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Patient Administration Work Group | Maturity Level: 2 | Trial Use | Security Category: Patient | Compartments: Patient, Practitioner |
Detailed Descriptions for the elements in the EpisodeOfCare resource.
EpisodeOfCare | |
Element Id | EpisodeOfCare |
Definition | An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time. |
Short Display | An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility |
Cardinality | 0..* |
Type | DomainResource |
Alternate Names | Case Program Problem |
Summary | false |
EpisodeOfCare.identifier | |
Element Id | EpisodeOfCare.identifier |
Definition | The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes. |
Short Display | Business Identifier(s) relevant for this EpisodeOfCare |
Note | This is a business identifier, not a resource identifier (see discussion) |
Cardinality | 0..* |
Type | Identifier |
Summary | false |
EpisodeOfCare.status | |
Element Id | EpisodeOfCare.status |
Definition | planned | waitlist | active | onhold | finished | cancelled. |
Short Display | planned | waitlist | active | onhold | finished | cancelled | entered-in-error |
Cardinality | 1..1 |
Terminology Binding | Episode Of Care Status (Required) |
Type | code |
Is Modifier | true (Reason: This element is labelled 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 | This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid. |
EpisodeOfCare.statusHistory | |
Element Id | EpisodeOfCare.statusHistory |
Definition | The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource). |
Short Display | Past list of status codes (the current status may be included to cover the start date of the status) |
Cardinality | 0..* |
Summary | false |
EpisodeOfCare.statusHistory.status | |
Element Id | EpisodeOfCare.statusHistory.status |
Definition | planned | waitlist | active | onhold | finished | cancelled. |
Short Display | planned | waitlist | active | onhold | finished | cancelled | entered-in-error |
Cardinality | 1..1 |
Terminology Binding | Episode Of Care Status (Required) |
Type | code |
Summary | false |
EpisodeOfCare.statusHistory.period | |
Element Id | EpisodeOfCare.statusHistory.period |
Definition | The period during this EpisodeOfCare that the specific status applied. |
Short Display | Duration the EpisodeOfCare was in the specified status |
Cardinality | 1..1 |
Type | Period |
Summary | false |
EpisodeOfCare.type | |
Element Id | EpisodeOfCare.type |
Definition | A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care. |
Short Display | Type/class - e.g. specialist referral, disease management |
Cardinality | 0..* |
Terminology Binding | Episode Of Care Type (Example) |
Type | CodeableConcept |
Summary | true |
Comments | The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications. |
EpisodeOfCare.reason | |
Element Id | EpisodeOfCare.reason |
Definition | The list of medical reasons that are expected to be addressed during the episode of care. |
Short Display | The list of medical reasons that are expected to be addressed during the episode of care |
Cardinality | 0..* |
Summary | true |
Comments | The reason communicates what medical problem the patient has that should be addressed during the episode of care. This reason could be patient reported complaint, a clinical indication that was determined in a previous encounter or episode of care, or some planned care such as an immunization recommendation. In the case where you have a primary reason, but are expecting to also address other problems, you can list the primary reason with a use code of 'Chief Complaint', while the other problems being addressed would have a use code of 'Reason for Visit'. Examples:
|
EpisodeOfCare.reason.use | |
Element Id | EpisodeOfCare.reason.use |
Definition | What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening). |
Short Display | What the reason value should be used for/as |
Cardinality | 0..1 |
Terminology Binding | Encounter Reason Use (Example) |
Type | CodeableConcept |
Summary | true |
EpisodeOfCare.reason.value | |
Element Id | EpisodeOfCare.reason.value |
Definition | The medical reason that is expected to be addressed during the episode of care, expressed as a text, code or a reference to another resource. |
Short Display | Medical reason to be addressed |
Cardinality | 0..* |
Terminology Binding | Encounter Reason Codes (Example) |
Type | CodeableReference(Condition | Procedure | Observation | HealthcareService) |
Summary | true |
EpisodeOfCare.diagnosis | |
Element Id | EpisodeOfCare.diagnosis |
Definition | The list of medical conditions that were addressed during the episode of care. |
Short Display | The list of medical conditions that were addressed during the episode of care |
Cardinality | 0..* |
Summary | true |
Comments | The diagnosis communicates what medical conditions were actually addressed during the episode of care. If a diagnosis was provided as a reason, and was treated during the episode of care, it may be listed in both EpisodeOfCare.reason and EpisodeOfCare.diagnosis. Diagnoses related to billing can be documented on the Account resources which supports ranking for the purpose of reimbursement. |
EpisodeOfCare.diagnosis.condition | |
Element Id | EpisodeOfCare.diagnosis.condition |
Definition | The medical condition that was addressed during the episode of care, expressed as a text, code or a reference to another resource. |
Short Display | The medical condition that was addressed during the episode of care |
Cardinality | 0..* |
Terminology Binding | Condition/Problem/Diagnosis Codes (Example) |
Type | CodeableReference(Condition) |
Summary | true |
EpisodeOfCare.diagnosis.use | |
Element Id | EpisodeOfCare.diagnosis.use |
Definition | Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …). |
Short Display | Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …) |
Cardinality | 0..1 |
Terminology Binding | Encounter Diagnosis Use (Preferred) |
Type | CodeableConcept |
Summary | true |
EpisodeOfCare.patient | |
Element Id | EpisodeOfCare.patient |
Definition | The patient who is the focus of this episode of care. |
Short Display | The patient who is the focus of this episode of care |
Cardinality | 1..1 |
Type | Reference(Patient) |
Summary | true |
EpisodeOfCare.managingOrganization | |
Element Id | EpisodeOfCare.managingOrganization |
Definition | The organization that has assumed the specific responsibilities for care coordination, care delivery, or other services for the specified duration. |
Short Display | Organization that assumes responsibility for care coordination |
Cardinality | 0..1 |
Type | Reference(Organization) |
Summary | true |
Comments | If multiple organizations are involved in care delivery, the care teams from those organizations would be represented in EpisodeOfCare.team, while the primary organization managing the care would be listed in EpisodeOfCare.managingOrganization. Other organizations may have their own EpisodeOfCare for tracking their activities. |
EpisodeOfCare.period | |
Element Id | EpisodeOfCare.period |
Definition | The interval during which the managing organization assumes the defined responsibility. |
Short Display | Interval during responsibility is assumed |
Cardinality | 0..1 |
Type | Period |
Summary | true |
EpisodeOfCare.referralRequest | |
Element Id | EpisodeOfCare.referralRequest |
Definition | Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals. |
Short Display | Originating Referral Request(s) |
Cardinality | 0..* |
Type | Reference(ServiceRequest) |
Summary | false |
EpisodeOfCare.careManager | |
Element Id | EpisodeOfCare.careManager |
Definition | The practitioner that is the care manager/care coordinator for this patient. |
Short Display | Care manager/care coordinator for the patient |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole) |
Summary | false |
EpisodeOfCare.careTeam | |
Element Id | EpisodeOfCare.careTeam |
Definition | The list of practitioners that may be facilitating this episode of care for specific purposes. |
Short Display | Other practitioners facilitating this episode of care |
Cardinality | 0..* |
Type | Reference(CareTeam) |
Alternate Names | CareTeam |
Summary | false |
EpisodeOfCare.account | |
Element Id | EpisodeOfCare.account |
Definition | The set of accounts that may be used for billing for this EpisodeOfCare. |
Short Display | The set of accounts that may be used for billing for this EpisodeOfCare |
Cardinality | 0..* |
Type | Reference(Account) |
Summary | false |
Comments | The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules. |