We are trying to determine if there is an appropriate FHIR DSTU2 resource for a data model we call “Alert Event”. We have used this data model to store the output of decision support/workflow logic that typically requires some notification of and potential action from a system user. For example, during ordering, a CDS rule may fire that states that the ordered item is contraindicated. It may also recommend an alternative. In the first case, the user may be required to just acknowledge the alert. In the second case, the user may be required to accept or reject the recommendation. We record the original alert in the patient’s record, along with the corresponding user response. We also associate information, if appropriate, from the patient’s record that triggered the event. For example, a critical lab result that triggered an alert for clinician intervention would record the alert (“critical lab alert”), the user response (“acknowledge”), and the ID of the triggering patient event (the data string ID for the lab result). (Note that this example implies an asynchronous alerting, which we want the Alert Event model to handle, too.) The Flag resource might handle the notification itself, but it seems too simplistic to store the rest of the information we need. We can supply the detail of the Alert Event model and an example use case if that would help.
Flag is intended to draw attention to key information in a patient record. DetectedIssue covers the sort of contraindications you’ve identified and can also capture what mitigating steps (if any) were taken in response.
Thank you Lloyd. We completely missed that resource. It does indeed appear to handle our use case. We will look at it more closely to be sure, but I think it will work.