Status: Active: Approved (STU)

Definition: Active information or a warning, about a patient or their situation, which may affect how their care or support is delivered.

Introduction

NB: Whilst the term “Patient” is used by FHIR, the profile is equally relevant to a “citizen”, “service user” or “client” in other contexts such as Social Care.

This profile sets minimum expectations for the Flag resource.

Coverage and references

• Data Providers MUST offer Social Care Flag FHIR resources to represent flags against its own patients.
• Only active / inactive flags should be made available for consumption.
• When referencing a Flag then the “reference” (URL of FHIR Resource) and “display” (The Flag type.display) MUST be populated.

Mandatory fields

The following fields are mandatory:

• status only flags which are currently active and/or inactive flags that could benefit clinicians / users against a person should be shared.

• category this provides a level of categorisation, i.e. Risk to others, Risk to self, safeguarding concern, leagal status of the patient and other. This should always be known and is vital for meaningful display purposes. Here We have defined a custom code list for the most common categories of flags used by Social Care. We fully expect that this list will need to be extended for use by healthcare providers. If you need further categories considering, please get in touch.

• code code is used to record the type of flag assigned to a patient. Here we specify a preferred list which was developed for Social Care. Again we expect that this list will need to expand to cater for healthcare providers. Please get in touch should you required further ‘flag types’ adding.

code.text SHOULD be populated with the local name of the flag, this is not a repeat of the code.display, and this field MUST be populated to further describe the flag when ‘Other’ is selected as the type.

• subject.patient The patient to which the flag is assigned.

Must Support fields

In addition, the following fields are “Must Support” - i.e. they must be populated if relevant and known:

• period.start period.start should be populated with the date that the flag was placed against the patient.

Optional fields

Other fields are optional and may be populated if known - on the understanding that not all data consumers will necessarily make use of them. Optional fields to note include:

• identifier:localIdentfier - As with most other resources, there is the option to include a local identifier which may help to identify the flag record at a local level.

• author option to provide a link to the practitioner or organisation which placed the flag against the patient.

Discouraged or Removed fields

• encounter - removed

• code(SNOMEDCT) - This slice created by Care Connect has been removed to avoid confusion with the list of flag types generated by the Social Care Data Standards working group.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CareConnect-Flag-1

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for identifier		0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:localIdentifier		0..1	Identifier	Business identifier
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	S	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
status	S	1..1	code	Indicates whether this flag is active or whether it is no longer active
category	S	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
code	S	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
coding		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
subject	S	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
period
start	S	0..1	dateTime	The date that the flag was placed against the patient
encounter		0..0
author		0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	Σ	0..1	Identifier	Business identifier
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	SΣ	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	Indicates whether this flag is active or whether it is no longer active Binding: FlagStatus (required): Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error.
category	SΣ	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
code	SΣ	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	SNOMED CT representation identifying specific flagged issues
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	Σ	0..1	Period	Time period when flag is active
start	SΣC	0..1	dateTime	The date that the flag was placed against the patient
author	Σ	0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Flag.meta.security	extensible	All Security Labels
Flag.meta.tag	example	Common Tags
Flag.meta.tag:Source	example	Common Tags
Flag.meta.tag:Provenance	example	Common Tags
Flag.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Flag.identifier.use	required	IdentifierUse
Flag.identifier:localIdentifier.use	required	IdentifierUse
Flag.status	required	FlagStatus
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Flag	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Flag	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Flag	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Flag	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()

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	Σ	0..1	Identifier	Business identifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	SΣ	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Indicates whether this flag is active or whether it is no longer active Binding: FlagStatus (required): Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error.
category	SΣ	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:snomedCT	Σ	0..1	Coding	SNOMED CT representation identifying specific flagged issues
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	Σ	0..1	Period	Time period when flag is active
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	The date that the flag was placed against the patient
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
author	Σ	0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Flag.meta.security	extensible	All Security Labels
Flag.meta.tag	example	Common Tags
Flag.meta.tag:Source	example	Common Tags
Flag.meta.tag:Provenance	example	Common Tags
Flag.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Flag.identifier.use	required	IdentifierUse
Flag.identifier.type	extensible	Identifier Type Codes
Flag.identifier:localIdentifier.use	required	IdentifierUse
Flag.identifier:localIdentifier.type	extensible	Identifier Type Codes
Flag.status	required	FlagStatus
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

Differential View

This structure is derived from CareConnect-Flag-1

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for identifier		0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:localIdentifier		0..1	Identifier	Business identifier
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	S	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
status	S	1..1	code	Indicates whether this flag is active or whether it is no longer active
category	S	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
code	S	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
coding		0..*	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
subject	S	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
period
start	S	0..1	dateTime	The date that the flag was placed against the patient
encounter		0..0
author		0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	Σ	0..1	Identifier	Business identifier
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	SΣ	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	Indicates whether this flag is active or whether it is no longer active Binding: FlagStatus (required): Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error.
category	SΣ	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
code	SΣ	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
coding:snomedCT	Σ	0..1	Coding	SNOMED CT representation identifying specific flagged issues
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	Σ	0..1	Period	Time period when flag is active
start	SΣC	0..1	dateTime	The date that the flag was placed against the patient
author	Σ	0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Flag.meta.security	extensible	All Security Labels
Flag.meta.tag	example	Common Tags
Flag.meta.tag:Source	example	Common Tags
Flag.meta.tag:Provenance	example	Common Tags
Flag.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Flag.identifier.use	required	IdentifierUse
Flag.identifier:localIdentifier.use	required	IdentifierUse
Flag.status	required	FlagStatus
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Flag	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Flag	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Flag	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Flag	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Flag		0..*	CareConnect-Flag-1	Key information to flag to healthcare providers
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	Σ	0..1	Identifier	Business identifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-flag-identifier
value	SΣ	1..1	string	The Local flag Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Indicates whether this flag is active or whether it is no longer active Binding: FlagStatus (required): Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or entered in error.
category	SΣ	1..1	CodeableConcept	Clinical, administrative, etc. Binding: Interweave Flag Category (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Coded or textual message to display to user Binding: Interweave Flag Type (preferred)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:snomedCT	Σ	0..1	Coding	SNOMED CT representation identifying specific flagged issues
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient to which the flag is assigned.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	Σ	0..1	Period	Time period when flag is active
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	The date that the flag was placed against the patient
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
author	Σ	0..1	Reference(Device | CareConnectPatient1 | CareConnect-Organization-1 | CareConnect-Practitioner-1)	The practitioner, organizational team or organization which placed the flag against the patient.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Flag.meta.security	extensible	All Security Labels
Flag.meta.tag	example	Common Tags
Flag.meta.tag:Source	example	Common Tags
Flag.meta.tag:Provenance	example	Common Tags
Flag.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Flag.identifier.use	required	IdentifierUse
Flag.identifier.type	extensible	Identifier Type Codes
Flag.identifier:localIdentifier.use	required	IdentifierUse
Flag.identifier:localIdentifier.type	extensible	Identifier Type Codes
Flag.status	required	FlagStatus
Flag.category	required	Interweave Flag Category
Flag.code	preferred	Interweave Flag Type

This structure is derived from CareConnect-Flag-1

Summary

Mandatory: 3 elements (12 nested mandatory elements)
Must-Support: 17 elements
Fixed Value: 3 elements
Prohibited: 2 elements

Structures

This structure refers to these other structures:

• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)

Slices

This structure defines the following Slices:

• The element Flag.meta.tag is sliced based on the value of value:system
• The element Flag.identifier is sliced based on the value of value:system