Add a new element to DetectedIssue called "managementCode".  This element would indicate the type of action (management) required.  This element would need a value set binding of management codes.  As an example, for Medi-Span (Wolters Kluwer), the possible values are {Professional Intervention Required, Professional Review Suggested, and Potential Risk}.  The binding to the new value set should be something other than "required", since different systems may use different values.

The cardinality should be 0..1.