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

The official URL for this profile is:

    http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter-r4

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from US Core Encounter Profile

Summary

Mandatory: 1 element
Must-Support: 13 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-location-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter-r4

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance

This structure is derived from US Core Encounter Profile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* |  |
ext-insurance |  | 0..* | Reference(CoverageR4) | Insurance URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance
serviceType | S | 0..1 | CodeableConcept |
subject | S | 1..1 | Reference(PatientR4) |
episodeOfCare |  | 0..* | Reference(EpisodeOfCare) |
basedOn |  | 0..* | Reference(ServiceRequestR4) |
appointment | S | 0..* | Reference(AppointmentR4) |
length | S | 0..1 | Duration |
reasonCode | S | 0..* | CodeableConcept |
reasonReference | S | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) |
diagnosis | S | 0..* | BackboneElement |
condition | S | 1..1 | Reference(US Core Condition Profile | US Core Procedure Profile) |
location | S | 0..* | BackboneElement |
location | S | 1..1 | Reference(LocationR4) |
status | S | 0..1 | code |
period | S | 0..1 | Period |
partOf |  | 0..1 | Reference(EncounterR4) |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter | I | 0..* |  | US Core Encounter Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
ext-insurance | I | 0..* | Reference(CoverageR4) | Insurance URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required)
statusHistory | I | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required)
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible)
classHistory | I | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: V3 Value SetActEncounterCode (extensible)
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible)
serviceType | S Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example)
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example)
subject | S Σ | 1..1 | Reference(PatientR4) | The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequestR4) | The ServiceRequest that initiated this encounter
participant | S Σ I | 0..* | BackboneElement | List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible)
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(PractitionerR4) | Persons involved in the encounter other than the patient
appointment | S Σ | 0..* | Reference(AppointmentR4) | The appointment that scheduled this encounter
period | S | 0..1 | Period | The start and end time of the encounter
length | S | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred)
reasonReference | S Σ | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference)
diagnosis | S Σ I | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | S Σ | 1..1 | Reference(US Core Condition Profile | US Core Procedure Profile) | 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 …) Binding: DiagnosisRole (preferred)
rank | S | 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
hospitalization | S I | 0..1 | BackboneElement | Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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) Binding: AdmitSource (preferred)
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 RE-ADMISSION INDICATOR (example)
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example)
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred)
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred)
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (example)
location | S I | 0..* | BackboneElement | List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(LocationR4) | Location the encounter takes place
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required)
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example)
period | S | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(EncounterR4) | Another Encounter this encounter is part of
Documentation for this format

This structure is derived from US Core Encounter Profile

Summary

Mandatory: 1 element
Must-Support: 13 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-location-r4
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter-r4

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance

Differential View

This structure is derived from US Core Encounter Profile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter |  | 0..* |  |
ext-insurance |  | 0..* | Reference(CoverageR4) | Insurance URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance
serviceType | S | 0..1 | CodeableConcept |
subject | S | 1..1 | Reference(PatientR4) |
episodeOfCare |  | 0..* | Reference(EpisodeOfCare) |
basedOn |  | 0..* | Reference(ServiceRequestR4) |
appointment | S | 0..* | Reference(AppointmentR4) |
length | S | 0..1 | Duration |
reasonCode | S | 0..* | CodeableConcept |
reasonReference | S | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) |
diagnosis | S | 0..* | BackboneElement |
condition | S | 1..1 | Reference(US Core Condition Profile | US Core Procedure Profile) |
location | S | 0..* | BackboneElement |
location | S | 1..1 | Reference(LocationR4) |
status | S | 0..1 | code |
period | S | 0..1 | Period |
partOf |  | 0..1 | Reference(EncounterR4) |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Encounter | I | 0..* |  | US Core Encounter Profile
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
ext-insurance | I | 0..* | Reference(CoverageR4) | Insurance URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible)
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General': http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General': 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required)
statusHistory | I | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required)
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible)
classHistory | I | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: V3 Value SetActEncounterCode (extensible)
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: US Core Encounter Type (extensible)
serviceType | S Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example)
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example)
subject | S Σ | 1..1 | Reference(PatientR4) | The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequestR4) | The ServiceRequest that initiated this encounter
participant | S Σ I | 0..* | BackboneElement | List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible)
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(PractitionerR4) | Persons involved in the encounter other than the patient
appointment | S Σ | 0..* | Reference(AppointmentR4) | The appointment that scheduled this encounter
period | S | 0..1 | Period | The start and end time of the encounter
length | S | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred)
reasonReference | S Σ | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference)
diagnosis | S Σ I | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | S Σ | 1..1 | Reference(US Core Condition Profile | US Core Procedure Profile) | 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 …) Binding: DiagnosisRole (preferred)
rank | S | 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
hospitalization | S I | 0..1 | BackboneElement | Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
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) Binding: AdmitSource (preferred)
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 RE-ADMISSION INDICATOR (example)
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example)
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred)
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred)
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: DischargeDisposition (example)
location | S I | 0..* | BackboneElement | List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(LocationR4) | Location the encounter takes place
status | S | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required)
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example)
period | S | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(Organization) | The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(EncounterR4) | Another Encounter this encounter is part of
Documentation for this format

Other representations of profile: Schematron

### Terminology Bindings

Path | Conformance | ValueSet
Encounter.status | required | EncounterStatus
Encounter.class | extensible | v3.ActEncounterCode
Encounter.type | extensible | US_Core_Encounter_Type
Encounter.serviceType | example | ServiceType
Encounter.participant.type | extensible | ParticipantType
Encounter.reasonCode | preferred | EncounterReasonCodes
Encounter.hospitalization.dischargeDisposition | example | DischargeDisposition
Encounter.location.status | required | EncounterLocationStatus

### Constraints

Id | Path | Details | Requirements
dom-2 | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-4 | Encounter | 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-3 | Encounter | 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-6 | Encounter | A resource should have narrative for robust management : text.div.exists() |
dom-5 | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
ele-1 | Encounter.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Encounter.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Encounter.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | Encounter.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | Encounter.statusHistory | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Encounter.classHistory | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Encounter.participant | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Encounter.diagnosis | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Encounter.hospitalization | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Encounter.location | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |