Flag

$10 / year

A flag is a warning or notification of some sort presented to the user, who may be a clinician or some other person involved in patient care. It usually represents something of sufficient significance to warrant a special display of some sort, rather than just a note in the resource. The purpose of a Flag is to alert practitioners to information that is important to influence their interaction with a patient prior to a detailed review of the record.

Complexity

Flags are not used to convey information to a specific individual or organization (e.g. an abnormal lab result reported to the ordering clinician, reporting of an adverse reaction to a regulatory authority). These are handled using the Communication Request and Communication resources.

Flags are not raised as a result of a reported or proposed action (e.g. drug-drug interactions, duplicate therapy warnings). These would be handled using detected issue. A flag has a subject representing the resource that will trigger its display. This subject can be of different types, as described in the examples below:

– A note that a patient has an overdue account, which the provider may wish to discuss with them in case of hardship for example (subject = Patient)
– An outbreak of Ebola in a particular region (subject=Location) so that all patients from that region have a higher risk of having that condition
– A particular provider is unavailable for referrals over a given period (subject = Practitioner)
– A patient who is enrolled in a clinical trial (subject=Group)
– Special guidance or caveats to be aware of when following a protocol (subject=Plan Definition)
– Warnings about using a drug in a formulary require special approval (subject=Medication)
– etc.

A flag is typically presented as a label in a prominent location in the record to notify the clinician of the potential issues, though it may also appear in other contexts; e.g. notes applicable to a radiology technician, or to a clinician performing a home visit. For patients, the information in the flag will often be derived from the record, and therefore, for a thorough and careful clinician, who has the time to review the notes will be redundant. However, given the volume of information frequently found in patients’ records and the potentially serious consequences of losing sight of some facts, this redundancy is deemed appropriate. As well, some flags may reflect information not captured by any other resource in the record. (E.g. “Patient has large dog at home”)

In line with its purpose, a flag is concise, highlighting a small set of high-priority issues among the much larger set of data in the chart. Readers who want more detail should consult the chart or other sources of information. Caution should be exercised in creating Flag instances. If entries are created for information that could be gleaned in a sufficiently timely fashion by reviewing the patient record, the flag list will itself become overwhelming and will cease to serve its intended purpose.

Date Created

2018-09-20

Last Modified

2019-11-01

Version

4.0.1

Update Frequency

Annual

Temporal Coverage

N/A

Spatial Coverage

United States

Source

John Snow Labs; Health Level Seven International;

Source License URL

Source License Requirements

N/A

Source Citation

N/A

Keywords

FHIR, HL7, Medical Terminology, Processes Data, Processes Information, Processes Documentation, Health Information Exchange, Electronic Health Records, FHIR Smart, Smart on FHIR

Other Titles

FHIR Flag Resource, Electronic Health Records Exchange Through FHIR

NameDescriptionTypeConstraints
Concept_NameName of the concept in the FHIR structure.stringrequired : 1
Computer_Ready_NameA Computer-ready name (e.g. a token) that identifies the structure - suitable for code generation. Note that this name (and other names relevant for code generation, including element & slice names, codes etc) may collide with reserved words in the relevant target language, and code generators will need to handle this.string-
TypeThe type the structure describes.string-
Dollar_RefThe "$ref" string value contains a Uniform Resource Identifier (URI) which identifies the location of the JSON value being referenced.string-
DescriptionA free text natural language description of the structure and its use.string-
ItemsThe value of the keyword should be an object or an array of objects. If the keyword value is an object, then for the data array to be valid each item of the array should be valid according to the schema in this value.string-
EnumThe enum is used to restrict a value to a fixed set of values. It must be an array with at least one element, where each element is unique.string-
RequiredThe value of the keyword should be an array of unique strings. The data object to be valid should contain all properties with names equal to the elements in the keyword value.string-
ConstThe value of this keyword can be anything. The data is valid if it is deeply equal to the value of the keyword.string-
Concept NameComputer Ready NameTypeDollar RefDescriptionItemsEnumRequiredConst
FlagresourceTypeThis is a Flag resourceFlag
Flagid#/definitions/idThe logical id of the resource as used in the URL for the resource. Once assigned this value never changes.
Flagmeta#/definitions/MetaThe 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.
FlagimplicitRules#/definitions/uriA 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.
Flag_implicitRules#/definitions/ElementExtensions for implicitRules
Flaglanguage#/definitions/codeThe base language in which the resource is written.
Flag_language#/definitions/ElementExtensions for language
Flagtext#/definitions/NarrativeA 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.
FlagcontainedarrayThese 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.{'$ref': '#/definitions/ResourceList'}
FlagextensionarrayMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension there is a set of requirements that SHALL be met as part of the definition of the extension.{'$ref': '#/definitions/Extension'}
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