Description of use case on Spine via the FHIR® Reasonable Adjustments API

1 Update Adjustment

Trigger:

Post-operative appointment with GP. Patient requests change of ‘Easy Read’ Adjustment to ‘Large Print’

System Scope:

ClientSystem includes GPSystem client, SCRa, 1-click etc.
ServerSystem includes Spine, PDS, SDS, FlagServer etc.

Summary:

During appointment GP discusses RA Record, Patient requests change of Reasonable Adjustment ‘Easy Read’ to ‘Large Print’.
Practitioner updates (soft deletes) existing ‘Easy Read’ Adjustment, records Removal reason ‘Entered in error’
Practitioner creates new ‘Large Print’ Adjustment.

Pre

  • Practitioner logged into ClientSystem, traces & verifies demographic info
  • Practitioner opens Patient’s RARecord
    • System retrieves and displays RARecord for Patient’s NHS
  • Practitioner discusses RARecord and RA with Patient, Patient doesn’t like Easy Read
  • Practitioner discusses options w Patient, Patient agrees change RA ‘Easy Read’ to ‘Large Print’

Main

  • Practitioner removes (soft deletes) existing ‘Easy Read’ Adjustment, records Removal reason ‘Entered in error’;
    • ClientSystem updates client-side Flag resource
  • Practitioner commits RARecord
    • ClientSystem submits Update Flag request (xml) (json)
      • ServerSystem submits Update Flag response (xml) (json)
  • Practitioner records new ‘Large Print’ Adjustment
    • ClientSystem captures and structures Adjustment information as new RARecord-Flag-1 resource
  • Practitioner commits RARecord
    • ClientSystem submits Create Flag request (xml) (json)
      • ServerSystem submits Create Flag response (xml) (json)

2 Interaction Examples

Examples of http requests, responses and payloads

2.1 Update Flag Request - xml example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186 HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+xml
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:Flag.write:1
If-Match: W/"aa755bd6-2be9-4971-972a-6724879c5cb1"


http body

UpdateFlagRequest.xml XML Example

<!-- xml example file 
UpdateExample-UpdateFlagRequest.xml -->
<Flag xmlns="http://hl7.org/fhir">
    <id value="2acb0536-0a8f-48c9-8a2f-6ee82860f186"/>
    <meta>
        <versionId value="aa755bd6-2be9-4971-972a-6724879c5cb1"/>
        <lastUpdated value="2018-07-24T10:01:00+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"/>
    </meta>
    <contained>
        <Provenance>
            <id value="43124f67-b09d-453d-b889-a5e2e8780b9e"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"/>
            </target>
            <recorded value="2018-07-24T10:05:33+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#43124f67-b09d-453d-b889-a5e2e8780b9e"/>
            </valueReference>
        </extension>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-RemovalReason-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-RemovalReason-1"/>
                <code value="Error"/>
                <display value="The Reasonable Adjustment Flag was created in error"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1"/>
                <code value="comms"/>
                <display value="Communication"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <status value="inactive"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requiresinformationineasyread"/>
            <display value="Requires information in Easyread"/>
        </coding>
    </code>
    <subject>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
</Flag>

2.2 Update Flag Request - json example

http request & headers

PUT https://clinicals.spineservices.nhs.uk/STU3/Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186 HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+json
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:Flag.write:1
If-Match: W/"aa755bd6-2be9-4971-972a-6724879c5cb1"

http body

Update Flag Request JSON Example

{
  "resourceType": "Flag",
  "id": "2acb0536-0a8f-48c9-8a2f-6ee82860f186",
  "fhir_comments": [
    " xml example fileUpdateExample-UpdateFlagRequest.xml "
  ],
  "meta": {
    "versionId": "aa755bd6-2be9-4971-972a-6724879c5cb1",
    "lastUpdated": "2018-07-24T10:01:00+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "43124f67-b09d-453d-b889-a5e2e8780b9e",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"
        }
      ],
      "recorded": "2018-07-24T10:05:33+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R1974",
                  "display": "Community Learning Disabilities Nurse"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9",
            "display": "Nurse N"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some Hospital Learning Disability Support Department"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#43124f67-b09d-453d-b889-a5e2e8780b9e"
          }
        }
      ]
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-RemovalReason-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-RemovalReason-1",
            "code": "Error",
            "display": "The Reasonable Adjustment Flag was created in error"
          }
        ]
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1",
            "code": "comms",
            "display": "Communication"
          }
        ]
      }
    }
  ],
  "status": "inactive",
  "category": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
        "code": "reasonable adjustments flag",
        "display": "Reasonable Adjustments Flag"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requiresinformationineasyread",
        "display": "Requires information in Easyread"
      }
    ]
  },
  "subject": {
    "reference": "demographics.spineservices.nhs.uk/STU3/Patient/999999998"
  }
}

2.3 Update Flag Response - xml example

http request & headers

HTTP/1.1 200 OK
Date: Thur, 25 Jul 2018 11:00:00 GMT
Last-Modified: 2018-07-25T11:00:00+00:00
ETag: W/"b0c4bd5f-6133-4ac4-af48-82570ad15007”
Content-Type: application/fhir+xml

http body

Update Flag Response XML Example

<!-- xml example file 
UpdateExample-UpdateFlagResponse.xml -->
<Flag xmlns="http://hl7.org/fhir">
    <id value="2acb0536-0a8f-48c9-8a2f-6ee82860f186"/>
    <meta>
        <versionId value="b0c4bd5f-6133-4ac4-af48-82570ad15007"/>
        <lastUpdated value="2018-07-25T11:00:00+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"/>
    </meta>
    <contained>
        <Provenance>
            <id value="43124f67-b09d-453d-b889-a5e2e8780b9e"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"/>
            </target>
            <recorded value="2018-07-24T10:05:33+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R1974"/>
                        <display value="Community Learning Disabilities Nurse"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9"/>
                    <display value="Nurse N"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some Hospital Learning Disability Support Department"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <contained>
        <Provenance>
            <id value="07c0c8fa-4654-42f7-8d6c-e4b4e714cffd"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"/>
            </target>
            <recorded value="2018-07-25T11:00:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#43124f67-b09d-453d-b889-a5e2e8780b9e"/>
            </valueReference>
        </extension>
        <extension url="updated">
            <valueReference>
                <reference value="#07c0c8fa-4654-42f7-8d6c-e4b4e714cffd"/>
            </valueReference>
        </extension>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-RemovalReason-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-RemovalReason-1"/>
                <code value="Error"/>
                <display value="The Reasonable Adjustment Flag was created in error"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1"/>
                <code value="comms"/>
                <display value="Communication"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <status value="inactive"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requiresinformationineasyread"/>
            <display value="Requires information in Easyread"/>
        </coding>
    </code>
    <subject>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
</Flag>

2.4 Update Flag Response - json example

http request & headers

HTTP/1.1 200 OK
Date: Thur, 25 Jul 2018 11:00:00 GMT
Last-Modified: 2018-07-25T11:00:00+00:00
ETag: W/"b0c4bd5f-6133-4ac4-af48-82570ad15007”
Content-Type: application/fhir+json

http body

Update Flag Response JSON Example

{
  "resourceType": "Flag",
  "id": "2acb0536-0a8f-48c9-8a2f-6ee82860f186",
  "fhir_comments": [
    " xml example fileUpdateExample-UpdateFlagResponse.xml "
  ],
  "meta": {
    "versionId": "b0c4bd5f-6133-4ac4-af48-82570ad15007",
    "lastUpdated": "2018-07-25T11:00:00+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "43124f67-b09d-453d-b889-a5e2e8780b9e",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"
        }
      ],
      "recorded": "2018-07-24T10:05:33+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R1974",
                  "display": "Community Learning Disabilities Nurse"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/4tr6ee6a9",
            "display": "Nurse N"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some Hospital Learning Disability Support Department"
          }
        }
      ]
    },
    {
      "resourceType": "Provenance",
      "id": "07c0c8fa-4654-42f7-8d6c-e4b4e714cffd",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Flag/2acb0536-0a8f-48c9-8a2f-6ee82860f186"
        }
      ],
      "recorded": "2018-07-25T11:00:00+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R0260",
                  "display": "General Medical Practitioner"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9",
            "display": "Dr.D"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some GP Clinic"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#43124f67-b09d-453d-b889-a5e2e8780b9e"
          }
        },
        {
          "url": "updated",
          "valueReference": {
            "reference": "#07c0c8fa-4654-42f7-8d6c-e4b4e714cffd"
          }
        }
      ]
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-RemovalReason-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-RemovalReason-1",
            "code": "Error",
            "display": "The Reasonable Adjustment Flag was created in error"
          }
        ]
      }
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1",
            "code": "comms",
            "display": "Communication"
          }
        ]
      }
    }
  ],
  "status": "inactive",
  "category": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
        "code": "reasonable adjustments flag",
        "display": "Reasonable Adjustments Flag"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requiresinformationineasyread",
        "display": "Requires information in Easyread"
      }
    ]
  },
  "subject": {
    "reference": "demographics.spineservices.nhs.uk/STU3/Patient/999999998"
  }
}

2.5 Create Flag Request - xml example

http request & headers

POST https://clinicals.spineservices.nhs.uk/STU3/Flag HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+xml
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:Flag.write:1

http body

Create Flag Request XML Example

<!-- xml example file 
UpdateExample-CreateFlagRequest.xml -->
<Flag xmlns="http://hl7.org/fhir">
    <meta>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"/>
    </meta>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1"/>
                <code value="other"/>
                <display value="Other reasonable adjustment context  and/ or considerations"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <status value="active"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requireswritteninformationinatleast28pointsansseriffont"/>
            <display value="Requires written information in at least 28 point sans serif font"/>
        </coding>
    </code>
    <subject>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
</Flag>

2.6 Create Flag Request - json example

http request & headers

POST https://clinicals.spineservices.nhs.uk/STU3/Flag HTTP/1.1
Authorization: Bearer [jwt_token_string]
FromASID: 123456123456
ToASID: 987654456789
Content-Type: application/fhir+json
Prefer: return=representation
InteractionID: urn:nhs:names:services:raflags:Flag.write:1

http body

Create Flag Request JSON Example

{
  "resourceType": "Flag",
  "fhir_comments": [
    " xml example fileUpdateExample-CreateFlagRequest.xml "
  ],
  "meta": {
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"
    ]
  },
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1",
            "code": "other",
            "display": "Other reasonable adjustment context  and/ or considerations"
          }
        ]
      }
    }
  ],
  "status": "active",
  "category": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
        "code": "reasonable adjustments flag",
        "display": "Reasonable Adjustments Flag"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requireswritteninformationinatleast28pointsansseriffont",
        "display": "Requires written information in at least 28 point sans serif font"
      }
    ]
  },
  "subject": {
    "reference": "demographics.spineservices.nhs.uk/STU3/Patient/999999998"
  }
}

2.7 Create Flag Response - xml example

http request & headers

HTTP/1.1 201 Created
Date: Thu, 25 Jul 2018 11:03:00 GMT
Last-Modified:2018-07-25T11:03:00+00:00
Location: https://clinicals.spineservices.nhs.uk/STU3/Flag/d82888a3-1584-4e7f-99f1-3e578a1c9d37/_history/5b293b55-5ca5-4670-91e2-adb905001b96
ETag: W/"5b293b55-5ca5-4670-91e2-adb905001b96”
Content-Type: application/fhir+xml

http body

Create Flag Response XML Example

<!-- xml example file 
UpdateExample-CreateFlagResponse.xml -->
<Flag xmlns="http://hl7.org/fhir">
    <id value="d82888a3-1584-4e7f-99f1-3e578a1c9d37"/>
    <meta>
        <versionId value="5b293b55-5ca5-4670-91e2-adb905001b96"/>
        <lastUpdated value="2018-07-25T11:03:00+00:00"/>
        <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"/>
    </meta>
    <contained>
        <Provenance>
            <id value="9e6fb1d3-4f10-4087-8782-bff20bf2a07f"/>
            <meta>
                <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"/>
            </meta>
            <target>
                <reference value="Flag/d82888a3-1584-4e7f-99f1-3e578a1c9d37"/>
            </target>
            <recorded value="2018-07-25T11:03:00+00:00"/>
            <agent>
                <role>
                    <coding>
                        <system value="https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1"/>
                        <code value="R0260"/>
                        <display value="General Medical Practitioner"/>
                    </coding>
                </role>
                <whoReference>
                    <reference value="https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9"/>
                    <display value="Dr.D"/>
                </whoReference>
                <onBehalfOfReference>
                    <reference value="https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7"/>
                    <display value="Some GP Clinic"/>
                </onBehalfOfReference>
            </agent>
        </Provenance>
    </contained>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1">
        <extension url="created">
            <valueReference>
                <reference value="#9e6fb1d3-4f10-4087-8782-bff20bf2a07f"/>
            </valueReference>
        </extension>
    </extension>
    <extension url="https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1">
        <valueCodeableConcept>
            <coding>
                <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1"/>
                <code value="other"/>
                <display value="Other reasonable adjustment context and/ or considerations"/>
            </coding>
        </valueCodeableConcept>
    </extension>
    <status value="active"/>
    <category>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1"/>
            <code value="reasonable adjustments flag"/>
            <display value="Reasonable Adjustments Flag"/>
        </coding>
    </category>
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1"/>
            <code value="requireswritteninformationinatleast28pointsansseriffont"/>
            <display value="Requires written information in at least 28 point sans serif font"/>
        </coding>
    </code>
    <subject>
            <reference value="demographics.spineservices.nhs.uk/STU3/Patient/999999998"/>
    </subject>
</Flag>

2.8 Create Flag Response - json example

http request & headers

HTTP/1.1 201 Created
Date: Thu, 25 Jul 2018 11:03:00 GMT
Last-Modified:2018-07-25T11:03:00+00:00
Location: https://clinicals.spineservices.nhs.uk/STU3/Flag/d82888a3-1584-4e7f-99f1-3e578a1c9d37/_history/5b293b55-5ca5-4670-91e2-adb905001b96
ETag: W/"5b293b55-5ca5-4670-91e2-adb905001b96”
Content-Type: application/fhir+json

http body

Create Flag Response JSON Example

{
  "resourceType": "Flag",
  "id": "d82888a3-1584-4e7f-99f1-3e578a1c9d37",
  "fhir_comments": [
    " xml example fileUpdateExample-CreateFlagResponse.xml "
  ],
  "meta": {
    "versionId": "5b293b55-5ca5-4670-91e2-adb905001b96",
    "lastUpdated": "2018-07-25T11:03:00+00:00",
    "profile": [
      "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Flag-1"
    ]
  },
  "contained": [
    {
      "resourceType": "Provenance",
      "id": "9e6fb1d3-4f10-4087-8782-bff20bf2a07f",
      "meta": {
        "profile": [
          "https://fhir.nhs.uk/STU3/StructureDefinition/RARecord-Provenance-1"
        ]
      },
      "target": [
        {
          "reference": "Flag/d82888a3-1584-4e7f-99f1-3e578a1c9d37"
        }
      ],
      "recorded": "2018-07-25T11:03:00+00:00",
      "agent": [
        {
          "role": [
            {
              "coding": [
                {
                  "system": "https://fhir.nhs.uk/STU3/CodeSystem/CareConnect-SDSJobRoleName-1",
                  "code": "R0260",
                  "display": "General Medical Practitioner"
                }
              ]
            }
          ],
          "whoReference": {
            "reference": "https://sds.spineservices.nhs.uk/STU3/Practitioner/2ee4tr6a9",
            "display": "Dr.D"
          },
          "onBehalfOfReference": {
            "reference": "https://directory.spineservices.nhs.uk/STU3/Organization/a3e5i7",
            "display": "Some GP Clinic"
          }
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-Provenance-1",
      "extension": [
        {
          "url": "created",
          "valueReference": {
            "reference": "#9e6fb1d3-4f10-4087-8782-bff20bf2a07f"
          }
        }
      ]
    },
    {
      "url": "https://fhir.nhs.uk/STU3/StructureDefinition/Extension-RARecord-AdjustmentCategory-1",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AdjustmentCategories-1",
            "code": "other",
            "display": "Other reasonable adjustment context and/ or considerations"
          }
        ]
      }
    }
  ],
  "status": "active",
  "category": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-FlagCategory-1",
        "code": "reasonable adjustments flag",
        "display": "Reasonable Adjustments Flag"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/CodeSystem-RARecord-AccessibleInformationAdjustments-1",
        "code": "requireswritteninformationinatleast28pointsansseriffont",
        "display": "Requires written information in at least 28 point sans serif font"
      }
    ]
  },
  "subject": {
    "reference": "demographics.spineservices.nhs.uk/STU3/Patient/999999998"
  }
}