HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm CI Build

This page is part of the electronic Case Reporting (eCR) (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions

SD.9 StructureDefinition-eicr-encounter

This Encounter profile represents the encounter related to the eICR event. Contained in the Encounter.participant, is the provider in charge of care (represented by the PractitionerRole.Practitioner) and the provider facility (represented by the PractitionerRole.Organization). The location (facility) in which care was provided when the case was triggered is contained in the encounter.location.

A trigger on an encounter diagnosis is indicated by the eICR Trigger Code Flag Extension in the diagnosis.

Where a trigger occurs outside of an encounter use code=”PHC2237” | system=”2.16.840.1.114222.4.5.274” (External Encounter) and omit period, participant, location, and serviceProvider. In this case, the responsible provider and facility information is contained in the eICR Composition.author.

SD.9.1 Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-encounter

Published on Wed Jan 29 20:30:08 UTC 2020 as a active by HL7 Public Health Work Group.

This profile builds on Encounter

Summary

Mandatory: 2 elements (3 nested mandatory elements)
Must-Support: 22 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Encounter.participant is sliced based on the value of type:type
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..*EncountereICR Encounter
... identifier S0..1Identifier
.... system S1..1uri
.... value S1..1string
... status S1..1code
... class S1..1CodingClass of encounter
.... data-absent-reason S0..1codeunknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
... subject S1..1Reference(eCR Patient)
... participant S0..*(Slice Definition)Slice: Unordered, Open by type:type
.... participant:sliceResponsibleProvider S0..1BackboneElementResponsible provider
..... type S1..*CodeableConceptResponsible provider
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ATND
..... period S0..1Period
..... individual 0..1Reference(eCR PractitionerRole)Responsible Provider
... period S0..1PeriodPatient encounter start and end times
.... start S0..1dateTimeEncounter start.
.... end S0..1dateTimeEncounter end.
... diagnosis S0..*BackboneElementEncounter diagnosis
.... extension S0..*ExtensionSlice: Unordered, Open by value:url
.... eicr-trigger-code-flag-extension S0..1(Complex)eICR Trigger Code Flag
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
.... condition S1..1Reference(eICR Condition)
... location S0..1BackboneElementeICR encounter location
.... location S1..1Reference(eICR Location)
... serviceProvider S0..1Reference(eCR Organization)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter I0..*EncountereICR Encounter
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier SΣI0..1IdentifierIdentifier(s) by which this encounter is known
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI1..1stringThe value that is unique
Example General: 123456
.... period ΣI0..1PeriodTime period when id is/was valid for use
.... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!SΣI1..1codeplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required)
... statusHistory I0..*BackboneElementList of past encounter statuses
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... status I1..1codeplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required)
.... period I1..1PeriodThe time that the episode was in the specified status
... class SΣI1..1CodingClass of encounter
Binding: V3 Value SetActEncounterCode (extensible)
... classHistory I0..*BackboneElementList of past encounter classes
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... class I1..1Codinginpatient | outpatient | ambulatory | emergency +
Binding: V3 Value SetActEncounterCode (extensible)
.... period I1..1PeriodThe time that the episode was in the specified class
... type SΣI1..1CodeableConceptType of encounter
Binding: US Core Encounter Type (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... data-absent-reason SI0..1codeunknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Slice: Unordered, Open by value:url
Binding: DataAbsentReason (required)
.... coding ΣI0..*CodingCode defined by a terminology system
.... text ΣI0..1stringPlain text representation of the concept
... serviceType ΣI0..1CodeableConceptSpecific type of service
Binding: ServiceType (example)
... priority I0..1CodeableConceptIndicates the urgency of the encounter
Binding: v3 Code System ActPriority (example)
... subject SΣI1..1Reference(eCR Patient)The patient or group present at the encounter
... episodeOfCare ΣI0..*Reference(EpisodeOfCare)Episode(s) of care that this encounter should be recorded against
... basedOn I0..*Reference(ServiceRequest)The ServiceRequest that initiated this encounter
... participant SΣI0..*(Slice Definition)List of participants involved in the encounter
Slice: Unordered, Open by type:type
.... participant:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type ΣI0..*CodeableConceptRole of participant in encounter
Binding: ParticipantType (extensible)
..... period I0..1PeriodPeriod of time during the encounter that the participant participated
..... individual ΣI0..1Reference(Practitioner | PractitionerRole | RelatedPerson)Persons involved in the encounter other than the patient
.... participant:sliceResponsibleProvider SΣI0..1BackboneElementResponsible provider
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..*CodeableConceptResponsible provider
Binding: ParticipantType (extensible)

Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ATND
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... period SI0..1PeriodPeriod of time during the encounter that the participant participated
..... individual ΣI0..1Reference(eCR PractitionerRole)Responsible Provider
... appointment ΣI0..*Reference(Appointment)The appointment that scheduled this encounter
... period SI0..1PeriodPatient encounter start and end times
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣI0..1dateTimeEncounter start.
.... end SΣI0..1dateTimeEncounter end.
... length I0..1DurationQuantity of time the encounter lasted (less time absent)
... reasonCode ΣI0..*CodeableConceptCoded reason the encounter takes place
Binding: EncounterReasonCodes (preferred)
... reasonReference ΣI0..*Reference(Condition | Procedure | Observation | ImmunizationRecommendation)Reason the encounter takes place (reference)
... diagnosis SΣI0..*BackboneElementEncounter diagnosis
.... id 0..1stringUnique id for inter-element referencing
.... extension SI0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eicr-trigger-code-flag-extension SI0..1(Complex)eICR Trigger Code Flag
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... condition SΣI1..1Reference(eICR Condition)The diagnosis or procedure relevant to the encounter
.... use I0..1CodeableConceptRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred)
.... rank I0..1positiveIntRanking of the diagnosis (for each role type)
... account I0..*Reference(Account)The set of accounts that may be used for billing for this Encounter
... hospitalization I0..1BackboneElementDetails about the admission to a healthcare service
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... preAdmissionIdentifier I0..1IdentifierPre-admission identifier
.... origin I0..1Reference(Location | Organization)The location/organization from which the patient came before admission
.... admitSource I0..1CodeableConceptFrom where patient was admitted (physician referral, transfer)
Binding: AdmitSource (preferred)
.... reAdmission I0..1CodeableConceptThe 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 I0..*CodeableConceptDiet preferences reported by the patient
Binding: Diet (example)
.... specialCourtesy I0..*CodeableConceptSpecial courtesies (VIP, board member)
Binding: SpecialCourtesy (preferred)
.... specialArrangement I0..*CodeableConceptWheelchair, translator, stretcher, etc.
Binding: SpecialArrangements (preferred)
.... destination I0..1Reference(Location | Organization)Location/organization to which the patient is discharged
.... dischargeDisposition I0..1CodeableConceptCategory or kind of location after discharge
Binding: DischargeDisposition (example)
... location SI0..1BackboneElementeICR encounter location
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... location SI1..1Reference(eICR Location)Location the encounter takes place
.... status I0..1codeplanned | active | reserved | completed
Binding: EncounterLocationStatus (required)
.... physicalType I0..1CodeableConceptThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Binding: LocationType (example)
.... period I0..1PeriodTime period during which the patient was present at the location
... serviceProvider SI0..1Reference(eCR Organization)The organization (facility) responsible for this encounter
... partOf I0..1Reference(Encounter)Another Encounter this encounter is part of

doco Documentation for this format

Summary

Mandatory: 2 elements (3 nested mandatory elements)
Must-Support: 22 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Encounter.participant is sliced based on the value of type:type

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..*EncountereICR Encounter
... identifier S0..1Identifier
.... system S1..1uri
.... value S1..1string
... status S1..1code
... class S1..1CodingClass of encounter
.... data-absent-reason S0..1codeunknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Binding: DataAbsentReason (required)
... subject S1..1Reference(eCR Patient)
... participant S0..*(Slice Definition)Slice: Unordered, Open by type:type
.... participant:sliceResponsibleProvider S0..1BackboneElementResponsible provider
..... type S1..*CodeableConceptResponsible provider
Required Pattern: At least the following
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ATND
..... period S0..1Period
..... individual 0..1Reference(eCR PractitionerRole)Responsible Provider
... period S0..1PeriodPatient encounter start and end times
.... start S0..1dateTimeEncounter start.
.... end S0..1dateTimeEncounter end.
... diagnosis S0..*BackboneElementEncounter diagnosis
.... extension S0..*ExtensionSlice: Unordered, Open by value:url
.... eicr-trigger-code-flag-extension S0..1(Complex)eICR Trigger Code Flag
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
.... condition S1..1Reference(eICR Condition)
... location S0..1BackboneElementeICR encounter location
.... location S1..1Reference(eICR Location)
... serviceProvider S0..1Reference(eCR Organization)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter I0..*EncountereICR Encounter
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier SΣI0..1IdentifierIdentifier(s) by which this encounter is known
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI1..1stringThe value that is unique
Example General: 123456
.... period ΣI0..1PeriodTime period when id is/was valid for use
.... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!SΣI1..1codeplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required)
... statusHistory I0..*BackboneElementList of past encounter statuses
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... status I1..1codeplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required)
.... period I1..1PeriodThe time that the episode was in the specified status
... class SΣI1..1CodingClass of encounter
Binding: V3 Value SetActEncounterCode (extensible)
... classHistory I0..*BackboneElementList of past encounter classes
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... class I1..1Codinginpatient | outpatient | ambulatory | emergency +
Binding: V3 Value SetActEncounterCode (extensible)
.... period I1..1PeriodThe time that the episode was in the specified class
... type SΣI1..1CodeableConceptType of encounter
Binding: US Core Encounter Type (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... data-absent-reason SI0..1codeunknown | asked | temp | notasked | masked | unsupported | astext | error
URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
Slice: Unordered, Open by value:url
Binding: DataAbsentReason (required)
.... coding ΣI0..*CodingCode defined by a terminology system
.... text ΣI0..1stringPlain text representation of the concept
... serviceType ΣI0..1CodeableConceptSpecific type of service
Binding: ServiceType (example)
... priority I0..1CodeableConceptIndicates the urgency of the encounter
Binding: v3 Code System ActPriority (example)
... subject SΣI1..1Reference(eCR Patient)The patient or group present at the encounter
... episodeOfCare ΣI0..*Reference(EpisodeOfCare)Episode(s) of care that this encounter should be recorded against
... basedOn I0..*Reference(ServiceRequest)The ServiceRequest that initiated this encounter
... participant SΣI0..*(Slice Definition)List of participants involved in the encounter
Slice: Unordered, Open by type:type
.... participant:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type ΣI0..*CodeableConceptRole of participant in encounter
Binding: ParticipantType (extensible)
..... period I0..1PeriodPeriod of time during the encounter that the participant participated
..... individual ΣI0..1Reference(Practitioner | PractitionerRole | RelatedPerson)Persons involved in the encounter other than the patient
.... participant:sliceResponsibleProvider SΣI0..1BackboneElementResponsible provider
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type SΣI1..*CodeableConceptResponsible provider
Binding: ParticipantType (extensible)

Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
....... version0..1stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ATND
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
...... text0..1stringPlain text representation of the concept
..... period SI0..1PeriodPeriod of time during the encounter that the participant participated
..... individual ΣI0..1Reference(eCR PractitionerRole)Responsible Provider
... appointment ΣI0..*Reference(Appointment)The appointment that scheduled this encounter
... period SI0..1PeriodPatient encounter start and end times
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣI0..1dateTimeEncounter start.
.... end SΣI0..1dateTimeEncounter end.
... length I0..1DurationQuantity of time the encounter lasted (less time absent)
... reasonCode ΣI0..*CodeableConceptCoded reason the encounter takes place
Binding: EncounterReasonCodes (preferred)
... reasonReference ΣI0..*Reference(Condition | Procedure | Observation | ImmunizationRecommendation)Reason the encounter takes place (reference)
... diagnosis SΣI0..*BackboneElementEncounter diagnosis
.... id 0..1stringUnique id for inter-element referencing
.... extension SI0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eicr-trigger-code-flag-extension SI0..1(Complex)eICR Trigger Code Flag
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... condition SΣI1..1Reference(eICR Condition)The diagnosis or procedure relevant to the encounter
.... use I0..1CodeableConceptRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Binding: DiagnosisRole (preferred)
.... rank I0..1positiveIntRanking of the diagnosis (for each role type)
... account I0..*Reference(Account)The set of accounts that may be used for billing for this Encounter
... hospitalization I0..1BackboneElementDetails about the admission to a healthcare service
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... preAdmissionIdentifier I0..1IdentifierPre-admission identifier
.... origin I0..1Reference(Location | Organization)The location/organization from which the patient came before admission
.... admitSource I0..1CodeableConceptFrom where patient was admitted (physician referral, transfer)
Binding: AdmitSource (preferred)
.... reAdmission I0..1CodeableConceptThe 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 I0..*CodeableConceptDiet preferences reported by the patient
Binding: Diet (example)
.... specialCourtesy I0..*CodeableConceptSpecial courtesies (VIP, board member)
Binding: SpecialCourtesy (preferred)
.... specialArrangement I0..*CodeableConceptWheelchair, translator, stretcher, etc.
Binding: SpecialArrangements (preferred)
.... destination I0..1Reference(Location | Organization)Location/organization to which the patient is discharged
.... dischargeDisposition I0..1CodeableConceptCategory or kind of location after discharge
Binding: DischargeDisposition (example)
... location SI0..1BackboneElementeICR encounter location
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... location SI1..1Reference(eICR Location)Location the encounter takes place
.... status I0..1codeplanned | active | reserved | completed
Binding: EncounterLocationStatus (required)
.... physicalType I0..1CodeableConceptThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Binding: LocationType (example)
.... period I0..1PeriodTime period during which the patient was present at the location
... serviceProvider SI0..1Reference(eCR Organization)The organization (facility) responsible for this encounter
... partOf I0..1Reference(Encounter)Another Encounter this encounter is part of

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron