Snapshot 3: Connectathon 32 Base
AdministrationThis page is part of the FHIR Specification (v5.0.0-snapshot3: R5 Snapshot #3, to support Connectathon 32). 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
| Patient Administration Work Group | Maturity Level: 2 | Trial Use | Security Category: Patient | Compartments: Encounter, Patient, Practitioner, RelatedPerson |
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. Encounter is primarily used to record information about the actual activities that occurred, where Appointment is used to record planned activities.
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 admission 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 admission. 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 admission component is intended to store the extended information relating to a admission event. It is always expected to be the same period as the encounter itself. Where the period is different, another encounter instance should be used to capture this information as a partOf this encounter instance.
The Procedure and encounter have references to each other, and these should be to different procedures; one for the procedure that was performed during the encounter (stored in Procedure.encounter), and another for cases where an encounter is a result of another procedure (stored in Encounter.reason) such as a follow-up encounter to resolve complications from an earlier procedure.
During the life-cycle of an encounter it will pass through many statuses. Typically these are in order or the
organization's 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 by scanning through all the versions of the encounter, checking the period of each,
and then 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.
There is no direct indication purely by the status field as to whether an encounter is considered "admitted".
The context of the encounter and business practices/policies/workflows/types can influence this definition.
(e.g., acute care facility, aged care center, outpatient clinic, emergency department, community-based clinic).
Statuses of "arrived", "triaged" or "in progress" could be considered the start of the admission, and also have the
presence of the admission sub-component entered.
The "discharged" status can be used when the patient care is complete but the encounter itself is not yet completed,
such as while collating required information for billing or other purposes, or could be skipped and go direct to "completed".
The "on leave" status might or might not be a part of the admission, for example if the patient
was permitted to go home for a weekend or some other form of external event.
The location is also likely to be filled in with a location status of "active".
For other examples such as an outpatient visit (day procedure - colonoscopy), the patient could also be
considered to be admitted, hence the encounter doesn't have a fixed definition of admitted.
At a minimum, we do believe that a patient IS admitted when the status is in-progress.
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 at a location of the facility, and then will
move to the ward where another part-of encounter may begin.
Communication resources are used for a simultaneous interaction between a practitioner and a patient where there is no
direct contact. Examples include a phone message, or transmission of some correspondence documentation.
There is no duration recorded for a communication resource, but it could contain sent and received times.
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.
Structure
| Name | Flags | Card. | Type | Description & Constraints  |
|---|---|---|---|---|
  Encounter | TU | DomainResource | An interaction during which services are provided to the patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
  identifier | Σ | 0..* | Identifier | Identifier(s) by which this encounter is known |
 status | ?!Σ | 1..1 | code | planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown EncounterStatus (Required) |
  statusHistory | 0..* | BackboneElement | List of past encounter statuses | |
 status | 1..1 | code | planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown EncounterStatus (Required) | |
 period | 1..1 | Period | The time that the episode was in the specified status | |
| class | Σ | 0..* | CodeableConcept | Classification of patient encounter context - e.g. Inpatient, outpatient Encounter class (Preferred) |
| classHistory | 0..* | BackboneElement | List of past encounter classes | |
| class | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Encounter class (Preferred) | |
| period | 1..1 | Period | The time that the episode was in the specified class | |
| priority | 0..1 | CodeableConcept | Indicates the urgency of the encounter ActPriority (Example) | |
| type | Σ | 0..* | CodeableConcept | Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...) EncounterType (Example) |
 serviceType | Σ | 0..* | CodeableReference(HealthcareService) | Specific type of service ServiceType (Example) |
| subject | Σ | 0..1 | Reference(Patient | Group) | The patient or group related to this encounter |
| subjectStatus | 0..1 | CodeableConcept | The current status of the subject in relation to the Encounter EncounterSubjectStatus (Example) | |
| episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against |
| basedOn | 0..* | Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest) | The request that initiated this encounter | |
| careTeam | 0..* | Reference(CareTeam) | The group(s) that are allocated to participate in this encounter | |
| partOf | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of | |
| serviceProvider | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter | |
| participant | ΣC | 0..* | BackboneElement | List of participants involved in the encounter + Rule: A type must be provided when no explicit actor is specified + Rule: A type cannot be provided for a patient or group participant |
| type | Σ | 0..* | CodeableConcept | Role of participant in encounter ParticipantType (Extensible) |
| period | 0..1 | Period | Period of time during the encounter that the participant participated | |
| actor | Σ | 0..1 | Reference(Patient | Group | RelatedPerson | Practitioner | PractitionerRole | Device | HealthcareService) | The individual, device, or service participating in the encounter |
| appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter |
| virtualService | 0..* | VirtualServiceDetail | Connection details of a virtual service (e.g. conference call) | |
| actualPeriod | 0..1 | Period | The actual start and end time of the encounter | |
| plannedStartDate | 0..1 | dateTime | The planned start date/time (or admission date) of the encounter | |
| plannedEndDate | 0..1 | dateTime | The planned end date/time (or discharge date) of the encounter | |
| length | 0..1 | Duration | Actual quantity of time the encounter lasted (less time absent) | |
| reason | Σ | 0..* | CodeableReference(Condition | DiagnosticReport | ImmunizationRecommendation | Observation | Procedure) | Reason the encounter takes place (core or reference) Encounter Reason Codes (Preferred) |
| diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter |
| condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter |
| use | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) DiagnosisRole (Preferred) | |
| rank | 0..1 | positiveInt | Ranking of the diagnosis (for each role type) | |
| account | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter | |
| admission | 0..1 | BackboneElement | Details about the admission to a healthcare service | |
| preAdmissionIdentifier | 0..1 | Identifier | Pre-admission identifier | |
| origin | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission | |
| admitSource | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) AdmitSource (Preferred) | |
| reAdmission | 0..1 | CodeableConcept | The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission hl7VS-re-admissionIndicator (Example) | |
| dietPreference | 0..* | CodeableConcept | Diet preferences reported by the patient Diet (Example) | |
| specialCourtesy | 0..* | CodeableConcept | Special courtesies (VIP, board member) SpecialCourtesy (Preferred) | |
| specialArrangement | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. SpecialArrangements (Preferred) | |
| destination | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged | |
| dischargeDisposition | 0..1 | CodeableConcept | Category or kind of location after discharge DischargeDisposition (Example) | |
 location | 0..* | BackboneElement | List of locations where the patient has been | |
 location | 1..1 | Reference(Location) | Location the encounter takes place | |
| status | 0..1 | code | planned | active | reserved | completed EncounterLocationStatus (Required) | |
| form | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) Location Form (Example) | |
| period | 0..1 | Period | Time period during which the patient was present at the location | |
| Documentation for this format | ||||
See the Extensions for this resource
UML Diagram (Legend)
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 | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown --> <statusHistory> <!-- 0..* List of past encounter statuses --> <status value="[code]"/><!-- 1..1 planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown --> <period><!-- 1..1 Period The time that the episode was in the specified status --></period> </statusHistory> <class><!-- 0..* CodeableConcept Classification of patient encounter context - e.g. Inpatient, outpatient
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 | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
"statusHistory" : [{ // List of past encounter statuses
"status" : "<code>", // R! planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
"period" : { Period } // R! The time that the episode was in the specified status
}],
"class" : [{ CodeableConcept }], // Classification of patient encounter context - e.g. Inpatient, outpatient
"classHistory" : [{ // List of past encounter classes
"class" : { Coding }, // R! inpatient | outpatient | ambulatory | emergency +
"period" : { Period } // R! The time that the episode was in the specified class
}],
"priority" : { CodeableConcept }, // Indicates the urgency of the encounter
"type" : [{ CodeableConcept }], // Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
"serviceType" : [{ CodeableReference(HealthcareService) }], // Specific type of service
"subject" : { Reference(Group|Patient) }, // The patient or group related to this encounter
"subjectStatus" : { CodeableConcept }, // The current status of the subject in relation to the Encounter
"episodeOfCare" : [{ Reference(EpisodeOfCare) }], // Episode(s) of care that this encounter should be recorded against
"basedOn" : [{ Reference(CarePlan|DeviceRequest|MedicationRequest|
ServiceRequest) }], // The request that initiated this encounter
"careTeam" : [{ Reference(CareTeam) }], // The group(s) that are allocated to participate in this encounter
"partOf" : { Reference(Encounter) }, // Another Encounter this encounter is part of
"serviceProvider" : { Reference(Organization) }, // The organization (facility) responsible for this encounter
"participant" : [{ // List of participants involved in the encounter
"type" : [{ CodeableConcept }], // Role of participant in encounter
"period" : { Period }, // Period of time during the encounter that the participant participated
"actor" : { Reference(Device|Group|HealthcareService|Patient|Practitioner|
PractitionerRole|RelatedPerson) } // The individual, device, or service participating in the encounter
}],
"appointment" : [{ Reference(Appointment) }], // The appointment that scheduled this encounter
"virtualService" : [{ VirtualServiceDetail }], // Connection details of a virtual service (e.g. conference call)
"actualPeriod" : { Period }, // The actual start and end time of the encounter
"plannedStartDate" : "<dateTime>", // The planned start date/time (or admission date) of the encounter
"plannedEndDate" : "<dateTime>", // The planned end date/time (or discharge date) of the encounter
"length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
"reason" : [{ CodeableReference(Condition|DiagnosticReport|
ImmunizationRecommendation|Observation|Procedure) }], // Reason the encounter takes place (core or reference)
"diagnosis" : [{ // The list of diagnosis relevant to this encounter
"condition" : { Reference(Condition|Procedure) }, // R! The diagnosis or procedure relevant to the encounter
"use" : { CodeableConcept }, // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
"rank" : "<positiveInt>" // Ranking of the diagnosis (for each role type)
}],
"account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
"admission" : { // Details about the admission to a healthcare service
"preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
"origin" : { Reference(Location|Organization) }, // The location/organization from which the patient came before admission
"admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
"reAdmission" : { CodeableConcept }, // The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
"dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
"specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
"specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc.
"destination" : { Reference(Location|Organization) }, // Location/organization to which the patient is discharged
"dischargeDisposition" : { CodeableConcept } // Category or kind of location after discharge
},
"location" : [{ // List of locations where the patient has been
"location" : { Reference(Location) }, // R! Location the encounter takes place
"status" : "<code>", // planned | active | reserved | completed
"form" : { CodeableConcept }, // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
"period" : { Period } // Time period during which the patient was present at the location
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since R4
| Encounter | |
| Encounter.class |
|
| Encounter.classHistory.class |
|
| Encounter.serviceType |
|
| Encounter.subjectStatus |
|
| Encounter.basedOn |
|
| Encounter.careTeam |
|
| Encounter.participant.actor |
|
| Encounter.virtualService |
|
| Encounter.actualPeriod |
|
| Encounter.plannedStartDate |
|
| Encounter.plannedEndDate |
|
| Encounter.reason |
|
| Encounter.admission |
|
| Encounter.admission.preAdmissionIdentifier |
|
| Encounter.admission.origin |
|
| Encounter.admission.admitSource |
|
| Encounter.admission.reAdmission |
|
| Encounter.admission.dietPreference |
|
| Encounter.admission.specialCourtesy |
|
| Encounter.admission.specialArrangement |
|
| Encounter.admission.destination |
|
| Encounter.admission.dischargeDisposition |
|
| Encounter.location.form |
|
| Encounter.participant.individual |
|
| Encounter.period |
|
| Encounter.reasonCode |
|
| Encounter.reasonReference |
|
| Encounter.hospitalization |
|
| Encounter.location.physicalType |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 10 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Encounter | TU | DomainResource | An interaction during which services are provided to the patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
| identifier | Σ | 0..* | Identifier | Identifier(s) by which this encounter is known |
| status | ?!Σ | 1..1 | code | planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown EncounterStatus (Required) |
| statusHistory | 0..* | BackboneElement | List of past encounter statuses | |
| status | 1..1 | code | planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown EncounterStatus (Required) | |
| period | 1..1 | Period | The time that the episode was in the specified status | |
| class | Σ | 0..* | CodeableConcept | Classification of patient encounter context - e.g. Inpatient, outpatient Encounter class (Preferred) |
| classHistory | 0..* | BackboneElement | List of past encounter classes | |
| class | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Encounter class (Preferred) | |
| period | 1..1 | Period | The time that the episode was in the specified class | |
| priority | 0..1 | CodeableConcept | Indicates the urgency of the encounter ActPriority (Example) | |
| type | Σ | 0..* | CodeableConcept | Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...) EncounterType (Example) |
| serviceType | Σ | 0..* | CodeableReference(HealthcareService) | Specific type of service ServiceType (Example) |
| subject | Σ | 0..1 | Reference(Patient | Group) | The patient or group related to this encounter |
| subjectStatus | 0..1 | CodeableConcept | The current status of the subject in relation to the Encounter EncounterSubjectStatus (Example) | |
| episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against |
| basedOn | 0..* | Reference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest) | The request that initiated this encounter | |
| careTeam | 0..* | Reference(CareTeam) | The group(s) that are allocated to participate in this encounter | |
| partOf | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of | |
| serviceProvider | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter | |
| participant | ΣC | 0..* | BackboneElement | List of participants involved in the encounter + Rule: A type must be provided when no explicit actor is specified + Rule: A type cannot be provided for a patient or group participant |
| type | Σ | 0..* | CodeableConcept | Role of participant in encounter ParticipantType (Extensible) |
| period | 0..1 | Period | Period of time during the encounter that the participant participated | |
| actor | Σ | 0..1 | Reference(Patient | Group | RelatedPerson | Practitioner | PractitionerRole | Device | HealthcareService) | The individual, device, or service participating in the encounter |
| appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter |
| virtualService | 0..* | VirtualServiceDetail | Connection details of a virtual service (e.g. conference call) | |
| actualPeriod | 0..1 | Period | The actual start and end time of the encounter | |
| plannedStartDate | 0..1 | dateTime | The planned start date/time (or admission date) of the encounter | |
| plannedEndDate | 0..1 | dateTime | The planned end date/time (or discharge date) of the encounter | |
| length | 0..1 | Duration | Actual quantity of time the encounter lasted (less time absent) | |
| reason | Σ | 0..* | CodeableReference(Condition | DiagnosticReport | ImmunizationRecommendation | Observation | Procedure) | Reason the encounter takes place (core or reference) Encounter Reason Codes (Preferred) |
| diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter |
| condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter |
| use | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) DiagnosisRole (Preferred) | |
| rank | 0..1 | positiveInt | Ranking of the diagnosis (for each role type) | |
| account | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter | |
| admission | 0..1 | BackboneElement | Details about the admission to a healthcare service | |
| preAdmissionIdentifier | 0..1 | Identifier | Pre-admission identifier | |
| origin | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission | |
| admitSource | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) AdmitSource (Preferred) | |
| reAdmission | 0..1 | CodeableConcept | The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission hl7VS-re-admissionIndicator (Example) | |
| dietPreference | 0..* | CodeableConcept | Diet preferences reported by the patient Diet (Example) | |
| specialCourtesy | 0..* | CodeableConcept | Special courtesies (VIP, board member) SpecialCourtesy (Preferred) | |
| specialArrangement | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. SpecialArrangements (Preferred) | |
| destination | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged | |
| dischargeDisposition | 0..1 | CodeableConcept | Category or kind of location after discharge DischargeDisposition (Example) | |
| location | 0..* | BackboneElement | List of locations where the patient has been | |
| location | 1..1 | Reference(Location) | Location the encounter takes place | |
| status | 0..1 | code | planned | active | reserved | completed EncounterLocationStatus (Required) | |
| form | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) Location Form (Example) | |
| period | 0..1 | Period | Time period during which the patient was present at the location | |
| Documentation for this format | ||||
See the Extensions for this resource
XML Template
<Encounter xmlns="http://hl7.org/fhir">
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 | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
"statusHistory" : [{ // List of past encounter statuses
"status" : "<code>", // R! planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
"period" : { Period } // R! The time that the episode was in the specified status
}],
"class" : [{ CodeableConcept }], // Classification of patient encounter context - e.g. Inpatient, outpatient
"classHistory" : [{ // List of past encounter classes
"class" : { Coding }, // R! inpatient | outpatient | ambulatory | emergency +
"period" : { Period } // R! The time that the episode was in the specified class
}],
"priority" : { CodeableConcept }, // Indicates the urgency of the encounter
"type" : [{ CodeableConcept }], // Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
"serviceType" : [{ CodeableReference(HealthcareService) }], // Specific type of service
"subject" : { Reference(Group|Patient) }, // The patient or group related to this encounter
"subjectStatus" : { CodeableConcept }, // The current status of the subject in relation to the Encounter
"episodeOfCare" : [{ Reference(EpisodeOfCare) }], // Episode(s) of care that this encounter should be recorded against
"basedOn" : [{ Reference(CarePlan|DeviceRequest|MedicationRequest|
ServiceRequest) }], // The request that initiated this encounter
"careTeam" : [{ Reference(CareTeam) }], // The group(s) that are allocated to participate in this encounter
"partOf" : { Reference(Encounter) }, // Another Encounter this encounter is part of
"serviceProvider" : { Reference(Organization) }, // The organization (facility) responsible for this encounter
"participant" : [{ // List of participants involved in the encounter
"type" : [{ CodeableConcept }], // Role of participant in encounter
"period" : { Period }, // Period of time during the encounter that the participant participated
"actor" : { Reference(Device|Group|HealthcareService|Patient|Practitioner|
PractitionerRole|RelatedPerson) } // The individual, device, or service participating in the encounter
}],
"appointment" : [{ Reference(Appointment) }], // The appointment that scheduled this encounter
"virtualService" : [{ VirtualServiceDetail }], // Connection details of a virtual service (e.g. conference call)
"actualPeriod" : { Period }, // The actual start and end time of the encounter
"plannedStartDate" : "<dateTime>", // The planned start date/time (or admission date) of the encounter
"plannedEndDate" : "<dateTime>", // The planned end date/time (or discharge date) of the encounter
"length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
"reason" : [{ CodeableReference(Condition|DiagnosticReport|
ImmunizationRecommendation|Observation|Procedure) }], // Reason the encounter takes place (core or reference)
"diagnosis" : [{ // The list of diagnosis relevant to this encounter
"condition" : { Reference(Condition|Procedure) }, // R! The diagnosis or procedure relevant to the encounter
"use" : { CodeableConcept }, // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
"rank" : "<positiveInt>" // Ranking of the diagnosis (for each role type)
}],
"account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
"admission" : { // Details about the admission to a healthcare service
"preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
"origin" : { Reference(Location|Organization) }, // The location/organization from which the patient came before admission
"admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
"reAdmission" : { CodeableConcept }, // The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
"dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
"specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
"specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc.
"destination" : { Reference(Location|Organization) }, // Location/organization to which the patient is discharged
"dischargeDisposition" : { CodeableConcept } // Category or kind of location after discharge
},
"location" : [{ // List of locations where the patient has been
"location" : { Reference(Location) }, // R! Location the encounter takes place
"status" : "<code>", // planned | active | reserved | completed
"form" : { CodeableConcept }, // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
"period" : { Period } // Time period during which the patient was present at the location
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since Release 4
| Encounter | |
| Encounter.class |
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| Encounter.classHistory.class |
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| Encounter.serviceType |
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| Encounter.subjectStatus |
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| Encounter.basedOn |
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| Encounter.careTeam |
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| Encounter.participant.actor |
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| Encounter.virtualService |
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| Encounter.actualPeriod |
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| Encounter.plannedStartDate |
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| Encounter.plannedEndDate |
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| Encounter.reason |
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| Encounter.admission |
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| Encounter.admission.preAdmissionIdentifier |
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| Encounter.admission.origin |
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| Encounter.admission.admitSource |
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| Encounter.admission.reAdmission |
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| Encounter.admission.dietPreference |
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| Encounter.admission.specialCourtesy |
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| Encounter.admission.specialArrangement |
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| Encounter.admission.destination |
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| Encounter.admission.dischargeDisposition |
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| Encounter.location.form |
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| Encounter.participant.individual |
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| Encounter.period |
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| Encounter.reasonCode |
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| Encounter.reasonReference |
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| Encounter.hospitalization |
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| Encounter.location.physicalType |
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See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 10 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors).)
Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis
| Path | Definition | Type | Reference |
|---|---|---|---|
| Encounter.status | Current state of the encounter. | Required | EncounterStatus |
| Encounter.statusHistory.status | Current state of the encounter. | Required | EncounterStatus |
| Encounter.class | This value set defines a set of codes that can be used to indicate the class of encounter: a specific code indicating class of service provided. | Preferred | EncounterClass |
| Encounter.classHistory.class | This value set defines a set of codes that can be used to indicate the class of encounter: a specific code indicating class of service provided. | Preferred | EncounterClass |
| Encounter.priority | A code or set of codes (e.g., for routine, emergency,) specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen. Discussion: This attribute is used in orders to indicate the ordered priority, and in event documentation it indicates the actual priority used to perform the act. In definition mood it indicates the available priorities. | Example | ActPriority |
| Encounter.type | This example value set defines a set of codes that can be used to indicate the type of encounter: a specific code indicating type of service provided. | Example | EncounterType |
| Encounter.serviceType | This value set defines an example set of codes of service-types. | Example | ServiceType |
| Encounter.subjectStatus | This example value set defines a set of codes that can be used to indicate the status of the subject within the encounter | Example | EncounterSubjectStatus |
| Encounter.participant.type | This value set defines a set of codes that can be used to indicate how an individual participates in an encounter. | Extensible | ParticipantType |
| Encounter.reason | This examples value set defines the set of codes that can be used to indicate reasons for an encounter. | Preferred | EncounterReasonCodes |
| Encounter.diagnosis.use | This value set defines a set of codes that can be used to express the role of a diagnosis on the Encounter or EpisodeOfCare record. | Preferred | DiagnosisRole |
| Encounter.admission.admitSource | This value set defines a set of codes that can be used to indicate from where the patient came in. | Preferred | AdmitSource |
| Encounter.admission.reAdmission | Value Set of codes which are used to specify that a patient is being re-admitted to a healthcare facility from which they were discharged, and indicates the circumstances around such re-admission. | Example | Hl7VSReAdmissionIndicator (a valid code from re-admissionIndicator ) |
| Encounter.admission.dietPreference | This value set defines a set of codes that can be used to indicate dietary preferences or restrictions a patient may have. | Example | Diet |
| Encounter.admission.specialCourtesy | This value set defines a set of codes that can be used to indicate special courtesies provided to the patient. | Preferred | SpecialCourtesy |
| Encounter.admission.specialArrangement | This value set defines a set of codes that can be used to indicate the kinds of special arrangements in place for a patients visit. | Preferred | SpecialArrangements |
| Encounter.admission.dischargeDisposition | This value set defines a set of codes that can be used to where the patient left the hospital. | Example | DischargeDisposition |
| Encounter.location.status | The status of the location. | Required | EncounterLocationStatus |
| Encounter.location.form | This example value set defines a set of codes that can be used to indicate the physical form of the Location. | Example | LocationForm (a valid code from Location type ) |
| UniqueKey | Level | Location | Description | Expression |
 enc-1 | Rule | Encounter.participant | A type must be provided when no explicit actor is specified | actor.exists() or type.exists() |
| enc-2 | Rule | Encounter.participant | A type cannot be provided for a patient or group participant | actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not() |
As stated, Encounter allows a flexible nesting of Encounters using the partOf element. For example:
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 use case.
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 | Expression | In Common |
| account | reference | The set of accounts that may be used for billing for this Encounter | Encounter.account (Account) | |
| appointment | reference | The appointment that scheduled this encounter | Encounter.appointment (Appointment) | |
| based-on | reference | The ServiceRequest that initiated this encounter | Encounter.basedOn (CarePlan, MedicationRequest, DeviceRequest, ServiceRequest) | |
| careteam | reference | Careteam allocated to participate in the encounter | Encounter.careTeam (CareTeam) | |
| class | token | Classification of patient encounter | Encounter.class | |
| date | date | A date within the actualPeriod the Encounter lasted | Encounter.actualPeriod | 17 Resources |
| date-start | date | The actual start date of the Encounter | Encounter.actualPeriod.start | |
| diagnosis | reference | The diagnosis or procedure relevant to the encounter | Encounter.diagnosis.condition (Condition, Procedure) | |
| end-date | date | The actual end date of the Encounter | Encounter.actualPeriod.end | |
| episode-of-care | reference | Episode(s) of care that this encounter should be recorded against | Encounter.episodeOfCare (EpisodeOfCare) | |
| identifier | token | Identifier(s) by which this encounter is known | Encounter.identifier | 30 Resources |
| length | quantity | 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.actor (Practitioner, Group, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson) | |
| participant-type | token | Role of participant in encounter | Encounter.participant.type | |
| patient | reference | The patient present at the encounter | Encounter.subject.where(resolve() is Patient) (Patient) | 33 Resources |
| practitioner | reference | Persons involved in the encounter other than the patient | Encounter.participant.actor.where(resolve() is Practitioner) (Practitioner) | |
| reason-code | token | Reference to a concept (by class) | Encounter.reason.concept | |
| reason-reference | reference | Reference to a resource (by instance) | Encounter.reason.reference | |
| service-provider | reference | The organization (facility) responsible for this encounter | Encounter.serviceProvider (Organization) | |
| special-arrangement | token | Wheelchair, translator, stretcher, etc. | Encounter.admission.specialArrangement | |
| status | token | planned | in-progress | on-hold | completed | cancelled | entered-in-error | unknown | Encounter.status | |
| subject | reference | The patient or group present at the encounter | Encounter.subject (Group, Patient) | |
| subject-status | token | The current status of the subject in relation to the Encounter | Encounter.subjectStatus | |
| type | token | Specific type of encounter | Encounter.type | 6 Resources |
FHIR ®© HL7.org 2011+. FHIR R5 Snapshot 3, hl7.fhir.core#5.0.0-snapshot3 generated on Wed, Dec 14, 2022 07:16+1100.
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