Clinical Practice Guidelines
2.0.0-ballot - ballot International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Resource Profile: CPGFlag - Detailed Descriptions

Active as of 2024-04-14

Definitions for the cpg-flag resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Flag
2. Flag.extension
SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Flag.extension:instantiatesCaseFeature
    Slice NameinstantiatesCaseFeature
    Control0..1
    TypeExtension(CPG Instantiates Case Feature Extension) (Extension Type: canonical(CPG Case Feature Definition))
    Must Supporttrue
    6. Flag.extension:caseFeatureType
    Slice NamecaseFeatureType
    Control0..1
    TypeExtension(CPG Case Feature Type Extension) (Extension Type: code)
    Must Supporttrue
    8. Flag.extension:caseFeaturePertinence
    Slice NamecaseFeaturePertinence
    Control0..1
    TypeExtension(CPG Case Feature Pertinence Extension) (Extension Type: code)
    Must Supporttrue
    10. Flag.extension:pertinent
    Slice Namepertinent
    Control0..*
    TypeExtension(CPG Pertinent Extension) (Extension Type: Reference)
    Must Supporttrue
    12. Flag.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    14. Flag.status
    Must Supporttrue
    16. Flag.category
    Control1..1
    Must Supporttrue
    18. Flag.code
    Must Supporttrue
    20. Flag.subject
    TypeReference(CPG Patient)
    Must Supporttrue
    22. Flag.period
    Must Supporttrue
    24. Flag.encounter
    TypeReference(CPG Encounter)
    Must Supporttrue
    26. Flag.author
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. Flag
    Definition

    Prospective warnings of potential issues when providing care to the patient.

    ShortKey information to flag to healthcare providers
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate NamesBarriers to Care, Alert, Warning
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. 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.

    ShortA set of rules under which this content was created
    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.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Flag.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. Flag.extension:instantiatesCaseFeature
      Slice NameinstantiatesCaseFeature
      Definition

      References the definition for this case feature.

      ShortCPG Instantiates Case Feature Extension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(CPG Instantiates Case Feature Extension) (Extension Type: canonical(CPG Case Feature Definition))
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Flag.extension:caseFeatureType
      Slice NamecaseFeatureType
      Definition

      Describes whether the case feature is asserted or inferred.

      ShortCPG Case Feature Type Extension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(CPG Case Feature Type Extension) (Extension Type: code)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Flag.extension:caseFeaturePertinence
      Slice NamecaseFeaturePertinence
      Definition

      Describes the pertinence of the case feature.

      ShortCPG Case Feature Pertinence Extension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(CPG Case Feature Pertinence Extension) (Extension Type: code)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. Flag.extension:pertinent
      Slice Namepertinent
      Definition

      The pertinent positive or negative information relevant to the recommendation.

      ShortCPG Pertinent Extension
      Comments

      This will typically be the most relevant case features used in determining applicability, but could also be other patient-specific information relevant to interpreting or assessing appropriateness of the recommendation with respect to the patient.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(CPG Pertinent Extension) (Extension Type: Reference)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      14. 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).

      ShortExtensions that cannot be ignored
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      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.

      Alternate Namesextensions, user content
      Invariantsele-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())
      16. 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.

      ShortBusiness identifier
      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.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Flag.status
      Definition

      Supports basic workflow.

      Shortactive | inactive | entered-in-error
      Comments

      This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

      Control1..1
      BindingThe codes SHALL be taken from FlagStatushttp://hl7.org/fhir/ValueSet/flag-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/flag-status|4.0.1)

      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.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. 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.

      ShortClinical, administrative, etc.
      Comments

      The value set will often need to be adjusted based on local business rules and usage context.

      Control10..1*
      BindingFor example codes, see FlagCategoryhttp://hl7.org/fhir/ValueSet/flag-category
      (example to http://hl7.org/fhir/ValueSet/flag-category)

      A general category for flags for filtering/display purposes.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Flag.code
      Definition

      The coded value or textual component of the flag to display to the user.

      ShortCoded or textual message to display to user
      Comments

      If non-coded, use CodeableConcept.text. This element should always be included in the narrative.

      Control1..1
      BindingFor example codes, see FlagCodehttp://hl7.org/fhir/ValueSet/flag-code
      (example to http://hl7.org/fhir/ValueSet/flag-code)

      Detail codes identifying specific flagged issues.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Flag.subject
      Definition

      The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with.

      ShortWho/What is flag about?
      Control1..1
      TypeReference(CPG Patient, Patient, Location, Group, Organization, Practitioner, PlanDefinition, Medication, Procedure)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. 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.

      ShortTime period when flag is active
      Control0..1
      TypePeriod
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Flag.encounter
      Definition

      This alert is only relevant during the encounter.

      ShortAlert relevant during 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.

      Control0..1
      TypeReference(CPG Encounter, Encounter)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Flag.author
      Definition

      The person, organization or device that created the flag.

      ShortFlag creator
      Control0..1
      TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Flag
      Definition

      Prospective warnings of potential issues when providing care to the patient.

      ShortKey information to flag to healthcare providers
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesBarriers to Care, Alert, Warning
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Flag.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      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.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. 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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. 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.

      ShortA set of rules under which this content was created
      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.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Flag.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. 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.

      ShortText summary of the resource, for human interpretation
      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.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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.

      ShortContained, inline 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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Flag.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-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())
      SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Flag.extension:instantiatesCaseFeature
        Slice NameinstantiatesCaseFeature
        Definition

        References the definition for this case feature.

        ShortCPG Instantiates Case Feature Extension
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(CPG Instantiates Case Feature Extension) (Extension Type: canonical(CPG Case Feature Definition))
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        18. Flag.extension:caseFeatureType
        Slice NamecaseFeatureType
        Definition

        Describes whether the case feature is asserted or inferred.

        ShortCPG Case Feature Type Extension
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(CPG Case Feature Type Extension) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        20. Flag.extension:caseFeaturePertinence
        Slice NamecaseFeaturePertinence
        Definition

        Describes the pertinence of the case feature.

        ShortCPG Case Feature Pertinence Extension
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(CPG Case Feature Pertinence Extension) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        22. Flag.extension:pertinent
        Slice Namepertinent
        Definition

        The pertinent positive or negative information relevant to the recommendation.

        ShortCPG Pertinent Extension
        Comments

        This will typically be the most relevant case features used in determining applicability, but could also be other patient-specific information relevant to interpreting or assessing appropriateness of the recommendation with respect to the patient.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(CPG Pertinent Extension) (Extension Type: Reference)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-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())
        24. 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).

        ShortExtensions that cannot be ignored
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        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.

        Alternate Namesextensions, user content
        Invariantsele-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())
        26. 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.

        ShortBusiness identifier
        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.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Flag.status
        Definition

        Supports basic workflow.

        Shortactive | inactive | entered-in-error
        Comments

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from FlagStatus
        (required to http://hl7.org/fhir/ValueSet/flag-status|4.0.1)

        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.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. 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.

        ShortClinical, administrative, etc.
        Comments

        The value set will often need to be adjusted based on local business rules and usage context.

        Control1..1
        BindingFor example codes, see FlagCategory
        (example to http://hl7.org/fhir/ValueSet/flag-category)

        A general category for flags for filtering/display purposes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Flag.code
        Definition

        The coded value or textual component of the flag to display to the user.

        ShortCoded or textual message to display to user
        Comments

        If non-coded, use CodeableConcept.text. This element should always be included in the narrative.

        Control1..1
        BindingFor example codes, see FlagCode
        (example to http://hl7.org/fhir/ValueSet/flag-code)

        Detail codes identifying specific flagged issues.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Flag.subject
        Definition

        The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with.

        ShortWho/What is flag about?
        Control1..1
        TypeReference(CPG Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. 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.

        ShortTime period when flag is active
        Control0..1
        TypePeriod
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Flag.encounter
        Definition

        This alert is only relevant during the encounter.

        ShortAlert relevant during 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.

        Control0..1
        TypeReference(CPG Encounter)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Flag.author
        Definition

        The person, organization or device that created the flag.

        ShortFlag creator
        Control0..1
        TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))