Flag

A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.

Resource Content

Search Parameters

Scope and Usage

Overview

A flag is a warning or notification presented to users (clinicians or other healthcare providers) that:

• Represents significant information warranting special display
• Contains a subject that triggers its display
• Is typically shown as a prominent label in the patient record
• Should be concise and highlight high-priority issues

Subject Types and Examples

Flags can reference different subject types:

• Patient: Overdue account notifications for discussion
• Location: Regional health alerts (e.g., Ebola outbreak risks)
• Practitioner: Provider availability status
• Group: Clinical trial enrollment
• PlanDefinition: Protocol-specific guidance
• Medication: Special approval requirements for drugs

Common Use Cases

Patient-Related Flags:

• Risk Factors

  • Functional risk of falls
  • Spousal restraining orders
  • Latex allergy

• Special Accommodations

  • Hard of hearing
  • Need for easy-open caps

• Provider Safety

  • Presence of pets/animals
  • Potential aggressive behavior
  • Infection control precautions

• Administrative

  • Incomplete information
  • Pre-payment requirements

Out of Scope

Flags should not be used for:

1. Potential allergy or drug interactions (use DetectedIssue instead)
2. Known adverse reactions (use AllergyIntolerance instead)

Important Considerations

• Flags may contain information not captured elsewhere (e.g., "Patient has large dog at home")
• Create flags judiciously to prevent information overload
• Flags persist in records for defined periods
• Implementation guidelines vary by community
• While some information may be redundant (e.g., latex allergy), this redundancy serves a safety purpose

Boundaries and Relationships

Flags may highlight a highly condensed view of information found in the AllergyIntolerance, Condition, Observation, Procedure and possibly other resources. A common extension allows the linkage of a Flag to the supporting detail resource. The purpose of these other resources is to provide detailed clinical information. The purpose of a Flag is to alert practitioners to information that is important to influence their interaction with a Patient prior to detailed review of the record.

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

Flags are not raised as a result of a reported or proposed action (e.g. drug-drug interactions, duplicate therapy warnings). These would be handled using DetectedIssue.

Referenced Elements

N/A