QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 7.0.1. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Encounter

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter Version: 7.0.0-ballot
Active as of 2018-08-22 Computable Name: QICoreEncounter

Profile of Encounter for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Must Have:
  • identifier.system: The namespace for the identifier value
  • identifier.value: The value that is unique
  • status: (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
  • class: Classification of patient encounter
  • type: (QI) Specific type of encounter
  • subject: (QI) The patient or group present at the encounter
  • location.location: (QI) Location the encounter takes place
QI Elements:
  • participant: (QI) List of participants involved in the encounter
  • participant.individual: (QI) Persons involved in the encounter other than the patient
  • period: (QI) The start and end time of the encounter
  • reasonCode: (QI) Coded reason the encounter takes place
  • reasonReference: (QI) Reason the encounter takes place (reference)
  • hospitalization: (QI) Details about the admission to a healthcare service
  • hospitalization.dischargeDisposition: (QI) Category or kind of location after discharge
  • location: (QI) List of locations where the patient has been
  • location.period: (QI) Time period during which the patient was present at the location
  • serviceProvider: (QI) The organization (facility) responsible for this encounter
Primary code path: type
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

The following example illustrates accessing an inpatient encounter:

define "Ophthalmology Encounter Codes":
  [Encounter: class in "Inpatient Encounter Classes"] InpatientEncounter
    where InpatientEncounter.type in "Ophthalmology Encounter Codes"

See the patterns page for implementation and usage patterns.

Examples

Inpatient Admission for Appendicitis

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreEncounterProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter USCoreEncounterProfile
... status 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
... type 1..* CodeableConcept (QI) Specific type of encounter
... subject 1..1 Reference(QICore Patient) (QI) The patient or group present at the encounter
.... individual 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... period 0..1 Period (QI) The start and end time of the encounter
... reasonCode 0..* CodeableConcept (QI) Coded reason the encounter takes place
... reasonReference Σ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... hospitalization 0..1 BackboneElement (QI) Details about the admission to a healthcare service
.... origin 0..1 Reference(QICore Location) The location/organization from which the patient came before admission
.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location 0..* BackboneElement (QI) List of locations where the patient has been
.... location 1..1 Reference(QICore Location) (QI) Location the encounter takes place
.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* USCoreEncounterProfile An interaction during which services are provided to the patient
... meta SΣ 0..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource last changed
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
... status ?!SΣ 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required): Current state of the encounter.

... class SΣ 1..1 Coding Classification of patient encounter
Binding: ActEncounterCode (extensible): Classification of the encounter.

... type SΣ 1..* CodeableConcept (QI) Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... subject SΣ 1..1 Reference(QICore Patient) (QI) The patient or group present at the encounter
... participant SΣ 0..* BackboneElement (QI) List of participants involved in the encounter
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 0..* CodeableConcept Role of participant in encounter
Binding: ParticipantType (extensible): Role of participant in encounter.


.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... period S 0..1 Period (QI) The start and end time of the encounter
... reasonCode SΣ 0..* CodeableConcept (QI) Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement (QI) Details about the admission to a healthcare service
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... origin 0..1 Reference(QICore Location) The location/organization from which the patient came before admission
.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location S 0..* BackboneElement (QI) List of locations where the patient has been
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... location S 1..1 Reference(QICore Location) (QI) Location the encounter takes place
.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Encounter.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Encounter.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.typeextensibleParticipantType
http://hl7.org/fhir/ValueSet/encounter-participant-type
from the FHIR Standard
Encounter.reasonCodepreferredEncounterReasonCodes
http://hl7.org/fhir/ValueSet/encounter-reason
from the FHIR Standard
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorEncounterIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorEncounterIf 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-4errorEncounterIf 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-5errorEncounterIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceEncounterA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* USCoreEncounterProfile An interaction during which services are provided to the patient
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... 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): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 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): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 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 ?!SΣ 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required): Current state of the encounter.

... statusHistory 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): Current state of the encounter.

.... period 1..1 Period The time that the episode was in the specified status
... class SΣ 1..1 Coding Classification of patient encounter
Binding: ActEncounterCode (extensible): Classification of the encounter.

... classHistory 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: ActEncounterCode (extensible): Classification of the encounter.

.... period 1..1 Period The time that the episode was in the specified class
... type SΣ 1..* CodeableConcept (QI) Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... serviceType Σ 0..1 CodeableConcept Specific type of service
Binding: ServiceType (example): Broad categorization of the service that is to be provided.

... priority 0..1 CodeableConcept Indicates the urgency of the encounter
Binding: ActPriority (example): Indicates the urgency of the encounter.

... subject SΣ 1..1 Reference(QICore Patient) (QI) 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(ServiceRequest) The ServiceRequest that initiated this encounter
... participant SΣ 0..* BackboneElement (QI) 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 SΣ 0..* CodeableConcept Role of participant in encounter
Binding: ParticipantType (extensible): Role of participant in encounter.


.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... appointment Σ 0..* Reference(Appointment) The appointment that scheduled this encounter
... period S 0..1 Period (QI) The start and end time of the encounter
... length 0..1 Duration Quantity of time the encounter lasted (less time absent)
... reasonCode SΣ 0..* CodeableConcept (QI) Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... diagnosis Σ 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 Σ 1..1 Reference(Condition | Procedure) 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): The type of diagnosis this condition represents.

.... rank 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 0..1 BackboneElement (QI) 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(QICore Location) 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): From where the patient was admitted.

.... 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: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.

.... dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.


.... specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
Binding: SpecialCourtesy (preferred): Special courtesies.


.... specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc.
Binding: SpecialArrangements (preferred): Special arrangements.


.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location S 0..* BackboneElement (QI) 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(QICore Location) (QI) Location the encounter takes place
.... status 0..1 code planned | active | reserved | completed
Binding: EncounterLocationStatus (required): The status of the location.

.... physicalType 0..1 CodeableConcept The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Binding: LocationType (example): Physical form of the location.

.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Encounter.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Encounter.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Encounter.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Encounter.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Encounter.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Encounter.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.statusHistory.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceTypeexampleServiceType
http://hl7.org/fhir/ValueSet/service-type
from the FHIR Standard
Encounter.priorityexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.typeextensibleParticipantType
http://hl7.org/fhir/ValueSet/encounter-participant-type
from the FHIR Standard
Encounter.reasonCodepreferredEncounterReasonCodes
http://hl7.org/fhir/ValueSet/encounter-reason
from the FHIR Standard
Encounter.diagnosis.usepreferredDiagnosisRole
http://hl7.org/fhir/ValueSet/diagnosis-role
from the FHIR Standard
Encounter.hospitalization.admitSourcepreferredAdmitSource
http://hl7.org/fhir/ValueSet/encounter-admit-source
from the FHIR Standard
Encounter.hospitalization.reAdmissionexampleHl7VSReAdmissionIndicator
http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreferenceexampleDiet
http://hl7.org/fhir/ValueSet/encounter-diet
from the FHIR Standard
Encounter.hospitalization.specialCourtesypreferredSpecialCourtesy
http://hl7.org/fhir/ValueSet/encounter-special-courtesy
from the FHIR Standard
Encounter.hospitalization.specialArrangementpreferredSpecialArrangements
http://hl7.org/fhir/ValueSet/encounter-special-arrangements
from the FHIR Standard
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition
Encounter.location.statusrequiredEncounterLocationStatus
http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1
from the FHIR Standard
Encounter.location.physicalTypeexampleLocationType
http://hl7.org/fhir/ValueSet/location-physical-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorEncounterIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorEncounterIf 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-4errorEncounterIf 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-5errorEncounterIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceEncounterA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from USCoreEncounterProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter USCoreEncounterProfile
... status 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
... type 1..* CodeableConcept (QI) Specific type of encounter
... subject 1..1 Reference(QICore Patient) (QI) The patient or group present at the encounter
.... individual 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... period 0..1 Period (QI) The start and end time of the encounter
... reasonCode 0..* CodeableConcept (QI) Coded reason the encounter takes place
... reasonReference Σ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... hospitalization 0..1 BackboneElement (QI) Details about the admission to a healthcare service
.... origin 0..1 Reference(QICore Location) The location/organization from which the patient came before admission
.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location 0..* BackboneElement (QI) List of locations where the patient has been
.... location 1..1 Reference(QICore Location) (QI) Location the encounter takes place
.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* USCoreEncounterProfile An interaction during which services are provided to the patient
... meta SΣ 0..1 Meta Metadata about the resource
.... lastUpdated SΣ 0..1 instant When the resource last changed
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 1..1 string The value that is unique
Example General: 123456
... status ?!SΣ 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required): Current state of the encounter.

... class SΣ 1..1 Coding Classification of patient encounter
Binding: ActEncounterCode (extensible): Classification of the encounter.

... type SΣ 1..* CodeableConcept (QI) Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... subject SΣ 1..1 Reference(QICore Patient) (QI) The patient or group present at the encounter
... participant SΣ 0..* BackboneElement (QI) List of participants involved in the encounter
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 0..* CodeableConcept Role of participant in encounter
Binding: ParticipantType (extensible): Role of participant in encounter.


.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... period S 0..1 Period (QI) The start and end time of the encounter
... reasonCode SΣ 0..* CodeableConcept (QI) Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement (QI) Details about the admission to a healthcare service
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... origin 0..1 Reference(QICore Location) The location/organization from which the patient came before admission
.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location S 0..* BackboneElement (QI) List of locations where the patient has been
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... location S 1..1 Reference(QICore Location) (QI) Location the encounter takes place
.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Encounter.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Encounter.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.typeextensibleParticipantType
http://hl7.org/fhir/ValueSet/encounter-participant-type
from the FHIR Standard
Encounter.reasonCodepreferredEncounterReasonCodes
http://hl7.org/fhir/ValueSet/encounter-reason
from the FHIR Standard
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorEncounterIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorEncounterIf 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-4errorEncounterIf 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-5errorEncounterIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceEncounterA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* USCoreEncounterProfile An interaction during which services are provided to the patient
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated SΣ 0..1 instant When the resource last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... 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): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 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): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣ 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 ?!SΣ 1..1 code (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Binding: EncounterStatus (required): Current state of the encounter.

... statusHistory 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): Current state of the encounter.

.... period 1..1 Period The time that the episode was in the specified status
... class SΣ 1..1 Coding Classification of patient encounter
Binding: ActEncounterCode (extensible): Classification of the encounter.

... classHistory 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: ActEncounterCode (extensible): Classification of the encounter.

.... period 1..1 Period The time that the episode was in the specified class
... type SΣ 1..* CodeableConcept (QI) Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... serviceType Σ 0..1 CodeableConcept Specific type of service
Binding: ServiceType (example): Broad categorization of the service that is to be provided.

... priority 0..1 CodeableConcept Indicates the urgency of the encounter
Binding: ActPriority (example): Indicates the urgency of the encounter.

... subject SΣ 1..1 Reference(QICore Patient) (QI) 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(ServiceRequest) The ServiceRequest that initiated this encounter
... participant SΣ 0..* BackboneElement (QI) 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 SΣ 0..* CodeableConcept Role of participant in encounter
Binding: ParticipantType (extensible): Role of participant in encounter.


.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual SΣ 0..1 Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) (QI) Persons involved in the encounter other than the patient
... appointment Σ 0..* Reference(Appointment) The appointment that scheduled this encounter
... period S 0..1 Period (QI) The start and end time of the encounter
... length 0..1 Duration Quantity of time the encounter lasted (less time absent)
... reasonCode SΣ 0..* CodeableConcept (QI) Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) (QI) Reason the encounter takes place (reference)
... diagnosis Σ 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 Σ 1..1 Reference(Condition | Procedure) 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): The type of diagnosis this condition represents.

.... rank 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 0..1 BackboneElement (QI) 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(QICore Location) 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): From where the patient was admitted.

.... 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: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.

.... dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.


.... specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
Binding: SpecialCourtesy (preferred): Special courtesies.


.... specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc.
Binding: SpecialArrangements (preferred): Special arrangements.


.... destination 0..1 Reference(QICore Location) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept (QI) Category or kind of location after discharge
Binding: Clinical Discharge Disposition (extensible)
... location S 0..* BackboneElement (QI) 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(QICore Location) (QI) Location the encounter takes place
.... status 0..1 code planned | active | reserved | completed
Binding: EncounterLocationStatus (required): The status of the location.

.... physicalType 0..1 CodeableConcept The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Binding: LocationType (example): Physical form of the location.

.... period 0..1 Period (QI) Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(QICore Organization) (QI) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(QICore Encounter) Another Encounter this encounter is part of

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Encounter.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Encounter.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
Encounter.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Encounter.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Encounter.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Encounter.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.statusHistory.statusrequiredEncounterStatus
http://hl7.org/fhir/ValueSet/encounter-status|4.0.1
from the FHIR Standard
Encounter.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.classextensibleActEncounterCode
http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceTypeexampleServiceType
http://hl7.org/fhir/ValueSet/service-type
from the FHIR Standard
Encounter.priorityexampleActPriority
http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.typeextensibleParticipantType
http://hl7.org/fhir/ValueSet/encounter-participant-type
from the FHIR Standard
Encounter.reasonCodepreferredEncounterReasonCodes
http://hl7.org/fhir/ValueSet/encounter-reason
from the FHIR Standard
Encounter.diagnosis.usepreferredDiagnosisRole
http://hl7.org/fhir/ValueSet/diagnosis-role
from the FHIR Standard
Encounter.hospitalization.admitSourcepreferredAdmitSource
http://hl7.org/fhir/ValueSet/encounter-admit-source
from the FHIR Standard
Encounter.hospitalization.reAdmissionexampleHl7VSReAdmissionIndicator
http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreferenceexampleDiet
http://hl7.org/fhir/ValueSet/encounter-diet
from the FHIR Standard
Encounter.hospitalization.specialCourtesypreferredSpecialCourtesy
http://hl7.org/fhir/ValueSet/encounter-special-courtesy
from the FHIR Standard
Encounter.hospitalization.specialArrangementpreferredSpecialArrangements
http://hl7.org/fhir/ValueSet/encounter-special-arrangements
from the FHIR Standard
Encounter.hospitalization.dischargeDispositionextensibleClinicalDischargeDisposition
http://terminology.hl7.org/ValueSet/clinical-discharge-disposition
Encounter.location.statusrequiredEncounterLocationStatus
http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1
from the FHIR Standard
Encounter.location.physicalTypeexampleLocationType
http://hl7.org/fhir/ValueSet/location-physical-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorEncounterIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorEncounterIf 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-4errorEncounterIf 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-5errorEncounterIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceEncounterA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron