |
Alias | Barriers to Care, Alert, Warning |
Invariants |
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Mappings |
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Flag.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | System.String |
Summary | True |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Flag.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
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Mappings |
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Flag.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Invariants |
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Mappings |
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Flag.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. CommonLanguages (preferred) |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants |
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Mappings |
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Flag.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants |
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Mappings |
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Flag.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Mappings |
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Flag.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Flag.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Flag.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. |
Cardinality | 0...* |
Type | Identifier |
Summary | True |
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. |
Invariants |
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Mappings |
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Flag.status | |
Definition | Supports basic workflow. |
Cardinality | 1...1 |
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) |
Must Support | True |
Modifier | True |
Summary | True |
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
Invariants |
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Mappings |
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Flag.category | |
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. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | A general category for flags for filtering/display purposes. FlagCategory (example) |
Summary | True |
Comments | The value set will often need to be adjusted based on local business rules and usage context. |
Invariants |
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Mappings |
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Flag.code | |
Definition | The coded value or textual component of the flag to display to the user. |
Cardinality | 1...1 |
Type | CodeableConcept |
Binding | Detail codes identifying specific flagged issues. FlagCode (example) |
Must Support | True |
Summary | True |
Comments | If non-coded, use CodeableConcept.text. This element should always be included in the narrative. |
Invariants |
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Mappings |
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Flag.subject | |
Definition | The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. |
Cardinality | 1...1 |
Type | Reference(Patient | Location | Group | Organization | Practitioner | PlanDefinition | Medication | Procedure) |
Must Support | True |
Summary | True |
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. |
Invariants |
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Mappings |
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Flag.period | |
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. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
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. |
Invariants |
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Mappings |
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Flag.encounter | |
Definition | This alert is only relevant during the encounter. |
Cardinality | 0...1 |
Type | Reference(Encounter) |
Summary | True |
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. |
Invariants |
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Mappings |
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Flag.author | |
Definition | The person, organization or device that created the flag. |
Cardinality | 0...1 |
Type | Reference(Device | Organization | Patient | Practitioner | PractitionerRole) |
Summary | True |
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. |
Invariants |
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Mappings |
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Table View
Flag | .. | |
Flag.status | .. | |
Flag.code | .. | |
Flag.subject | .. |
XML View
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="UKCore-Flag" /> <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Flag" /> <version value="1.2.0" /> <name value="UKCoreFlag" /> <title value="UK Core Flag" /> <status value="draft" /> <date value="2023-12-12" /> <publisher value="HL7 UK" /> <contact> <name value="HL7 UK" /> <telecom> <system value="email" /> <value value="ukcore@hl7.org.uk" /> <use value="work" /> <rank value="1" /> </telecom> </contact> <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Flag](https://hl7.org/fhir/R4/Flag.html)." /> <purpose value="A flag is a warning or notification of some sort presented to the user - who may be a clinician or some other person involve in patient care. It usually represents something of sufficient significance to warrant a special display of some sort - rather than just a note in the resource. A flag has a subject representing the resource that will trigger its display. \n\nThis subject can be of different types, as described in the examples below: \n\n- A note that a patient has an overdue account, which the provider may wish to discuss with them - in case of hardship, for example (`subject = Patient`) \n- An outbreak of Ebola in a particular region (`subject = Location`) so that all patients from that region have a higher risk of having that condition \n- A particular provider is unavailable for referrals over a given period (`subject = Practitioner`) \n- A patient who is enrolled in a clinical trial (`subject = Group`) \n- Special guidance or caveats to be aware of when following a protocol (`subject = PlanDefinition`) \n- Warnings about using a drug in a formulary requires special approval (`subject = Medication`)" /> <copyright value="Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Flag" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Flag" /> <derivation value="constraint" /> <differential> <element id="Flag.status"> <path value="Flag.status" /> <mustSupport value="true" /> </element> <element id="Flag.code"> <path value="Flag.code" /> <mustSupport value="true" /> </element> <element id="Flag.subject"> <path value="Flag.subject" /> <mustSupport value="true" /> </element> </differential> </StructureDefinition>
JSON View
{ "resourceType": "StructureDefinition", "id": "UKCore-Flag", "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Flag", "version": "1.2.0", "name": "UKCoreFlag", "title": "UK Core Flag", "status": "draft", "date": "2023-12-12", "publisher": "HL7 UK", "contact": [ { "name": "HL7 UK", "telecom": [ { "system": "email", "value": "ukcore@hl7.org.uk", "use": "work", "rank": 1 } ] } ], "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Flag](https://hl7.org/fhir/R4/Flag.html).", "purpose": "A flag is a warning or notification of some sort presented to the user - who may be a clinician or some other person involve in patient care. It usually represents something of sufficient significance to warrant a special display of some sort - rather than just a note in the resource. A flag has a subject representing the resource that will trigger its display. \n\nThis subject can be of different types, as described in the examples below: \n\n- A note that a patient has an overdue account, which the provider may wish to discuss with them - in case of hardship, for example (`subject = Patient`) \n- An outbreak of Ebola in a particular region (`subject = Location`) so that all patients from that region have a higher risk of having that condition \n- A particular provider is unavailable for referrals over a given period (`subject = Practitioner`) \n- A patient who is enrolled in a clinical trial (`subject = Group`) \n- Special guidance or caveats to be aware of when following a protocol (`subject = PlanDefinition`) \n- Warnings about using a drug in a formulary requires special approval (`subject = Medication`)", "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Flag", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Flag", "derivation": "constraint", "differential": { "element": [ { "id": "Flag.status", "path": "Flag.status", "mustSupport": true }, { "id": "Flag.code", "path": "Flag.code", "mustSupport": true }, { "id": "Flag.subject", "path": "Flag.subject", "mustSupport": true } ] } }
Usage
This Profile has the following derived profiles:This Profile is referenced in the following Extensions:
This Profile is referenced in the following Profiles:
Feedback
Click here to:Examples
Food Allergy - An example to illustrate a flag regarding a food allergy.Example UKCore-Flag-FoodAllergy
Example Usage Scenarios
The following are example usage scenarios for the UK Core Flag profile:
- Query for flag information for a given Patient
- Exchange flag information within a FHIR document or message.
Profile Specific Implementation Guidance:
Minimum Viable Content
A minimum viable content that all provider and consumer systems SHALL support are the following elements.
Element | Reason |
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Flag.status |
Supports basic workflow. |
Flag.code |
The coded value or textual component of the flag to display to the user. |
Flag.subject |
The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. |
subject
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
- Profile UKCore-Location
- Profile UKCore-Medication
- Profile UKCore-Organization
- Profile UKCore-Patient
- Profile UKCore-Practitioner
- Profile UKCore-Procedure
- Group Resource
- PlanDefinition Resource
encounter
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Encounter.