Profile_R2_Flag_R4 - Definitions - Extensions for Using Data Elements from FHIR DSTU2 in FHIR R4 v0.1.0

Is Modifier false

Summary true

4. Flag.meta

Definition

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

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. Flag.meta.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

8. Flag.meta.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

This element introduces a set of slices on Flag.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

10. Flag.meta.extension:meta

Slice Name meta

Definition

DSTU2: Flag.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

Short DSTU2: meta additional types

Comments

Element Flag.meta is mapped to FHIR R4 element Flag.meta as SourceIsBroaderThanTarget. The mappings for Flag.meta do not cover the following types: Meta. The mappings for Flag.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

Control 0..1

Type Extension(DSTU2: meta additional types) (Extension Type: Meta)

Is Modifier false

Summary false

12. Flag.meta.versionId

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Short Version specific identifier

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

14. Flag.meta.lastUpdated

Definition

When the resource last changed - e.g. when the version changed.

Short When the resource version last changed

Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

Control 0..1

instant

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

16. Flag.meta.source

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Short Identifies where the resource comes from

Comments

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

18. Flag.meta.profile

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Short Profiles this resource claims to conform to

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control 0..*

Type canonical(StructureDefinition)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

20. Flag.meta.security

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Short Security Labels applied to this resource

Comments

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Control 0..*

Unless not suitable, these codes SHALL be taken from All Security Labels

(extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

Security Labels from the Healthcare Privacy and Security Classification System.

Coding

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

22. Flag.meta.tag

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Short Tags applied to this resource

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Control 0..*

For example codes, see CommonTags
(example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Coding

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

24. Flag.implicitRules

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1

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

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

26. Flag.language

Definition

The base language in which the resource is written.

Short Language 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).

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

28. Flag.text

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

30. Flag.text.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

32. Flag.text.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

34. Flag.text.extension:text

Slice Name text

Definition

DSTU2: Flag.text additional types (Narrative) additional types from child elements (div, status)

Short DSTU2: text additional types

Comments

Element Flag.text is mapped to FHIR R4 element Flag.text as SourceIsBroaderThanTarget. The mappings for Flag.text do not cover the following types: Narrative. The mappings for Flag.text do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Control 0..1

Type Extension(DSTU2: text additional types) (Complex Extension)

Is Modifier false

36. Flag.text.status

Definition

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

Short generated | extensions | additional | empty

Control 1..1

The codes SHALL be taken from NarrativeStatus
(required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

The status of a resource narrative.

code

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

38. Flag.text.div

Definition

The actual narrative content, a stripped down version of XHTML.

Short Limited xhtml content

Comments

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

Control 1..1

xhtml

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())

40. 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.

Short Contained, inline Resources

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

42. Flag.extension

Definition

May 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.

Short Additional 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.

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

44. Flag.modifierExtension

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content

46. Flag.identifier

Definition

Business identifiers assigned to this flag by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Short Business identifier

Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

48. Flag.identifier.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

50. Flag.identifier.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

52. Flag.identifier.extension:identifier

Slice Name identifier

Definition

DSTU2: Flag.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

Short DSTU2: identifier additional types

Comments

Element Flag.identifier is mapped to FHIR R4 element Flag.identifier as SourceIsBroaderThanTarget. The mappings for Flag.identifier do not cover the following types: Identifier. The mappings for Flag.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value.

Control 0..*

Type Extension(DSTU2: identifier additional types) (Extension Type: Identifier)

Is Modifier false

Summary false

54. Flag.identifier.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 0..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

code

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

56. Flag.identifier.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

CodeableConcept

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

58. Flag.identifier.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General: http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

60. Flag.identifier.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Example General: 123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

62. Flag.identifier.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

64. Flag.identifier.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

66. Flag.status

Definition

Supports basic workflow.

Short active | 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.

Control 1..1

The codes SHALL be taken from FlagStatus
(required to http://hl7.org/fhir/ValueSet/flag-status|4.0.1)

Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error.

code

Is Modifier true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

68. Flag.category

Definition

Allows a flag to be divided into different categories like clinical, administrative etc. Intended to be used as a means of filtering which flags are displayed to particular user or in a given context.

Short Clinical, administrative, etc.

Comments

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

Control 0..*

For example codes, see FlagCategory
(example to http://hl7.org/fhir/ValueSet/flag-category|4.0.1)

A general category for flags for filtering/display purposes.

CodeableConcept

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

70. Flag.code

Definition

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

Short Coded or textual message to display to user

Comments

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

Control 1..1

For example codes, see FlagCode
(example to http://hl7.org/fhir/ValueSet/flag-code|4.0.1)

Detail codes identifying specific flagged issues.

CodeableConcept

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

72. Flag.subject

Definition

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

Short Who/What is flag about?

Control 1..1

Type Reference(Patient, Location, Group, Organization, Practitioner, PlanDefinition, Medication, Procedure)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

74. 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.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

76. Flag.subject.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

78. Flag.subject.extension:subject

Slice Name subject

Definition

DSTU2: Flag.subject

Short DSTU2: subject

Comments

Element Flag.subject is mapped to FHIR R4 element Flag.subject as RelatedTo. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element Flag.subject with unmapped reference targets: Group, Location, Organization, Patient, Practitioner.

Control 0..1

Type Extension(Alternate Reference) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

80. 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.

Short Literal 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.

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

82. Flag.subject.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

Short Type the reference refers to (e.g. "Patient")

Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType

(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

84. Flag.subject.identifier

Definition

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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.

Short Logical 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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

86. Flag.subject.display

Definition

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

Short Text 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.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

88. 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.

Short Time period when flag is active

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

90. 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.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

92. Flag.period.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

94. Flag.period.extension:period

Slice Name period

Definition

DSTU2: Flag.period additional types (Period) additional types from child elements (end, start)

Short DSTU2: period additional types

Comments

Element Flag.period is mapped to FHIR R4 element Flag.period as SourceIsBroaderThanTarget. The mappings for Flag.period do not cover the following types: Period. The mappings for Flag.period do not cover the following types based on type expansion: end, start.

Control 0..1

Type Extension(DSTU2: period additional types) (Extension Type: Period)

Is Modifier false

Summary false

96. Flag.period.start

Definition

The start of the period. The boundary is inclusive.

Short Starting time with inclusive boundary

Comments

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

Control 0..1
This element is affected by the following invariants: per-1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

98. Flag.period.end

Definition

The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. 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.

Short End 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 an end value of 2012-02-03.

Control 0..1
This element is affected by the following invariants: per-1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Meaning if Missing If the end of the period is missing, it means that the period is ongoing

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

100. Flag.encounter

Definition

This alert is only relevant during the encounter.

Short Alert 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.

Control 0..1

Type Reference(Encounter)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. Flag.encounter.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

104. Flag.encounter.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

106. Flag.encounter.extension:encounter

Slice Name encounter

Definition

DSTU2: Flag.encounter additional types from child elements (display, reference)

Short DSTU2: encounter additional types

Comments

Element Flag.encounter is mapped to FHIR R4 element Flag.encounter as SourceIsBroaderThanTarget. The mappings for Flag.encounter do not cover the following types based on type expansion: display, reference. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element Flag.encounter with unmapped reference targets: Encounter.

Control 0..1

Type Extension(Alternate Reference) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

108. Flag.encounter.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. Flag.encounter.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Short Type the reference refers to (e.g. "Patient")

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType

(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. Flag.encounter.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

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

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

114. Flag.encounter.display

Definition

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

Short Text 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.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

116. Flag.author

Definition

The person, organization or device that created the flag.

Short Flag creator

Control 0..1

Type Reference(Device, Organization, Patient, Practitioner, PractitionerRole)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

118. 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.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

120. Flag.author.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on Flag.author.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

122. Flag.author.extension:author

Slice Name author

Definition

DSTU2: Flag.author

Short DSTU2: author

Comments

Element Flag.author is mapped to FHIR R4 element Flag.author as RelatedTo. The standard extension alternate-reference has been mapped as the representation of FHIR DSTU2 element Flag.author with unmapped reference targets: Device, Organization, Patient, Practitioner.

Control 0..1

Type Extension(Alternate Reference) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

124. Flag.author.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. Flag.author.type

Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

Short Type the reference refers to (e.g. "Patient")

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from ResourceType

(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. Flag.author.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

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

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

130. Flag.author.display

Definition

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

Short Text 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.

Control 0..1