This page is part of the FHIR Specification (v0.5.0: DSTU 2 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

5.18 Resource Encounter - Content

This resource maintained by the Patient Administration Work Group

An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

5.18.1 Scope and Usage

A patient encounter is further characterized by the setting in which it takes place. Amongst them are ambulatory, emergency, home health, inpatient and virtual encounters. An Encounter encompasses the lifecycle from pre-admission, the actual encounter (for ambulatory encounters), and admission, stay and discharge (for inpatient encounters). During the encounter the patient may move from practitioner to practitioner and location to location.

Because of the broad scope of Encounter, not all elements will be relevant in all settings. For this reason, admission/discharge related information is kept in a separate Hospitalization component within Encounter. The class element is used to distinguish between these settings, which will guide further validation and application of business rules.

There is also substantial variance from organization to organization (and between jurisdictions and countries) on which business events translate to the start of a new Encounter, or what level of aggregation is used for Encounter. For example, each single visit of a practitioner during a hospitalization may lead to a new instance of Encounter, but depending on local practice and the systems involved, it may well be that this is aggregated to a single instance for a whole hospitalization. Even more aggregation may occur where jurisdictions introduce groups of Encounters for financial or other reasons. Encounters can be aggregated or grouped under other Encounters using the partOf element. See below for examples.

Encounter instances may exist before the actual encounter takes place to convey pre-admission information, including using Encounters elements to reflect the planned start date or planned encounter locations. In this case the status element is set to 'planned'.

The Hospitalization component is intended to store the extended information relating to a hospitalization event. This is always expected to be the same period as the encounter itself, where this is different then another encounter is entered which captures this information which is a partOf this encounter instance.

5.18.1.1 Status Management

During the life-cycle of an encounter it will pass through many statuses. Typically these are in order or the organizations workflow: planned, in-progress, finished/cancelled.
This status information is often used for other things, and often an analysis of the status history is required. This could be done my scanning throuh all the versions of the encounter and then checking the period of each, and doing some form of post processing. To ease the burden of this (or where a system doesn't support resource histories) a status history component is included.

5.18.2 Boundaries and Relationships

The Encounter resource is not to be used to store appointment information, the Appointment resource is intended to be used for that. Note that in many systems outpatient encounters (which are in scope for Encounter) and Appointment are used concurrently. In FHIR, Appointment is used for establishing a date for the encounter, while Encounter is applicable to information about the actual Encounter, i.e. the patient showing up.
As such an encounter in the "planned" status is not identical to the appointment that scheduled it, but it is the encounter prior to its actual occurrence, with the expectation that encounter will be updated as it progresses to completion. Patient arrival at a location does not necessarily mean the start of the encounter (e.g., a patient arrives an hour earlier than he is actually seen by a practitioner).

An appointment is normally used for the planning stage of an appointment, searching, locating an available time, then making the appointment. Once this process is completed and the appointment is about to start, then the appointment will be marked as fulfilled, and linked to the newly created encounter.
This new encounter may start in an "arrived" status when they are admitted with a location of the facility, and then will move to the ward where another part-of encounter may begin.

Standard Extension: Associated Encounter
This extension should be used to reference an encounter where there is no property that already defines this association on the resource.

This resource is referenced by Communication, CommunicationRequest, Composition, Condition, DeviceUseRequest, DiagnosticOrder, DiagnosticReport, Immunization, MedicationAdministration, MedicationPrescription, NutritionOrder, Observation, Procedure, ProcedureRequest, QuestionnaireAnswers, ReferralRequest and VisionPrescription

Structure

Name	Flags	Card.	Type	Description & Constraints
Encounter			DomainResource	An interaction during which services are provided to the patient
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?! Σ	1..1	code	planned \| arrived \| in-progress \| onleave \| finished \| cancelled EncounterState (Required)
statusHistory		0..*	Element	List of Encounter statuses
status		1..1	code	planned \| arrived \| in-progress \| onleave \| finished \| cancelled EncounterState (Required)
period		1..1	Period	The time that the episode was in the specified status
class	Σ	0..1	code	inpatient \| outpatient \| ambulatory \| emergency + EncounterClass (Required)
type	Σ	0..*	CodeableConcept	Specific type of encounter EncounterType (Example)
patient	Σ	0..1	Patient	The patient present at the encounter
episodeOfCare	Σ	0..1	EpisodeOfCare	An episode of care that this encounter should be recorded against
incomingReferralRequest		0..*	ReferralRequest	Incoming Referral Request
participant	Σ	0..*	Element	List of participants involved in the encounter
type	Σ	0..*	CodeableConcept	Role of participant in encounter ParticipantType (Required)
period		0..1	Period	Period of time during the encounter participant was present
individual	Σ	0..1	Practitioner \| RelatedPerson	Persons involved in the encounter other than the patient
fulfills	Σ	0..1	Appointment	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reason	Σ	0..*	CodeableConcept	Reason the encounter takes place (code) EncounterReason (Example)
indication		0..*	Any	Reason the encounter takes place (resource)
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Priority (Example)
hospitalization		0..1	Element	Details about an admission to a clinic
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Location	The location from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) AdmitSource (Required)
dietPreference		0..1	CodeableConcept	Diet preferences reported by the patient PatientDiet (Example)
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Courtesies (Required)
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc Arrangements (Required)
destination		0..1	Location	Location to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge DischargeDisp (Required)
dischargeDiagnosis		0..1	Any	The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete
reAdmission		0..1	boolean	Is this hospitalization a readmission?
location		0..*	Element	List of locations the patient has been at
location		1..1	Location	Location the encounter takes place
status		0..1	code	planned \| present \| reserved EncounterLocationStatus (Required)
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Organization	The custodian organization of this Encounter record
partOf		0..1	Encounter	Another Encounter this encounter is part of

UML Diagram

XML Template

<Encounter xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) by which this encounter is known --></identifier>
 <status value="[code]"/><!-- 1..1 planned | arrived | in-progress | onleave | finished | cancelled -->
 <statusHistory>  <!-- 0..* List of Encounter statuses -->
  <status value="[code]"/><!-- 1..1 planned | arrived | in-progress | onleave | finished | cancelled -->
  <period><!-- 1..1 Period The time that the episode was in the specified status --></period>
 </statusHistory>
 <class value="[code]"/><!-- 0..1 inpatient | outpatient | ambulatory | emergency + -->
 <type><!-- 0..* CodeableConcept Specific type of encounter --></type>
 <patient><!-- 0..1 Reference(Patient) The patient present at the encounter --></patient>
 <episodeOfCare><!-- 0..1 Reference(EpisodeOfCare) 
     An episode of care that this encounter should be recorded against --></episodeOfCare>
 <incomingReferralRequest><!-- 0..* Reference(ReferralRequest) 
     Incoming Referral Request --></incomingReferralRequest>
 <participant>  <!-- 0..* List of participants involved in the encounter -->
  <type><!-- 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter participant was present --></period>
  <individual><!-- 0..1 Reference(Practitioner|RelatedPerson) 
      Persons involved in the encounter other than the patient --></individual>
 </participant>
 <fulfills><!-- 0..1 Reference(Appointment) The appointment that scheduled this encounter --></fulfills>
 <period><!-- 0..1 Period The start and end time of the encounter --></period>
 <length><!-- 0..1 Duration Quantity of time the encounter lasted (less time absent) --></length>
 <reason><!-- 0..* CodeableConcept Reason the encounter takes place (code) --></reason>
 <indication><!-- 0..* Reference(Any) Reason the encounter takes place (resource) --></indication>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter --></priority>
 <hospitalization>  <!-- 0..1 Details about an admission to a clinic -->
  <preAdmissionIdentifier><!-- 0..1 Identifier Pre-admission identifier --></preAdmissionIdentifier>
  <origin><!-- 0..1 Reference(Location) 
      The location from which the patient came before admission --></origin>
  <admitSource><!-- 0..1 CodeableConcept From where patient was admitted (physician referral, transfer) --></admitSource>
  <dietPreference><!-- 0..1 CodeableConcept Diet preferences reported by the patient --></dietPreference>
  <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
  <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc --></specialArrangement>
  <destination><!-- 0..1 Reference(Location) Location to which the patient is discharged --></destination>
  <dischargeDisposition><!-- 0..1 CodeableConcept Category or kind of location after discharge --></dischargeDisposition>
  <dischargeDiagnosis><!-- 0..1 Reference(Any) 
      The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete --></dischargeDiagnosis>
  <reAdmission value="[boolean]"/><!-- 0..1 Is this hospitalization a readmission? -->
 </hospitalization>
 <location>  <!-- 0..* List of locations the patient has been at -->
  <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location>
  <status value="[code]"/><!-- 0..1 planned | present | reserved -->
  <period><!-- 0..1 Period Time period during which the patient was present at the location --></period>
 </location>
 <serviceProvider><!-- 0..1 Reference(Organization) 
     The custodian organization of this Encounter record --></serviceProvider>
 <partOf><!-- 0..1 Reference(Encounter) Another Encounter this encounter is part of --></partOf>
</Encounter>

JSON Template

{
  "resourceType" : "Encounter",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) by which this encounter is known
  "status" : "<code>", // R!  planned | arrived | in-progress | onleave | finished | cancelled
  "statusHistory" : [{ // List of Encounter statuses
    "status" : "<code>", // R!  planned | arrived | in-progress | onleave | finished | cancelled
    "period" : { Period } // R!  The time that the episode was in the specified status
  }],
  "class" : "<code>", // inpatient | outpatient | ambulatory | emergency +
  "type" : [{ CodeableConcept }], // Specific type of encounter
  "patient" : { Reference(Patient) }, // The patient present at the encounter
  "episodeOfCare" : { Reference(EpisodeOfCare) }, // 
     An episode of care that this encounter should be recorded against
  "incomingReferralRequest" : [{ Reference(ReferralRequest) }], // 
     Incoming Referral Request
  "participant" : [{ // List of participants involved in the encounter
    "type" : [{ CodeableConcept }], // Role of participant in encounter
    "period" : { Period }, // Period of time during the encounter participant was present
    "individual" : { Reference(Practitioner|RelatedPerson) } // 
      Persons involved in the encounter other than the patient
  }],
  "fulfills" : { Reference(Appointment) }, // The appointment that scheduled this encounter
  "period" : { Period }, // The start and end time of the encounter
  "length" : { Duration }, // Quantity of time the encounter lasted (less time absent)
  "reason" : [{ CodeableConcept }], // Reason the encounter takes place (code)
  "indication" : [{ Reference(Any) }], // Reason the encounter takes place (resource)
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter
  "hospitalization" : { // Details about an admission to a clinic
    "preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
    "origin" : { Reference(Location) }, // 
      The location from which the patient came before admission
    "admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
    "dietPreference" : { CodeableConcept }, // Diet preferences reported by the patient
    "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
    "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc
    "destination" : { Reference(Location) }, // Location to which the patient is discharged
    "dischargeDisposition" : { CodeableConcept }, // Category or kind of location after discharge
    "dischargeDiagnosis" : { Reference(Any) }, // 
      The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete
    "reAdmission" : <boolean> // Is this hospitalization a readmission?
  },
  "location" : [{ // List of locations the patient has been at
    "location" : { Reference(Location) }, // R!  Location the encounter takes place
    "status" : "<code>", // planned | present | reserved
    "period" : { Period } // Time period during which the patient was present at the location
  }],
  "serviceProvider" : { Reference(Organization) }, // 
     The custodian organization of this Encounter record
  "partOf" : { Reference(Encounter) } // Another Encounter this encounter is part of
}

Structure

Name	Flags	Card.	Type	Description & Constraints
Encounter			DomainResource	An interaction during which services are provided to the patient
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?! Σ	1..1	code	planned \| arrived \| in-progress \| onleave \| finished \| cancelled EncounterState (Required)
statusHistory		0..*	Element	List of Encounter statuses
status		1..1	code	planned \| arrived \| in-progress \| onleave \| finished \| cancelled EncounterState (Required)
period		1..1	Period	The time that the episode was in the specified status
class	Σ	0..1	code	inpatient \| outpatient \| ambulatory \| emergency + EncounterClass (Required)
type	Σ	0..*	CodeableConcept	Specific type of encounter EncounterType (Example)
patient	Σ	0..1	Patient	The patient present at the encounter
episodeOfCare	Σ	0..1	EpisodeOfCare	An episode of care that this encounter should be recorded against
incomingReferralRequest		0..*	ReferralRequest	Incoming Referral Request
participant	Σ	0..*	Element	List of participants involved in the encounter
type	Σ	0..*	CodeableConcept	Role of participant in encounter ParticipantType (Required)
period		0..1	Period	Period of time during the encounter participant was present
individual	Σ	0..1	Practitioner \| RelatedPerson	Persons involved in the encounter other than the patient
fulfills	Σ	0..1	Appointment	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reason	Σ	0..*	CodeableConcept	Reason the encounter takes place (code) EncounterReason (Example)
indication		0..*	Any	Reason the encounter takes place (resource)
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Priority (Example)
hospitalization		0..1	Element	Details about an admission to a clinic
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Location	The location from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) AdmitSource (Required)
dietPreference		0..1	CodeableConcept	Diet preferences reported by the patient PatientDiet (Example)
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Courtesies (Required)
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc Arrangements (Required)
destination		0..1	Location	Location to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge DischargeDisp (Required)
dischargeDiagnosis		0..1	Any	The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete
reAdmission		0..1	boolean	Is this hospitalization a readmission?
location		0..*	Element	List of locations the patient has been at
location		1..1	Location	Location the encounter takes place
status		0..1	code	planned \| present \| reserved EncounterLocationStatus (Required)
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Organization	The custodian organization of this Encounter record
partOf		0..1	Encounter	Another Encounter this encounter is part of

UML Diagram

XML Template

<Encounter xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) by which this encounter is known --></identifier>
 <status value="[code]"/><!-- 1..1 planned | arrived | in-progress | onleave | finished | cancelled -->
 <statusHistory>  <!-- 0..* List of Encounter statuses -->
  <status value="[code]"/><!-- 1..1 planned | arrived | in-progress | onleave | finished | cancelled -->
  <period><!-- 1..1 Period The time that the episode was in the specified status --></period>
 </statusHistory>
 <class value="[code]"/><!-- 0..1 inpatient | outpatient | ambulatory | emergency + -->
 <type><!-- 0..* CodeableConcept Specific type of encounter --></type>
 <patient><!-- 0..1 Reference(Patient) The patient present at the encounter --></patient>
 <episodeOfCare><!-- 0..1 Reference(EpisodeOfCare) 
     An episode of care that this encounter should be recorded against --></episodeOfCare>
 <incomingReferralRequest><!-- 0..* Reference(ReferralRequest) 
     Incoming Referral Request --></incomingReferralRequest>
 <participant>  <!-- 0..* List of participants involved in the encounter -->
  <type><!-- 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter participant was present --></period>
  <individual><!-- 0..1 Reference(Practitioner|RelatedPerson) 
      Persons involved in the encounter other than the patient --></individual>
 </participant>
 <fulfills><!-- 0..1 Reference(Appointment) The appointment that scheduled this encounter --></fulfills>
 <period><!-- 0..1 Period The start and end time of the encounter --></period>
 <length><!-- 0..1 Duration Quantity of time the encounter lasted (less time absent) --></length>
 <reason><!-- 0..* CodeableConcept Reason the encounter takes place (code) --></reason>
 <indication><!-- 0..* Reference(Any) Reason the encounter takes place (resource) --></indication>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter --></priority>
 <hospitalization>  <!-- 0..1 Details about an admission to a clinic -->
  <preAdmissionIdentifier><!-- 0..1 Identifier Pre-admission identifier --></preAdmissionIdentifier>
  <origin><!-- 0..1 Reference(Location) 
      The location from which the patient came before admission --></origin>
  <admitSource><!-- 0..1 CodeableConcept From where patient was admitted (physician referral, transfer) --></admitSource>
  <dietPreference><!-- 0..1 CodeableConcept Diet preferences reported by the patient --></dietPreference>
  <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
  <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc --></specialArrangement>
  <destination><!-- 0..1 Reference(Location) Location to which the patient is discharged --></destination>
  <dischargeDisposition><!-- 0..1 CodeableConcept Category or kind of location after discharge --></dischargeDisposition>
  <dischargeDiagnosis><!-- 0..1 Reference(Any) 
      The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete --></dischargeDiagnosis>
  <reAdmission value="[boolean]"/><!-- 0..1 Is this hospitalization a readmission? -->
 </hospitalization>
 <location>  <!-- 0..* List of locations the patient has been at -->
  <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location>
  <status value="[code]"/><!-- 0..1 planned | present | reserved -->
  <period><!-- 0..1 Period Time period during which the patient was present at the location --></period>
 </location>
 <serviceProvider><!-- 0..1 Reference(Organization) 
     The custodian organization of this Encounter record --></serviceProvider>
 <partOf><!-- 0..1 Reference(Encounter) Another Encounter this encounter is part of --></partOf>
</Encounter>

JSON Template

{
  "resourceType" : "Encounter",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) by which this encounter is known
  "status" : "<code>", // R!  planned | arrived | in-progress | onleave | finished | cancelled
  "statusHistory" : [{ // List of Encounter statuses
    "status" : "<code>", // R!  planned | arrived | in-progress | onleave | finished | cancelled
    "period" : { Period } // R!  The time that the episode was in the specified status
  }],
  "class" : "<code>", // inpatient | outpatient | ambulatory | emergency +
  "type" : [{ CodeableConcept }], // Specific type of encounter
  "patient" : { Reference(Patient) }, // The patient present at the encounter
  "episodeOfCare" : { Reference(EpisodeOfCare) }, // 
     An episode of care that this encounter should be recorded against
  "incomingReferralRequest" : [{ Reference(ReferralRequest) }], // 
     Incoming Referral Request
  "participant" : [{ // List of participants involved in the encounter
    "type" : [{ CodeableConcept }], // Role of participant in encounter
    "period" : { Period }, // Period of time during the encounter participant was present
    "individual" : { Reference(Practitioner|RelatedPerson) } // 
      Persons involved in the encounter other than the patient
  }],
  "fulfills" : { Reference(Appointment) }, // The appointment that scheduled this encounter
  "period" : { Period }, // The start and end time of the encounter
  "length" : { Duration }, // Quantity of time the encounter lasted (less time absent)
  "reason" : [{ CodeableConcept }], // Reason the encounter takes place (code)
  "indication" : [{ Reference(Any) }], // Reason the encounter takes place (resource)
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter
  "hospitalization" : { // Details about an admission to a clinic
    "preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
    "origin" : { Reference(Location) }, // 
      The location from which the patient came before admission
    "admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
    "dietPreference" : { CodeableConcept }, // Diet preferences reported by the patient
    "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
    "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc
    "destination" : { Reference(Location) }, // Location to which the patient is discharged
    "dischargeDisposition" : { CodeableConcept }, // Category or kind of location after discharge
    "dischargeDiagnosis" : { Reference(Any) }, // 
      The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete
    "reAdmission" : <boolean> // Is this hospitalization a readmission?
  },
  "location" : [{ // List of locations the patient has been at
    "location" : { Reference(Location) }, // R!  Location the encounter takes place
    "status" : "<code>", // planned | present | reserved
    "period" : { Period } // Time period during which the patient was present at the location
  }],
  "serviceProvider" : { Reference(Organization) }, // 
     The custodian organization of this Encounter record
  "partOf" : { Reference(Encounter) } // Another Encounter this encounter is part of
}

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON)

5.18.3.1 Terminology Bindings

Path	Definition	Type	Reference
Encounter.status Encounter.statusHistory.status	Current state of the encounter	Required	http://hl7.org/fhir/encounter-state
Encounter.class	Classification of the encounter	Required	http://hl7.org/fhir/encounter-class
Encounter.type	The type of encounter	Example	http://hl7.org/fhir/vs/encounter-type
Encounter.participant.type	Role of participant in encounter	Required	http://hl7.org/fhir/vs/encounter-participant-type
Encounter.reason	Reason why the encounter takes place	Example	http://hl7.org/fhir/vs/encounter-reason
Encounter.priority	Indicates the urgency of the encounter	Example	http://hl7.org/fhir/vs/encounter-priority
Encounter.hospitalization.admitSource	From where the patient was admitted	Required	http://hl7.org/fhir/vs/encounter-admit-source
Encounter.hospitalization.dietPreference	Medical, cultural or ethical food preferences to help with catering requirements	Example	http://hl7.org/fhir/vs/encounter-diet
Encounter.hospitalization.specialCourtesy	Special courtesies	Required	http://hl7.org/fhir/vs/encounter-special-courtesy
Encounter.hospitalization.specialArrangement	Special arrangements	Required	http://hl7.org/fhir/vs/encounter-special-arrangements
Encounter.hospitalization.dischargeDisposition	Discharge Disposition	Required	http://hl7.org/fhir/vs/encounter-discharge-disposition
Encounter.location.status	The status of the location	Required	http://hl7.org/fhir/encounter-location-status

Path

Definition

Type

Reference

Encounter.status
Encounter.statusHistory.status

Current state of the encounter

Required

http://hl7.org/fhir/encounter-state

Encounter.class

Classification of the encounter

Required

http://hl7.org/fhir/encounter-class

Encounter.type

The type of encounter

Example

http://hl7.org/fhir/vs/encounter-type

Encounter.participant.type

Role of participant in encounter

Required

http://hl7.org/fhir/vs/encounter-participant-type

Encounter.reason

Reason why the encounter takes place

Example

http://hl7.org/fhir/vs/encounter-reason

Encounter.priority

Indicates the urgency of the encounter

Example

http://hl7.org/fhir/vs/encounter-priority

Encounter.hospitalization.admitSource

From where the patient was admitted

Required

http://hl7.org/fhir/vs/encounter-admit-source

Encounter.hospitalization.dietPreference

Medical, cultural or ethical food preferences to help with catering requirements

Example

http://hl7.org/fhir/vs/encounter-diet

Encounter.hospitalization.specialCourtesy

Special courtesies

Required

http://hl7.org/fhir/vs/encounter-special-courtesy

Encounter.hospitalization.specialArrangement

Special arrangements

Required

http://hl7.org/fhir/vs/encounter-special-arrangements

Encounter.hospitalization.dischargeDisposition

Discharge Disposition

Required

http://hl7.org/fhir/vs/encounter-discharge-disposition

Encounter.location.status

The status of the location

Required

http://hl7.org/fhir/encounter-location-status

5.18.4 Notes

The class element describes the setting (in/outpatient etc.) in which the Encounter took place. Since this is important for interpreting the context of the encounter, choosing the appropriate business rules to enforce and for the management of the process, this element is required.
In future versions of FHIR, some kind of charge posting vehicle (e.g. Account) will be added.

5.18.5 Example usage

As stated, Encounter allows a flexible nesting of Encounters using the partOf element. For example:

A patient is admitted for two weeks - This could be modeled using a single Encounter instance, in which the start and length are given for the duration of the whole stay. The admitting doctor and the responsible doctor during the stay are specified using the Participant component.
During the encounter, the patient moves from the admitting department to the Intensive Care unit and back - Three more detailed additional Encounters can be created, one for each location in which the patient stayed. Each of these Encounters has a single location (twice the admitting department and once the Intensive Care unit) and one or more participants at that location. These Encounters may use the partOf relationship to indicate these movements occurred during the longer overarching Encounter.
During the last part of the stay, the patient is visited by the members of the multi-disciplinary team that treated him for final evaluation - If relevant, for each of these short visits, an Encounter may be created with a single participant. Since these took place during the last part of the stay, the partOf element can be used to associate these short visits with either the third patient movement or the bigger overall encounter.

Exactly how the Encounter is used depends on information available in the source system, the relevance of exchange of each level of Encounter and demands specific to the communicating partners. The expectation is that for each domain of exchange, Profiles are used to limit the flexibility of Encounter to meet the demands of the usecase.

5.18.6 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Paths
date	date	A date within the period the Encounter lasted	Encounter.period
episodeofcare	reference	An episode of care that this encounter should be recorded against	Encounter.episodeOfCare (EpisodeOfCare)
fulfills	reference	The appointment that scheduled this encounter	Encounter.fulfills (Appointment)
identifier	token	Identifier(s) by which this encounter is known	Encounter.identifier
incomingreferral	reference	Incoming Referral Request	Encounter.incomingReferralRequest (ReferralRequest)
indication	reference	Reason the encounter takes place (resource)	Encounter.indication (Any)
length	number	Length of encounter in days	Encounter.length
location	reference	Location the encounter takes place	Encounter.location.location (Location)
location-period	date	Time period during which the patient was present at the location	Encounter.location.period
part-of	reference	Another Encounter this encounter is part of	Encounter.partOf (Encounter)
participant	reference	Persons involved in the encounter other than the patient	Encounter.participant.individual (Practitioner, RelatedPerson)
participant-type	token	Role of participant in encounter	Encounter.participant.type
patient	reference	The patient present at the encounter	Encounter.patient (Patient)
practitioner	reference	Persons involved in the encounter other than the patient	Encounter.participant.individual (Practitioner)
reason	token	Reason the encounter takes place (code)	Encounter.reason
special-arrangement	token	Wheelchair, translator, stretcher, etc	Encounter.hospitalization.specialArrangement
status	token	planned \| arrived \| in-progress \| onleave \| finished \| cancelled	Encounter.status
type	token	Specific type of encounter	Encounter.type