Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Patient Administration icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Patient, Practitioner

Detailed Descriptions for the elements in the EpisodeOfCare resource.

EpisodeOfCare
Element IdEpisodeOfCare
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 DisplayAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
Cardinality0..*
TypeDomainResource
Alternate NamesCase Program Problem
Summaryfalse
EpisodeOfCare.identifier
Element IdEpisodeOfCare.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 DisplayBusiness Identifier(s) relevant for this EpisodeOfCare
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summaryfalse
EpisodeOfCare.status
Element IdEpisodeOfCare.status
Definition

planned | waitlist | active | onhold | finished | cancelled.

Short Displayplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Cardinality1..1
Terminology BindingEpisode Of Care Status (Required)
Typecode
Is Modifiertrue (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)
Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

EpisodeOfCare.statusHistory
Element IdEpisodeOfCare.statusHistory
Definition

The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

Short DisplayPast list of status codes (the current status may be included to cover the start date of the status)
Cardinality0..*
Summaryfalse
EpisodeOfCare.statusHistory.status
Element IdEpisodeOfCare.statusHistory.status
Definition

planned | waitlist | active | onhold | finished | cancelled.

Short Displayplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Cardinality1..1
Terminology BindingEpisode Of Care Status (Required)
Typecode
Summaryfalse
EpisodeOfCare.statusHistory.period
Element IdEpisodeOfCare.statusHistory.period
Definition

The period during this EpisodeOfCare that the specific status applied.

Short DisplayDuration the EpisodeOfCare was in the specified status
Cardinality1..1
TypePeriod
Summaryfalse
EpisodeOfCare.type
Element IdEpisodeOfCare.type
Definition

A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

Short DisplayType/class - e.g. specialist referral, disease management
Cardinality0..*
Terminology BindingEpisode Of Care Type (Example)
TypeCodeableConcept
Summarytrue
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 IdEpisodeOfCare.reason
Definition

The list of medical reasons that are expected to be addressed during the episode of care.

Short DisplayThe list of medical reasons that are expected to be addressed during the episode of care
Cardinality0..*
Summarytrue
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:

  • pregnancy would use HealthcareService or a coding as the reason
  • patient home monitoring could use Condition as the reason
EpisodeOfCare.reason.use
Element IdEpisodeOfCare.reason.use
Definition

What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening).

Short DisplayWhat the reason value should be used for/as
Cardinality0..1
Terminology BindingEncounter Reason Use (Example)
TypeCodeableConcept
Summarytrue
EpisodeOfCare.reason.value
Element IdEpisodeOfCare.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 DisplayMedical reason to be addressed
Cardinality0..*
Terminology BindingEncounter Reason Codes (Example)
TypeCodeableReference(Condition | Procedure | Observation | HealthcareService)
Summarytrue
EpisodeOfCare.diagnosis
Element IdEpisodeOfCare.diagnosis
Definition

The list of medical conditions that were addressed during the episode of care.

Short DisplayThe list of medical conditions that were addressed during the episode of care
Cardinality0..*
Summarytrue
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 IdEpisodeOfCare.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 DisplayThe medical condition that was addressed during the episode of care
Cardinality0..*
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableReference(Condition)
Summarytrue
EpisodeOfCare.diagnosis.use
Element IdEpisodeOfCare.diagnosis.use
Definition

Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …).

Short DisplayRole that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Cardinality0..1
Terminology BindingEncounter Diagnosis Use (Preferred)
TypeCodeableConcept
Summarytrue
EpisodeOfCare.patient
Element IdEpisodeOfCare.patient
Definition

The patient who is the focus of this episode of care.

Short DisplayThe patient who is the focus of this episode of care
Cardinality1..1
TypeReference(Patient)
Summarytrue
EpisodeOfCare.managingOrganization
Element IdEpisodeOfCare.managingOrganization
Definition

The organization that has assumed the specific responsibilities for care coordination, care delivery, or other services for the specified duration.

Short DisplayOrganization that assumes responsibility for care coordination
Cardinality0..1
TypeReference(Organization)
Summarytrue
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 IdEpisodeOfCare.period
Definition

The interval during which the managing organization assumes the defined responsibility.

Short DisplayInterval during responsibility is assumed
Cardinality0..1
TypePeriod
Summarytrue
EpisodeOfCare.referralRequest
Element IdEpisodeOfCare.referralRequest
Definition

Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

Short DisplayOriginating Referral Request(s)
Cardinality0..*
TypeReference(ServiceRequest)
Summaryfalse
EpisodeOfCare.careManager
Element IdEpisodeOfCare.careManager
Definition

The practitioner that is the care manager/care coordinator for this patient.

Short DisplayCare manager/care coordinator for the patient
Cardinality0..1
TypeReference(Practitioner | PractitionerRole)
Summaryfalse
EpisodeOfCare.careTeam
Element IdEpisodeOfCare.careTeam
Definition

The list of practitioners that may be facilitating this episode of care for specific purposes.

Short DisplayOther practitioners facilitating this episode of care
Cardinality0..*
TypeReference(CareTeam)
Alternate NamesCareTeam
Summaryfalse
EpisodeOfCare.account
Element IdEpisodeOfCare.account
Definition

The set of accounts that may be used for billing for this EpisodeOfCare.

Short DisplayThe set of accounts that may be used for billing for this EpisodeOfCare
Cardinality0..*
TypeReference(Account)
Summaryfalse
Comments

The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules.