* Salesforce Health Cloud *

We are implementing Salesforce Health Cloud and have encountered a limitation with the Clinical Service Request object (ClinicalServiceRequest).

The object does not appear to be supported as a triggering object for:

•  Record-triggered flows 
•  Automation event-triggered flows 

Our requirement is to execute automation when a Clinical Service Request is created or updated. The lack of native Flow support is blocking the intended workflow design. 

Approaches considered

We have considered:

•  Publishing a custom Platform Event 
•  Using an Apex trigger to initiate the automation 
•  Updating an intermediary custom object that is supported by the automation event 

These options introduce additional code, monitoring, deployment, idempotency, and support requirements for functionality that we expected to be available declaratively. 

Questions

1.  Is the lack of Flow trigger support for ClinicalServiceRequest in SFMC a known product limitation? 
2.  Is there a supported configuration or Health Cloud event framework that enables automation when these records are created or updated? 
3.  Is there a recommended declarative workaround that avoids Apex or a custom Platform Event? 
4.  Is support for health cloud objects in SFMC advance flows on the Salesforce Health Cloud roadmap? 

Thanks in advance.

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Hi Health Cloud / OmniStudio community,

We are replacing a legacy Health Check solution with Salesforce Health Cloud Discovery Framework Assessments.

The target model must support many forms, many assessment questions, and multiple languages.

Context

Health Cloud Assessments use Discovery Framework and OmniStudio to build assessment forms. The assessment forms are created with OmniScript / OmniStudio and surfaced through the Assessment component.

Salesforce documentation for multi-language OmniScripts describes the out-of-the-box translation approach using Custom Labels. The OmniScript custom label reference also shows that many element properties, including labels, help/error text, and select/radio/multiselect option values, rely on custom labels for translation.

In our first implemented form, the translation setup already generated approximately 250 Custom Labels. Since Salesforce Custom Labels are limited per org (5000), this does not appear scalable for additional forms, questions, response values, and languages.

What we evaluated

Salesforce has suggested Custom Metadata Types as a more scalable translation-management option.

However, in our testing, Discovery Framework assessment rendering does not resolve translated text dynamically from Custom Metadata Types at runtime (this is also documented as a limitation). In other words, we have not found a supported way to keep one assessment form and dynamically inject all question text, help text, and response values from CMDT based on selected language.

Resulting design decision

Because of this, we are currently moving toward a governed **one-form-per-language** model:

- one Discovery Framework assessment form per language

- questions authored directly in the local language

- local AssessmentQuestion / AssessmentQuestionVersion records per language

- a global parent/anchor question identity for reporting

- normalized answer identifiers for cross-language reporting

This avoids Custom Label exhaustion and keeps the runtime compatible with Discovery Framework, but it increases governance and deployment overhead.

Question to the community

Has anyone implemented large-scale multilingual Health Cloud Discovery Framework Assessments?

If yes:

1. Did you use OmniStudio multi-language Custom Labels, or did you also move to one form per language?

2. Has anyone successfully used Custom Metadata Types or another translation store at runtime inside Discovery Framework assessments?

3. How do you manage translated question text, help text, and picklist/radio/multiselect response values at scale?

4. How do you keep global reporting consistent across translated assessment forms?

5. Are there any Salesforce-supported patterns we should consider before finalizing the one-form-per-language approach?

Any experience, lessons learned, or recommended architecture patterns would be appreciated.