Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib Alert - Detailed Descriptions

Active as of 2024-04-09

Definitions for the zib-Alert resource profile.

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

0. Flag
ShortAlert
2. Flag.extension
SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Flag.extension:ConcernReference
    Slice NameConcernReference
    Definition

    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. If there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used.

    ShortCondition
    Control0..1
    TypeExtension(Flag details) (Extension Type: Reference(Resource))
    Alternate NamesConditie
    6. Flag.extension:ConcernReference.valueReference:valueReference
    Slice NamevalueReference
    8. Flag.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    10. Flag.category
    Definition

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

    ShortAlertType
    BindingUnless not suitable, these codes SHALL be taken from AlertTypeCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000)

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

    Alternate NamesAlertType
    Example<br/><b>Example of AlertType</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "75323-6", "display" : "condition", "userSelected" : false }] }
    12. Flag.code
    Definition

    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.

    ShortAlertName
    BindingUnless not suitable, these codes SHALL be taken from AlertNaamCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000)
    Alternate NamesAlertNaam
    Example<br/><b>Example of AlertName</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "432415000", "display" : "Methicillin resistant staphylococcus aureus carrier" }] }
    14. Flag.subject
    TypeReference(nl-core-patient, nl-core-location, Group, nl-core-organization, nl-core-practitioner, PlanDefinition, http://nictiz.nl/fhir/StructureDefinition/zib-Product, HCIM Procedure)
    16. Flag.subject.extension
    SlicingThis element introduces a set of slices on Flag.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. Flag.subject.extension:practitionerRole
      Slice NamepractitionerRole
      Control0..1
      TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
      20. Flag.period
      22. Flag.period.start
      Definition

      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).

      ShortStartDateTime
      Alternate NamesBeginDatumTijd
      Example<br/><b>Example of StartDateTime</b>:2017-02-07
      24. Flag.encounter
      TypeReference(HCIM Encounter)
      26. Flag.author
      TypeReference(HCIM MedicalDevice Product, nl-core-patient, nl-core-practitioner, nl-core-organization)
      28. Flag.author.extension
      SlicingThis element introduces a set of slices on Flag.author.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 30. Flag.author.extension:practitionerRole
        Slice NamepractitionerRole
        Control0..1
        TypeExtension(PractitionerRole Reference) (Extension Type: Reference)

        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.

        ShortAlertKey information to flag to healthcare providers
        Control0..*
        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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: 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())
        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.

        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.

        This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

        Control0..1
        Typeuri
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        4. Flag.extension
        Definition

        An Extension


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

        ShortExtensionAdditional Content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 6. Flag.extension:ConcernReference
          Slice NameConcernReference
          Definition

          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. If there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used.

          ShortCondition
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Flag details) (Extension Type: Reference(Resource))
          Alternate NamesConditie
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          8. Flag.extension:ConcernReference.url
          Definition

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

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/flag-detail
          10. Flag.extension:ConcernReference.valueReference:valueReference
          Slice NamevalueReference
          Definition

          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

          ShortValue of extension
          Control0..1
          TypeReference(Resource), date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
          12. 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. Usually modifier elements provide negation or qualification. In order 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.

          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 No Modifier Reason provideed in previous versions of FHIR
          Alternate Namesextensions, user content
          14. Flag.identifier
          Definition

          Identifier assigned to the flag for external use (outside the FHIR environment).

          ShortBusiness identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Summarytrue
          16. Flag.status
          Definition

          Supports basic workflow.

          Shortactive | 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
          (required to http://hl7.org/fhir/ValueSet/flag-status)

          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.

          Typecode
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          18. Flag.category
          Definition

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


          Allows an 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.

          ShortAlertTypeClinical, administrative, etc.
          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from For example codes, see AlertTypeCodelijsthttp://hl7.org/fhir/ValueSet/flag-category
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000)

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


          A general category for flags for filtering/display purposes.

          TypeCodeableConcept
          Summarytrue
          Alternate NamesAlertType
          Example<br/><b>Example of AlertType</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "75323-6", "display" : "condition", "userSelected" : false }] }
          20. Flag.code
          Definition

          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.


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

          ShortAlertNameCoded 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
          BindingUnless not suitable, these codes SHALL be taken from For example codes, see AlertNaamCodelijsthttp://hl7.org/fhir/ValueSet/flag-code
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000)
          TypeCodeableConcept
          Summarytrue
          Alternate NamesAlertNaam
          Example<br/><b>Example of AlertName</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "432415000", "display" : "Methicillin resistant staphylococcus aureus carrier" }] }
          22. 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(nl-core-patient, nl-core-location, Group, nl-core-organization, nl-core-practitioner, PlanDefinition, http://nictiz.nl/fhir/StructureDefinition/zib-Product, HCIM Procedure, Patient, Location, Organization, Practitioner, Medication, Procedure)
          Summarytrue
          24. Flag.subject.extension
          Definition

          An Extension


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

          ShortExtensionAdditional Content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Flag.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 26. Flag.subject.extension:practitionerRole
            Slice NamepractitionerRole
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control0..1
            TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
            28. 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(HCIM Encounter, Encounter)
            Summarytrue
            30. Flag.author
            Definition

            The person, organization or device that created the flag.

            ShortFlag creator
            Control0..1
            TypeReference(HCIM MedicalDevice Product, nl-core-patient, nl-core-practitioner, nl-core-organization, Device, Organization, Patient, Practitioner)
            Summarytrue
            32. Flag.author.extension
            Definition

            An Extension


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

            ShortExtensionAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Flag.author.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 34. Flag.author.extension:practitionerRole
              Slice NamepractitionerRole
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control0..1
              TypeExtension(PractitionerRole Reference) (Extension Type: Reference)

              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.

              ShortAlert
              Control0..*
              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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: 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())
              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
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              4. Flag.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Summarytrue
              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.

              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.

              This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

              Control0..1
              Typeuri
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              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
              BindingUnless not suitable, these codes SHALL be taken from Common Languages
              (extensible to http://hl7.org/fhir/ValueSet/languages)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              10. Flag.text
              Definition

              A human-readable narrative that contains a summary of the resource, and may 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 in formation is added later.

              Control0..1
              This element is affected by the following invariants: dom-1
              TypeNarrative
              Alternate Namesnarrative, html, xhtml, display
              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.

              Control0..*
              TypeResource
              Alternate Namesinline resources, anonymous resources, contained resources
              14. Flag.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              SlicingThis element introduces a set of slices on Flag.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 16. Flag.extension:ConcernReference
                Slice NameConcernReference
                Definition

                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. If there is a contraindication, the code system G-Standard Contraindications (Table 40) from the ProblemNameCodeList of the ConcernTransfer information model should be used.

                ShortCondition
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Flag details) (Extension Type: Reference(Resource))
                Alternate NamesConditie
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                18. Flag.extension:ConcernReference.id
                Definition

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

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                20. Flag.extension:ConcernReference.extension
                Definition

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

                ShortAdditional Content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Alternate Namesextensions, user content
                SlicingThis element introduces a set of slices on Flag.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 22. Flag.extension:ConcernReference.url
                  Definition

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

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/flag-detail
                  24. Flag.extension:ConcernReference.valueReference:valueReference
                  Slice NamevalueReference
                  Definition

                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                  ShortValue of extension
                  Control0..1
                  TypeReference(Resource)
                  26. 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. Usually modifier elements provide negation or qualification. In order 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.

                  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 No Modifier Reason provideed in previous versions of FHIR
                  Alternate Namesextensions, user content
                  28. Flag.identifier
                  Definition

                  Identifier assigned to the flag for external use (outside the FHIR environment).

                  ShortBusiness identifier
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..*
                  TypeIdentifier
                  Summarytrue
                  30. Flag.status
                  Definition

                  Supports basic workflow.

                  Shortactive | 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 FlagStatus
                  (required to http://hl7.org/fhir/ValueSet/flag-status)

                  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.

                  Typecode
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  32. Flag.category
                  Definition

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

                  ShortAlertType
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from AlertTypeCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.1--20171231000000)

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

                  TypeCodeableConcept
                  Summarytrue
                  Alternate NamesAlertType
                  Example<br/><b>Example of AlertType</b>:{ "coding" : [{ "system" : "http://loinc.org", "code" : "75323-6", "display" : "condition", "userSelected" : false }] }
                  34. Flag.code
                  Definition

                  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.

                  ShortAlertName
                  Comments

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

                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from AlertNaamCodelijst
                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.3.2--20171231000000)
                  TypeCodeableConcept
                  Summarytrue
                  Alternate NamesAlertNaam
                  Example<br/><b>Example of AlertName</b>:{ "coding" : [{ "system" : "http://snomed.info/sct", "code" : "432415000", "display" : "Methicillin resistant staphylococcus aureus carrier" }] }
                  36. 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(nl-core-patient, nl-core-location, Group, nl-core-organization, nl-core-practitioner, PlanDefinition, http://nictiz.nl/fhir/StructureDefinition/zib-Product, HCIM Procedure)
                  Summarytrue
                  38. Flag.subject.id
                  Definition

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

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  40. Flag.subject.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  SlicingThis element introduces a set of slices on Flag.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 42. Flag.subject.extension:practitionerRole
                    Slice NamepractitionerRole
                    Definition

                    Optional Extension Element - found in all resources.

                    ShortOptional Extensions Element
                    Control0..1
                    TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                    44. Flag.subject.reference
                    Definition

                    A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                    ShortLiteral reference, Relative, internal or absolute URL
                    Comments

                    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                    Control0..1
                    This element is affected by the following invariants: ref-1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    46. Flag.subject.identifier
                    Definition

                    An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    ShortLogical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    TypeIdentifier
                    Summarytrue
                    48. Flag.subject.display
                    Definition

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    50. 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
                    Summarytrue
                    52. Flag.period.id
                    Definition

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

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    54. Flag.period.extension
                    Definition

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

                    ShortAdditional Content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    SlicingThis element introduces a set of slices on Flag.period.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 56. Flag.period.start
                      Definition

                      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).

                      ShortStartDateTime
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate NamesBeginDatumTijd
                      Example<br/><b>Example of StartDateTime</b>:2017-02-07
                      58. Flag.period.end
                      Definition

                      The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                      ShortEnd time with inclusive boundary, if not ongoing
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                      60. 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(HCIM Encounter)
                      Summarytrue
                      62. Flag.author
                      Definition

                      The person, organization or device that created the flag.

                      ShortFlag creator
                      Control0..1
                      TypeReference(HCIM MedicalDevice Product, nl-core-patient, nl-core-practitioner, nl-core-organization)
                      Summarytrue
                      64. Flag.author.id
                      Definition

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

                      Shortxml:id (or equivalent in JSON)
                      Control0..1
                      Typestring
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      66. Flag.author.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      SlicingThis element introduces a set of slices on Flag.author.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 68. Flag.author.extension:practitionerRole
                        Slice NamepractitionerRole
                        Definition

                        Optional Extension Element - found in all resources.

                        ShortOptional Extensions Element
                        Control0..1
                        TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                        70. Flag.author.reference
                        Definition

                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                        ShortLiteral reference, Relative, internal or absolute URL
                        Comments

                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                        Control0..1
                        This element is affected by the following invariants: ref-1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        72. Flag.author.identifier
                        Definition

                        An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                        ShortLogical reference, when literal reference is not known
                        Comments

                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..1
                        TypeIdentifier
                        Summarytrue
                        74. Flag.author.display
                        Definition

                        Plain text narrative that identifies the resource in addition to the resource reference.

                        ShortText alternative for the resource
                        Comments

                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                        Control0..1
                        Typestring
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue