0.3.0 - Second STU ballot

This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.3.0: STU 1 Ballot 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: EncounterR4 - Detailed Descriptions

Definitions for the profile-encounter-r4 Profile.

1. Encounter
Definition | This is basic constraint on Encounter for use in US Core resources.
Control | 0..*
Alternate Names | Visit
Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.div.exists())
2. Encounter.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Encounter.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
4. Encounter.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
5. Encounter.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | A human language. The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages
Type | code
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
6. Encounter.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
7. Encounter.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. Encounter.extension
Definition | An Extension
Control | 0..*
Type | Extension
9. Encounter.extension:EncounterInsurance
Definition | Indicates coverage relevant to the request.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(InsuranceExtensionR4) (Extension Type: Reference(CoverageR4))
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Encounter.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
11. Encounter.identifier
Definition | Identifier(s) by which this encounter is known.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Must Support | true
12. Encounter.identifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
13. Encounter.identifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
14. Encounter.identifier.use
Definition | The purpose of this identifier.
Control | 0..1
Binding | Identifies the purpose for this identifier, if known . The codes SHALL be taken from IdentifierUse
Type | code
Is Modifier | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
15. Encounter.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Control | 0..1
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
Type | CodeableConcept
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
16. Encounter.identifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Control | 1..1
Type | uri
Must Support | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments | Identifier.system is always case sensitive.
Example | General:http://www.acme.com/identifiers/patient
17. Encounter.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Control | 1..1
Type | string
Must Support | true
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Example | General:123456
18. Encounter.identifier.period
Definition | Time period during which identifier is/was valid for use.
Control | 0..1
Type | Period
19. Encounter.identifier.assigner
Definition | Organization that issued/manages the identifier.
Control | 0..1
Type | Reference(Organization)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
20. Encounter.status
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Control | 1..1
Binding | Current state of the encounter. The codes SHALL be taken from EncounterStatus
Type | code
Is Modifier | true
Must Support | true
Comments | Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).
21. 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.
Control | 0..*
Type | BackboneElement
Comments | The current status is always found in the current version of the resource, not the status history.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Encounter.statusHistory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
23. Encounter.statusHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
24. Encounter.statusHistory.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
25. Encounter.statusHistory.status
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Control | 1..1
Binding | Current state of the encounter. The codes SHALL be taken from EncounterStatus
Type | code
26. Encounter.statusHistory.period
Definition | The time that the episode was in the specified status.
Control | 1..1
Type | Period
27. Encounter.class
Definition | Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.
Control | 1..1
Binding | Classification of the encounter. The codes SHALL be taken from V3 Value SetActEncounterCode; other codes may be used where these codes are not suitable
Type | Coding
Must Support | true
28. 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.
Control | 0..*
Type | BackboneElement
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Encounter.classHistory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
30. Encounter.classHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
31. Encounter.classHistory.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
32. Encounter.classHistory.class
Definition | inpatient | outpatient | ambulatory | emergency +.
Control | 1..1
Binding | Classification of the encounter. The codes SHALL be taken from V3 Value SetActEncounterCode; other codes may be used where these codes are not suitable
Type | Coding
33. Encounter.classHistory.period
Definition | The time that the episode was in the specified class.
Control | 1..1
Type | Period
34. Encounter.type
Definition | Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Control | 1..*
Binding | Valueset to describe the Encounter Type The codes SHALL be taken from US Core Encounter Type; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
Comments | Since there are many ways to further classify encounters, this element is 0..*.
35. Encounter.serviceType
Definition | Broad categorization of the service that is to be provided (e.g. cardiology).
Control | 0..1
Binding | Broad categorization of the service that is to be provided. For example codes, see ServiceType
Type | CodeableConcept
Must Support | true
36. Encounter.priority
Definition | Indicates the urgency of the encounter.
Control | 0..1
Binding | Indicates the urgency of the encounter. For example codes, see v3 Code System ActPriority
Type | CodeableConcept
37. Encounter.subject
Definition | The patient or group present at the encounter.
Control | 1..1
Type | Reference(PatientR4)
Must Support | true
Alternate Names | patient
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).
38. 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).
Control | 0..*
Type | Reference(EpisodeOfCare)
39. Encounter.basedOn
Definition | The request this encounter satisfies (e.g. incoming referral or procedure request).
Control | 0..*
Type | Reference(ServiceRequestR4)
Alternate Names | incomingReferral
40. Encounter.participant
Definition | The list of people responsible for providing the service.
Control | 0..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Encounter.participant.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
42. Encounter.participant.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
43. Encounter.participant.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
44. Encounter.participant.type
Definition | Role of participant in encounter.
Control | 0..*
Binding | Role of participant in encounter. The codes SHALL be taken from ParticipantType; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | 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.
45. 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.
Control | 0..1
Type | Period
Must Support | true
46. Encounter.participant.individual
Definition | Persons involved in the encounter other than the patient.
Control | 0..1
Type | Reference(PractitionerR4)
Must Support | true
47. Encounter.appointment
Definition | The appointment that scheduled this encounter.
Control | 0..*
Type | Reference(AppointmentR4)
Must Support | true
48. Encounter.period
Definition | The start and end time of the encounter.
Control | 0..1
Type | Period
Must Support | true
Comments | If not (yet) known, the end of the Period may be omitted.
49. Encounter.length
Definition | Quantity of time the encounter lasted. This excludes the time during leaves of absence.
Control | 0..1
Type | Duration
Must Support | true
Comments | May differ from the time the Encounter.period lasted because of leave of absence.
50. Encounter.reasonCode
Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Control | 0..*
Binding | Reason why the encounter takes place. The codes SHOULD be taken from EncounterReasonCodes
Type | CodeableConcept
Must Support | true
Alternate Names | Indication, Admission diagnosis
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).
51. Encounter.reasonReference
Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Control | 0..*
Type | Reference(Condition | Procedure | Observation | ImmunizationRecommendation)
Must Support | true
Alternate Names | Indication, Admission diagnosis
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).
52. Encounter.diagnosis
Definition | The list of diagnosis relevant to this encounter.
Control | 0..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Encounter.diagnosis.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
54. Encounter.diagnosis.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
55. Encounter.diagnosis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
56. 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.
Control | 1..1
Type | Reference(US Core Condition Profile | US Core Procedure Profile)
Must Support | true
Alternate Names | Admission diagnosis, discharge diagnosis, indication
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).
57. Encounter.diagnosis.use
Definition | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Control | 0..1
Binding | The type of diagnosis this condition represents. The codes SHOULD be taken from DiagnosisRole
Type | CodeableConcept
58. Encounter.diagnosis.rank
Definition | Ranking of the diagnosis (for each role type).
Control | 0..1
Type | positiveInt
Must Support | true
59. Encounter.account
Definition | The set of accounts that may be used for billing for this Encounter.
Control | 0..*
Type | Reference(Account)
Comments | The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.
60. Encounter.hospitalization
Definition | Details about the admission to a healthcare service.
Control | 0..1
Type | BackboneElement
Must Support | true
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Encounter.hospitalization.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
62. Encounter.hospitalization.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
63. Encounter.hospitalization.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
64. Encounter.hospitalization.preAdmissionIdentifier
Definition | Pre-admission identifier.
Control | 0..1
Type | Identifier
65. Encounter.hospitalization.origin
Definition | The location/organization from which the patient came before admission.
Control | 0..1
Type | Reference(Location | Organization)
66. Encounter.hospitalization.admitSource
Definition | From where patient was admitted (physician referral, transfer).
Control | 0..1
Binding | From where the patient was admitted. The codes SHOULD be taken from AdmitSource
Type | CodeableConcept
67. Encounter.hospitalization.reAdmission
Definition | Whether this hospitalization is a readmission and why if known.
Control | 0..1
Binding | The reason for re-admission of this hospitalization encounter. For example codes, see v2 RE-ADMISSION INDICATOR
Type | CodeableConcept
68. Encounter.hospitalization.dietPreference
Definition | Diet preferences reported by the patient.
Control | 0..*
Binding | Medical, cultural or ethical food preferences to help with catering requirements. For example codes, see Diet
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.
Comments | For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).
69. Encounter.hospitalization.specialCourtesy
Definition | Special courtesies (VIP, board member).
Control | 0..*
Binding | Special courtesies. The codes SHOULD be taken from SpecialCourtesy
Type | CodeableConcept
70. 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.
Control | 0..*
Binding | Special arrangements. The codes SHOULD be taken from SpecialArrangements
Type | CodeableConcept
71. Encounter.hospitalization.destination
Definition | Location/organization to which the patient is discharged.
Control | 0..1
Type | Reference(Location | Organization)
72. Encounter.hospitalization.dischargeDisposition
Definition | Category or kind of location after discharge.
Control | 0..1
Binding | Discharge Disposition. For example codes, see DischargeDisposition
Type | CodeableConcept
Must Support | true
73. Encounter.location
Definition | List of locations where the patient has been during this encounter.
Control | 0..*
Type | BackboneElement
Must Support | true
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".
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. Encounter.location.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
75. Encounter.location.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
76. Encounter.location.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
77. Encounter.location.location
Definition | The location where the encounter takes place.
Control | 1..1
Type | Reference(LocationR4)
Must Support | true
78. 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.
Control | 0..1
Binding | The status of the location. The codes SHALL be taken from EncounterLocationStatus
Type | code
Must Support | true
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.
79. 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.
Control | 0..1
Binding | Physical form of the location. For example codes, see LocationType
Type | CodeableConcept
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.
80. Encounter.location.period
Definition | Time period during which the patient was present at the location.
Control | 0..1
Type | Period
Must Support | true
81. 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.
Control | 0..1
Type | Reference(Organization)
82. Encounter.partOf
Definition | Another Encounter of which this encounter is a part of (administratively or in time).
Control | 0..1
Type | Reference(EncounterR4)
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.