HL7 Europe Hospital Discharge Report
0.0.1-ci - ci-build 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-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 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: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
Comments

Note that This extension will be replaced by Flag.supportingInfo in the FHIR R6 release.

Control0..*
TypeExtension(Flag details) (Extension Type: Reference(Resource))
Is Modifierfalse
Obligations
    ObligationsActor
    SHALL:handleHDRConsumer
    MAY:able-to-populateHDRCreator
    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
      SHALL:handleHDRConsumer
      MAY:able-to-populateHDRCreator
      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.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())
      10. 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:handleHDRConsumer
        SHOULD:able-to-populateHDRCreator
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. 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
        Obligations
          ObligationsActor
          SHALL:handleHDRConsumer
          SHALL:able-to-populateHDRCreator
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. 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:handleHDRConsumer
            SHALL:able-to-populateHDRCreator
            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
            2. Flag.extension:flagDetailExt
            Slice NameflagDetailExt
            Obligations
              ObligationsActor
              SHALL:handleHDRConsumer
              MAY:able-to-populateHDRCreator
              4. Flag.extension:flagPriorityExt
              Slice NameflagPriorityExt
              Obligations
                ObligationsActor
                SHALL:handleHDRConsumer
                MAY:able-to-populateHDRCreator
                6. Flag.status
                Obligations
                  ObligationsActor
                  SHALL:handleHDRConsumer
                  SHOULD:able-to-populateHDRCreator
                  8. Flag.code
                  Obligations
                    ObligationsActor
                    SHALL:handleHDRConsumer
                    SHALL:able-to-populateHDRCreator
                    10. Flag.subject
                    Obligations
                      ObligationsActor
                      SHALL:handleHDRConsumer
                      SHALL:able-to-populateHDRCreator

                      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 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
                        Comments

                        Note that This extension will be replaced by Flag.supportingInfo in the FHIR R6 release.

                        Control0..*
                        TypeExtension(Flag details) (Extension Type: Reference(Resource))
                        Is Modifierfalse
                        Obligations
                          ObligationsActor
                          SHALL:handleHDRConsumer
                          MAY:able-to-populateHDRCreator
                          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
                            SHALL:handleHDRConsumer
                            MAY:able-to-populateHDRCreator
                            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.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())
                            22. 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
                            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()))
                            24. 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:handleHDRConsumer
                              SHOULD:able-to-populateHDRCreator
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              26. 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)

                              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()))
                              28. 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
                              Obligations
                                ObligationsActor
                                SHALL:handleHDRConsumer
                                SHALL:able-to-populateHDRCreator
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                30. 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:handleHDRConsumer
                                  SHALL:able-to-populateHDRCreator
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  32. 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
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  34. 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()))
                                  36. Flag.author
                                  Definition

                                  The person, organization or device that created the flag.

                                  ShortFlag creator
                                  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()))