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.

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.

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

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

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

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

The period during this EpisodeOfCare that the specific status applied.

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

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.

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

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

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

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.

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

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.

The medical condition that was addressed during the episode of care, expressed as a text, code or a reference to another resource.

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

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

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

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.

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

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

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

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

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

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