One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://terminology.hl7.org/CodeSystem/data-absent-reason.

The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.

One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason.

Explanatory comments to the alert that can not be expressed in any of the other elements.

Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:

• value @ $this

Indicates the type of alert, meaning a rough description of the cause or origin of the warning.

• value @ $this

A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text.

If this slice is used, slice :dataAbsentReason MUST be absent and Flag.extension:concern MUST NOT exist. See the guidance on the root.

This slice MUST be used when Flag.extension:concern is populated. Slice :alertName MUST be absent in this case. See the guidance on the root.

The date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

The date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

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

One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://terminology.hl7.org/CodeSystem/data-absent-reason.

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.

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.

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

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.

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.

• value @ url

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

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.

The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.

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

One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason.

Optional Extension Element - found in all resources.

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

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.

Explanatory comments to the alert that can not be expressed in any of the other elements.

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

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).

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.

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.

Supports basic workflow.

Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:

• EndDateTime present and in the past: inactive
• EndDateTime absent: active
• EndDateTime present and in the future - goes against both FHIR and zib definitions, but in a case where this might occur: active

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

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.

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.

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

A general category for flags for filtering/display purposes.

• value @ $this

Indicates the type of alert, meaning a rough description of the cause or origin of the warning.

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.

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

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

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

Detail codes identifying specific flagged issues.

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

• value @ $this

A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text.

A reference to a code defined by a terminology system.

If this slice is used, slice :dataAbsentReason MUST be absent and Flag.extension:concern MUST NOT exist. See the guidance on the root.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

This slice MUST be used when Flag.extension:concern is populated. Slice :alertName MUST be absent in this case. See the guidance on the root.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

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

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

One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://terminology.hl7.org/CodeSystem/data-absent-reason.

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

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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.

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.

The base language in which the resource is written.

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).

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.

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.

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.

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.

An Extension

• value @ url

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

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

An Extension

• value @ url

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

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.

The patient’s health problem or condition that is the subject of the alert. This could involve a patient’s problem, condition or diagnosis that is seen as a contraindication in prescribing medication or which has to be taken into account when shaping diagnostic and therapeutic policy. This can be in the patient’s own interest, or it can involve a problem or disorder that can make the patient a risk to their surroundings, such as an infection hazard. These are references to conditions included on the patient’s problem list.

One of the zib concepts Condition::Concern and AlertName must be selected. If .code contains a code from AlertNaamCodelijst, .extension:concern SHALL not exist. On the other hand, if .extension:concern is populated, .code SHALL contain code not-applicable from system http://hl7.org/fhir/ValueSet/data-absent-reason.

Optional Extension Element - found in all resources.

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

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.

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.

• value @ url

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

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.

Explanatory comments to the alert that can not be expressed in any of the other elements.

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.

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.

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.

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.

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.

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

Supports basic workflow.

Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:

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.

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

• value @ $this

Indicates the type of alert, meaning a rough description of the cause or origin of the warning.

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

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

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

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

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.

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.

• value @ url

A reference to a code defined by a terminology system.

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Allows for alternative encodings within a code system, and translations to other code systems.

• value @ $this

A warning, other than a condition or problem. For example, a patient can be given an ‘Aggressive patient' alert. The warning can be entered in code (there are codes for frequently used alerts), but seeing the dynamic nature of the warnings cf. SARS and Ebola, these alerts will often be entered as free text.

If this slice is used, slice :dataAbsentReason MUST be absent and Flag.extension:concern MUST NOT exist. See the guidance on the root.

Allows for alternative encodings within a code system, and translations to other code systems.

A reference to a code defined by a terminology system.

This slice MUST be used when Flag.extension:concern is populated. Slice :alertName MUST be absent in this case. See the guidance on the root.

Allows for alternative encodings within a code system, and translations to other code systems.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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.

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

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.

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.

• value @ url

The date and time at which the described condition was entered as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

If the low element is missing, the meaning is that the low boundary is not known.

The date and time at which the described condition was retracted as a warning. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

This alert is only relevant during the encounter.

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.

The person, organization or device that created the flag.