This page is part of the FHIR Specification v4.3.0-snapshot1: R4B Snapshot to support the Jan 2022 Connectathon. About the R4B version of FHIR. The current officially released version is 4.3.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2
Patient Administration Work Group | Maturity Level: 2 | Trial Use | Security Category: Patient | Compartments: Encounter, Patient, Practitioner, RelatedPerson |
Detailed Descriptions for the elements in the Encounter resource.
Encounter | |
Element Id | Encounter |
Definition | 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. |
Cardinality | 0..* |
Type | DomainResource |
Alternate Names | Visit |
Summary | false |
Encounter.identifier | |
Element Id | Encounter.identifier |
Definition | Identifier(s) by which this encounter is known. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Cardinality | 0..* |
Type | Identifier |
Summary | true |
Encounter.status | |
Element Id | Encounter.status |
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +. |
Cardinality | 1..1 |
Terminology Binding | EncounterStatus (Required) |
Type | code |
Is Modifier | true (Reason: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid) |
Summary | true |
Comments | Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes). |
Encounter.statusHistory | |
Element Id | Encounter.statusHistory |
Definition | The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them. |
Cardinality | 0..* |
Summary | false |
Comments | The current status is always found in the current version of the resource, not the status history. |
Encounter.statusHistory.status | |
Element Id | Encounter.statusHistory.status |
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +. |
Cardinality | 1..1 |
Terminology Binding | EncounterStatus (Required) |
Type | code |
Summary | false |
Encounter.statusHistory.period | |
Element Id | Encounter.statusHistory.period |
Definition | The time that the episode was in the specified status. |
Cardinality | 1..1 |
Type | Period |
Summary | false |
Encounter.class | |
Element Id | Encounter.class |
Definition | Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. |
Cardinality | 1..1 |
Terminology Binding | ActEncounterCode (Extensible) |
Type | Coding |
Summary | true |
Encounter.classHistory | |
Element Id | Encounter.classHistory |
Definition | The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient. |
Cardinality | 0..* |
Summary | false |
Encounter.classHistory.class | |
Element Id | Encounter.classHistory.class |
Definition | inpatient | outpatient | ambulatory | emergency +. |
Cardinality | 1..1 |
Terminology Binding | ActEncounterCode (Extensible) |
Type | Coding |
Summary | false |
Encounter.classHistory.period | |
Element Id | Encounter.classHistory.period |
Definition | The time that the episode was in the specified class. |
Cardinality | 1..1 |
Type | Period |
Summary | false |
Encounter.type | |
Element Id | Encounter.type |
Definition | Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). |
Cardinality | 0..* |
Terminology Binding | EncounterType (Example) |
Type | CodeableConcept |
Summary | true |
Comments | Since there are many ways to further classify encounters, this element is 0..*. |
Encounter.serviceType | |
Element Id | Encounter.serviceType |
Definition | Broad categorization of the service that is to be provided (e.g. cardiology). |
Cardinality | 0..1 |
Terminology Binding | ServiceType (Example) |
Type | CodeableConcept |
Summary | true |
Encounter.priority | |
Element Id | Encounter.priority |
Definition | Indicates the urgency of the encounter. |
Cardinality | 0..1 |
Terminology Binding | ActPriority (Example) |
Type | CodeableConcept |
Summary | false |
Encounter.subject | |
Element Id | Encounter.subject |
Definition | The patient or group present at the encounter. |
Cardinality | 0..1 |
Type | Reference(Patient | Group) |
Alternate Names | patient |
Summary | true |
Comments | While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked). |
Encounter.episodeOfCare | |
Element Id | Encounter.episodeOfCare |
Definition | Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years). |
Cardinality | 0..* |
Type | Reference(EpisodeOfCare) |
Summary | true |
Encounter.basedOn | |
Element Id | Encounter.basedOn |
Definition | The request this encounter satisfies (e.g. incoming referral or procedure request). |
Cardinality | 0..* |
Type | Reference(ServiceRequest) |
Alternate Names | incomingReferral |
Summary | false |
Encounter.participant | |
Element Id | Encounter.participant |
Definition | The list of people responsible for providing the service. |
Cardinality | 0..* |
Summary | true |
Encounter.participant.type | |
Element Id | Encounter.participant.type |
Definition | Role of participant in encounter. |
Cardinality | 0..* |
Terminology Binding | ParticipantType (Extensible) |
Type | CodeableConcept |
Summary | true |
Comments | The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. |
Encounter.participant.period | |
Element Id | Encounter.participant.period |
Definition | The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. |
Cardinality | 0..1 |
Type | Period |
Summary | false |
Encounter.participant.individual | |
Element Id | Encounter.participant.individual |
Definition | Persons involved in the encounter other than the patient. |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole | RelatedPerson) |
Summary | true |
Encounter.appointment | |
Element Id | Encounter.appointment |
Definition | The appointment that scheduled this encounter. |
Cardinality | 0..* |
Type | Reference(Appointment) |
Summary | true |
Encounter.period | |
Element Id | Encounter.period |
Definition | The start and end time of the encounter. |
Cardinality | 0..1 |
Type | Period |
Summary | false |
Comments | If not (yet) known, the end of the Period may be omitted. |
Encounter.length | |
Element Id | Encounter.length |
Definition | Quantity of time the encounter lasted. This excludes the time during leaves of absence. |
Cardinality | 0..1 |
Type | Duration |
Summary | false |
Comments | May differ from the time the Encounter.period lasted because of leave of absence. |
Encounter.reasonCode | |
Element Id | Encounter.reasonCode |
Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. |
Cardinality | 0..* |
Terminology Binding | Encounter Reason Codes (Preferred) |
Type | CodeableConcept |
Alternate Names | Indication; Admission diagnosis |
Summary | true |
Comments | For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). |
Encounter.reasonReference | |
Element Id | Encounter.reasonReference |
Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. |
Cardinality | 0..* |
Type | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) |
Alternate Names | Indication; Admission diagnosis |
Summary | true |
Comments | For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). |
Encounter.diagnosis | |
Element Id | Encounter.diagnosis |
Definition | The list of diagnosis relevant to this encounter. |
Cardinality | 0..* |
Summary | true |
Encounter.diagnosis.condition | |
Element Id | Encounter.diagnosis.condition |
Definition | Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. |
Cardinality | 1..1 |
Type | Reference(Condition | Procedure) |
Alternate Names | Admission diagnosis; discharge diagnosis; indication |
Summary | true |
Comments | For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). |
Encounter.diagnosis.use | |
Element Id | Encounter.diagnosis.use |
Definition | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …). |
Cardinality | 0..1 |
Terminology Binding | DiagnosisRole (Preferred) |
Type | CodeableConcept |
Summary | false |
Encounter.diagnosis.rank | |
Element Id | Encounter.diagnosis.rank |
Definition | Ranking of the diagnosis (for each role type). |
Cardinality | 0..1 |
Type | positiveInt |
Summary | false |
Encounter.account | |
Element Id | Encounter.account |
Definition | The set of accounts that may be used for billing for this Encounter. |
Cardinality | 0..* |
Type | Reference(Account) |
Summary | false |
Comments | The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules. |
Encounter.hospitalization | |
Element Id | Encounter.hospitalization |
Definition | Details about the admission to a healthcare service. |
Cardinality | 0..1 |
Summary | false |
Comments | An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included. The duration recorded in the period of this encounter covers the entire scope of this hospitalization record. |
Encounter.hospitalization.preAdmissionIdentifier | |
Element Id | Encounter.hospitalization.preAdmissionIdentifier |
Definition | Pre-admission identifier. |
Cardinality | 0..1 |
Type | Identifier |
Summary | false |
Encounter.hospitalization.origin | |
Element Id | Encounter.hospitalization.origin |
Definition | The location/organization from which the patient came before admission. |
Cardinality | 0..1 |
Type | Reference(Location | Organization) |
Summary | false |
Encounter.hospitalization.admitSource | |
Element Id | Encounter.hospitalization.admitSource |
Definition | From where patient was admitted (physician referral, transfer). |
Cardinality | 0..1 |
Terminology Binding | AdmitSource (Preferred) |
Type | CodeableConcept |
Summary | false |
Encounter.hospitalization.reAdmission | |
Element Id | Encounter.hospitalization.reAdmission |
Definition | Whether this hospitalization is a readmission and why if known. |
Cardinality | 0..1 |
Terminology Binding | hl7VS-re-admissionIndicator (Example) |
Type | CodeableConcept |
Summary | false |
Encounter.hospitalization.dietPreference | |
Element Id | Encounter.hospitalization.dietPreference |
Definition | Diet preferences reported by the patient. |
Cardinality | 0..* |
Terminology Binding | Diet (Example) |
Type | CodeableConcept |
Requirements | Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter. |
Summary | false |
Comments | For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). |
Encounter.hospitalization.specialCourtesy | |
Element Id | Encounter.hospitalization.specialCourtesy |
Definition | Special courtesies (VIP, board member). |
Cardinality | 0..* |
Terminology Binding | SpecialCourtesy (Preferred) |
Type | CodeableConcept |
Summary | false |
Encounter.hospitalization.specialArrangement | |
Element Id | Encounter.hospitalization.specialArrangement |
Definition | Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. |
Cardinality | 0..* |
Terminology Binding | SpecialArrangements (Preferred) |
Type | CodeableConcept |
Summary | false |
Encounter.hospitalization.destination | |
Element Id | Encounter.hospitalization.destination |
Definition | Location/organization to which the patient is discharged. |
Cardinality | 0..1 |
Type | Reference(Location | Organization) |
Summary | false |
Encounter.hospitalization.dischargeDisposition | |
Element Id | Encounter.hospitalization.dischargeDisposition |
Definition | Category or kind of location after discharge. |
Cardinality | 0..1 |
Terminology Binding | DischargeDisposition (Example) |
Type | CodeableConcept |
Summary | false |
Encounter.location | |
Element Id | Encounter.location |
Definition | List of locations where the patient has been during this encounter. |
Cardinality | 0..* |
Summary | false |
Comments | Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual". |
Encounter.location.location | |
Element Id | Encounter.location.location |
Definition | The location where the encounter takes place. |
Cardinality | 1..1 |
Type | Reference(Location) |
Summary | false |
Encounter.location.status | |
Element Id | Encounter.location.status |
Definition | The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time. |
Cardinality | 0..1 |
Terminology Binding | EncounterLocationStatus (Required) |
Type | code |
Summary | false |
Comments | When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed. |
Encounter.location.physicalType | |
Element Id | Encounter.location.physicalType |
Definition | This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query. |
Cardinality | 0..1 |
Terminology Binding | LocationType (Example) |
Type | CodeableConcept |
Summary | false |
Comments | This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query. There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario. |
Encounter.location.period | |
Element Id | Encounter.location.period |
Definition | Time period during which the patient was present at the location. |
Cardinality | 0..1 |
Type | Period |
Summary | false |
Encounter.serviceProvider | |
Element Id | Encounter.serviceProvider |
Definition | The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy. |
Cardinality | 0..1 |
Type | Reference(Organization) |
Summary | false |
Encounter.partOf | |
Element Id | Encounter.partOf |
Definition | Another Encounter of which this encounter is a part of (administratively or in time). |
Cardinality | 0..1 |
Type | Reference(Encounter) |
Hierarchy | This reference is part of a strict Hierarchy |
Summary | false |
Comments | This is also used for associating a child's encounter back to the mother's encounter. Refer to the Notes section in the Patient resource for further details. |