HL7 Europe Hospital Discharge Report
1.0.0-ci - draft 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Resource Profile: FlagEuHdrObligation - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the flag-obl-eu-hdr resource profile.

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

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:flagDetailExt
Slice NameflagDetailExt
Definition

Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag.

ShortResource with details for flag
Control0..*
TypeExtension(Flag details) (Extension Type: Reference(Resource))
Is Modifierfalse
Obligations
    ObligationsActor
    SHALL:able-to-populateProducer
    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())
    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())
    6. Flag.extension:flagPriorityExt
    Slice NameflagPriorityExt
    Definition

    A code that identifies the priority of the alert, for example the Alert Priority flags column in IHE PCD TF 2 Table B.8-4.

    ShortAn alarm code
    Control0..1
    TypeExtension(Flag Priority) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHOULD:able-to-populateProducer
      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())
      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())
      8. Flag.extension:note
      Slice Namenote
      Definition

      Additional notes that apply to this resource or element.

      ShortAdditional notes that apply to this resource or element.
      Comments

      This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

      Control0..*
      TypeExtension(Note) (Extension Type: Annotation)
      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())
      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())
      10. Flag.extension:note.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. 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..0*
      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())
      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())
      SlicingThis element introduces a set of slices on Flag.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 12. Flag.extension:note.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://hl7.org/fhir/StructureDefinition/note
        14. Flag.extension:note.value[x]
        Definition

        Additional notes that apply to this resource or element.


        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortNotes for this resource/elementValue of extension
        Control10..1
        This element is affected by the following invariants: ext-1
        TypeAnnotation, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Flag.extension:note.value[x].text
        Definition

        The text of the annotation in markdown format.

        ShortAdditional information about the alertThe annotation - text content (as markdown)
        Control1..1
        Typemarkdown
        Is Modifierfalse
        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()))
        18. 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())
        20. Flag.status
        Definition

        Supports basic workflow.

        ShortAlert statusactive | 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
        Obligations
          ObligationsActor
          SHALL:able-to-populateProducer
          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|4.0.1
          (example to http://hl7.org/fhir/ValueSet/flag-code|4.0.1)

          Detail codes identifying specific flagged issues.

          TypeCodeableConcept
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:able-to-populateProducer
            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(Patient (EU core), Patient, Location, Group, Organization, Practitioner, PlanDefinition, Medication, Procedure)
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:able-to-populateProducer
              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 the alert is activeTime period when flag is active
              Control0..1
              TypePeriod
              Is Modifierfalse
              Obligations
                ObligationsActor
                SHALL:able-to-populateProducer
                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 foundhere

                0. Flag
                2. Flag.extension:flagDetailExt
                Slice NameflagDetailExt
                Obligations
                  ObligationsActor
                  SHALL:able-to-populateProducer
                  4. Flag.extension:flagPriorityExt
                  Slice NameflagPriorityExt
                  Obligations
                    ObligationsActor
                    SHOULD:able-to-populateProducer
                    6. Flag.status
                    Obligations
                      ObligationsActor
                      SHALL:able-to-populateProducer
                      8. Flag.code
                      Obligations
                        ObligationsActor
                        SHALL:able-to-populateProducer
                        10. Flag.subject
                        Obligations
                          ObligationsActor
                          SHALL:able-to-populateProducer
                          12. Flag.period
                          Obligations
                            ObligationsActor
                            SHALL:able-to-populateProducer

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

                            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 alert 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|4.0.1)

                            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 areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 16. Flag.extension:flagDetailExt
                              Slice NameflagDetailExt
                              Definition

                              Points to the Observation, AllergyIntolerance or other record that provides additional supporting information about this flag.

                              ShortResource with details for flag
                              Control0..*
                              TypeExtension(Flag details) (Extension Type: Reference(Resource))
                              Is Modifierfalse
                              Obligations
                                ObligationsActor
                                SHALL:able-to-populateProducer
                                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())
                                18. Flag.extension:flagPriorityExt
                                Slice NameflagPriorityExt
                                Definition

                                A code that identifies the priority of the alert, for example the Alert Priority flags column in IHE PCD TF 2 Table B.8-4.

                                ShortAn alarm code
                                Control0..1
                                TypeExtension(Flag Priority) (Extension Type: CodeableConcept)
                                Is Modifierfalse
                                Obligations
                                  ObligationsActor
                                  SHOULD:able-to-populateProducer
                                  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())
                                  20. Flag.extension:note
                                  Slice Namenote
                                  Definition

                                  Additional notes that apply to this resource or element.

                                  ShortAdditional notes that apply to this resource or element.
                                  Comments

                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                  Control0..*
                                  TypeExtension(Note) (Extension Type: Annotation)
                                  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())
                                  22. Flag.extension:note.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  24. Flag.extension:note.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..0
                                  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.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 26. Flag.extension:note.url
                                    Definition

                                    Source of the definition for the extension code - a logical name or a URL.

                                    Shortidentifies the meaning of the extension
                                    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.

                                    Control1..1
                                    Typeuri
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    Fixed Valuehttp://hl7.org/fhir/StructureDefinition/note
                                    28. Flag.extension:note.value[x]
                                    Definition

                                    Additional notes that apply to this resource or element.

                                    ShortNotes for this resource/element
                                    Control1..1
                                    This element is affected by the following invariants: ext-1
                                    TypeAnnotation
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    30. Flag.extension:note.value[x].id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    32. Flag.extension:note.value[x].extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. 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.

                                    ShortAdditional 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.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 34. Flag.extension:note.value[x].author[x]
                                      Definition

                                      The individual responsible for making the annotation.

                                      ShortIndividual responsible for the annotation
                                      Comments

                                      Organization is used when there's no need for specific attribution as to who made the comment.

                                      Control0..1
                                      TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      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()))
                                      36. Flag.extension:note.value[x].time
                                      Definition

                                      Indicates when this particular annotation was made.

                                      ShortWhen the annotation was made
                                      Control0..1
                                      TypedateTime
                                      Is Modifierfalse
                                      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()))
                                      38. Flag.extension:note.value[x].text
                                      Definition

                                      The text of the annotation in markdown format.

                                      ShortAdditional information about the alert
                                      Control1..1
                                      Typemarkdown
                                      Is Modifierfalse
                                      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()))
                                      40. 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())
                                      42. 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.

                                      ShortAlert business 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
                                      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()))
                                      44. Flag.status
                                      Definition

                                      Supports basic workflow.

                                      ShortAlert status
                                      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
                                      Obligations
                                        ObligationsActor
                                        SHALL:able-to-populateProducer
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        46. 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.

                                        Control0..*
                                        BindingFor example codes, see FlagCategory
                                        (example to http://hl7.org/fhir/ValueSet/flag-category|4.0.1)

                                        A general category for flags for filtering/display purposes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        48. 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|4.0.1)

                                        Detail codes identifying specific flagged issues.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:able-to-populateProducer
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          50. 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(Patient (EU core))
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:able-to-populateProducer
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            52. 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 the alert is active
                                            Control0..1
                                            TypePeriod
                                            Is Modifierfalse
                                            Obligations
                                              ObligationsActor
                                              SHALL:able-to-populateProducer
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              54. 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(Encounter)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              56. Flag.author
                                              Definition

                                              The person, organization or device that created the flag.

                                              ShortAuthor of the alert
                                              Control0..1
                                              TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))