US Core Implementation Guide
7.0.0 - STU7 United States of America flag

This page is part of the US Core (v7.0.0: STU7) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 8.0.0. For a full list of available versions, see the Directory of published versions. Page versions: R8 R7 R6 R5 R4 R3

Resource Profile: US Core Encounter Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter Version: 7.0.0
Standards status: Trial-use Maturity Level: 3 Computable Name: USCoreEncounterProfile
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.21

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

The US Core Encounter Profile inherits from the FHIR Encounter resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Encounter resource to record, search, and fetch basic encounter information for an individual patient. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

The following are example usage scenarios for this profile:

  • Query for a specific patient encounter
  • Query for recent patient encounters
  • Record or update an encounter

Mandatory and Must Support Data Elements

The following data elements must always be present (Mandatory definition) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Views below provides the formal summary, definitions, and terminology requirements.

Each Encounter Must Have:

  1. A status
  2. A classification such as inpatient, outpatient, or emergency
  3. An encounter type
  4. A patient

Each Encounter Must Support:

  1. A timestamp when the resource last changed*
  2. An encounter identifier
  3. Providers involved in the encounter
  4. When the encounter occurred
  5. Reason for the visit
  6. The discharge disposition
  7. Where the encounter occurred

Profile Specific Implementation Guidance:

  • To search for an encounter diagnosis, query for Condition resources that reference the Encounter of interest and have a category of encounter-diagnosis. An example search is shown in the Condition Quick Start section.
  • The Encounter resource can represent a reason using a code with Encounter.reasonCode or a reference with Encounter.reasonReference to Condition or other resources.
    • Although both are marked as Must Support, servers are not required to support both a code and a reference, but they SHALL support at least one of these elements.
    • The client application SHALL support both elements.
    • If Encounter.reasonReference references an Observation, it SHOULD conform to a US Core Observation if applicable. For example, a laboratory result SHOULD conform to the US Core Laboratory Result Observation Profile.
  • This profile supports where the encounter occurred. The location address can be represented by the Location referenced by Encounter.location.location or indirectly through the Organization referenced by Encounter.serviceProvider.
    • Although both are marked as Must Support, servers are not required to support both Encounter.location.location and Encounter.serviceProvider, but they SHALL support at least one of these elements.
    • The client application SHALL support both elements.
  • The following US Core Profiles indirectly reference the location/facility through references to US Core Encounter:

    If the event facility/location differs from the Encounter.location, systems SHOULD reference it directly:

    • Systems SHALL use the location element for all resources where the element is available.
    • Systems MAY use the standard Event Location Extension for US Core DiagnosticReport Profile for Laboratory Results Reporting and US Core Observation Clinical Result Profile.
  • * See the US Core General Guidance page for Searching Using lastUpdated. Updates to Meta.lastUpdated SHOULD reflect:
    • New encounters/visits
    • Changes in the status of encounters, including events that trigger the same status (e.g., in-progress → in-progress). These status changes correspond to events that can initiate HL7 V2 ADT messages.

Based upon additional testing, we intend to to upgrade the Meta.lastUpdated guidance (SHOULD) to requirements (SHALL) in the next version of US Core

Usage:

Formal Views of Profile Content

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

This structure is derived from Encounter

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter An interaction during which services are provided to the patient
... meta S 0..1 Meta Metadata about the resource
.... lastUpdated S 0..1 instant When the resource last changed
... identifier S 0..* Identifier Identifier(s) by which this encounter is known
.... system S 1..1 uri The namespace for the identifier value
.... value S 1..1 string The value that is unique
... status S 1..1 code planned | arrived | triaged | in-progress | onleave | finished | cancelled +
... class S 1..1 Coding Classification of patient encounter
... type S 1..* CodeableConcept Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type

... subject S 1..1 Reference(US Core Patient Profile S | Group) The patient or group present at the encounter
... participant S 0..* BackboneElement List of participants involved in the encounter
.... type S 0..* CodeableConcept Role of participant in encounter
.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual S 0..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile) Persons involved in the encounter other than the patient
... period S 0..1 Period The start and end time of the encounter
... reasonCode S 0..* CodeableConcept Coded reason the encounter takes place
... reasonReference S 0..* Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement Details about the admission to a healthcare service
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 0..* BackboneElement List of locations where the patient has been
.... location S 1..1 Reference(US Core Location Profile) Location the encounter takes place
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
from this IG
Encounter.hospitalization.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter 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
... identifier SΣ 0..* Identifier Identifier(s) by which this encounter is known
.... 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 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 Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... subject SΣ 1..1 Reference(US Core Patient Profile) The patient or group present at the encounter
... participant SΣ 0..* BackboneElement 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(US Core Practitioner Profile) Persons involved in the encounter other than the patient
... period S 0..1 Period The start and end time of the encounter
... reasonCode SΣ 0..* CodeableConcept Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(US Core Condition Problems and Health Concerns Profile | US Core Condition Encounter Diagnosis Profile) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement Details about the admission to a healthcare service
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 0..* BackboneElement 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(US Core Location Profile) Location the encounter takes place
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter

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
from this IG
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.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter 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 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 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(US Core Patient Profile S | Group) 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 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(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile) 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 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 Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) 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 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): 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(Location | Organization) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 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(US Core Location Profile) 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 Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(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
from this IG
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.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG
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

Differential View

This structure is derived from Encounter

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter An interaction during which services are provided to the patient
... meta S 0..1 Meta Metadata about the resource
.... lastUpdated S 0..1 instant When the resource last changed
... identifier S 0..* Identifier Identifier(s) by which this encounter is known
.... system S 1..1 uri The namespace for the identifier value
.... value S 1..1 string The value that is unique
... status S 1..1 code planned | arrived | triaged | in-progress | onleave | finished | cancelled +
... class S 1..1 Coding Classification of patient encounter
... type S 1..* CodeableConcept Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type

... subject S 1..1 Reference(US Core Patient Profile S | Group) The patient or group present at the encounter
... participant S 0..* BackboneElement List of participants involved in the encounter
.... type S 0..* CodeableConcept Role of participant in encounter
.... period S 0..1 Period Period of time during the encounter that the participant participated
.... individual S 0..1 Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile) Persons involved in the encounter other than the patient
... period S 0..1 Period The start and end time of the encounter
... reasonCode S 0..* CodeableConcept Coded reason the encounter takes place
... reasonReference S 0..* Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement Details about the admission to a healthcare service
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 0..* BackboneElement List of locations where the patient has been
.... location S 1..1 Reference(US Core Location Profile) Location the encounter takes place
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Encounter.typeextensibleUSCoreEncounterType
http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
from this IG
Encounter.hospitalization.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter 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
... identifier SΣ 0..* Identifier Identifier(s) by which this encounter is known
.... 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 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 Specific type of encounter
Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type


... subject SΣ 1..1 Reference(US Core Patient Profile) The patient or group present at the encounter
... participant SΣ 0..* BackboneElement 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(US Core Practitioner Profile) Persons involved in the encounter other than the patient
... period S 0..1 Period The start and end time of the encounter
... reasonCode SΣ 0..* CodeableConcept Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(US Core Condition Problems and Health Concerns Profile | US Core Condition Encounter Diagnosis Profile) Reason the encounter takes place (reference)
... hospitalization S 0..1 BackboneElement Details about the admission to a healthcare service
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 0..* BackboneElement 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(US Core Location Profile) Location the encounter takes place
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter

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
from this IG
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.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Encounter 0..* Encounter 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 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 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(US Core Patient Profile S | Group) 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 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(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile) 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 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 Coded reason the encounter takes place
Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.


... reasonReference SΣ 0..* Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) 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 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): 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(Location | Organization) Location/organization to which the patient is discharged
.... dischargeDisposition S 0..1 CodeableConcept Category or kind of location after discharge
Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17

... location S 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(US Core Location Profile) 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 Time period during which the patient was present at the location
... serviceProvider S 0..1 Reference(US Core Organization Profile) The organization (facility) responsible for this encounter
... partOf 0..1 Reference(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
from this IG
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.dischargeDispositionpreferredUSCoreDischargeDisposition
http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
from this IG
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

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Quick Start

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile’s information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the US Core Server CapabilityStatement for a complete list of supported RESTful interactions for this IG.

  • See the Scopes Format section for a description of the SMART scopes syntax.
  • See the Search Syntax section for a description of the US Core search syntax.
  • See the General Requirements section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

US Core Scopes

Servers providing access to encounter data SHALL support these US Core SMART Scopes:

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support both read Encounter by id AND Encounter search using the _id search parameter:

    GET [base]/Encounter/[id] or GET [base]/Encounter?_id=[id]

    Example:

    1. GET [base]/Encounter/12354
    2. GET [base]/Encounter?_id=12354

    Implementation Notes: Fetches a single Encounter (how to search by the logical id of the resource)

  2. SHALL support searching for all encounters for a patient using the patient search parameter:

    GET [base]/Encounter?patient={Type/}[id]

    Example:

    1. GET [base]/Encounter?patient=1137192

    Implementation Notes: Fetches a bundle of all Encounter resources for the specified patient (how to search by reference)

  3. SHALL support searching using the combination of the date and patient search parameters:

    • including support for these date comparators: gt,lt,ge,le
    • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Encounter?date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}&patient={Type/}[id]

    Example:

    1. GET [base]/Encounter?patient=example1&date=ge2019-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified date and patient (how to search by date and how to search by reference)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported:

  1. SHOULD support searching for an encounter by an identifier using the identifier search parameter:

    GET [base]/Encounter?identifier={system|}[code]

    Example:

    1. GET [base]/Encounter?identifier=http://hospital.smarthealthit.org|1032702

    Implementation Notes: Fetches a bundle containing any Encounter resources matching the identifier (how to search by token)

  2. SHOULD support searching using the combination of the class and patient search parameters:

    GET [base]/Encounter?class={system|}[code]&patient={Type/}[id]

    Example:

    1. GET [base]/Encounter?patient=example1&class= http://terminology.hl7.org/CodeSystem/v3-ActCode code|AMB

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified class and patient (how to search by reference and how to search by token)

  3. SHOULD support searching using the combination of the patient and type search parameters:

    GET [base]/Encounter?patient={Type/}[id]&type={system|}[code]

    Example:

    1. GET [base]/Encounter?patient=1137192&type=http://www.ama-assn.org/go/cpt code|99211

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified patient and type (how to search by reference and how to search by token)

  4. SHOULD support searching using the combination of the patient and location search parameters:

    GET [base]/Encounter?patient={Type/}[id]&location={Type/}[id]

    Example:

    1. GET [base]/Encounter?patient=1137192&location=Location/hospital

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified patient and location (how to search by reference)

  5. SHOULD support searching using the combination of the patient and status search parameters:

    GET [base]/Encounter?patient={Type/}[id]&status={system|}[code]

    Example:

    1. GET [base]/Encounter?patient=example1&status=finished

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified patient and status (how to search by reference and how to search by token)

  6. SHOULD support searching using the combination of the patient and discharge-disposition search parameters:

    GET [base]/Encounter?patient={Type/}[id]&discharge-disposition={system|}[code]

    Example:

    1. GET [base]/Encounter?patient=example1&discharge-disposition=01

    Implementation Notes: Fetches a bundle of all Encounter resources matching the specified patient and discharge-disposition (how to search by reference and how to search by token)

  7. SHOULD support searching using the combination of the patient and _lastUpdated search parameters:

    • including support for these _lastUpdated comparators: gt,lt,ge,le
    • including optional support for AND search on _lastUpdated (e.g._lastUpdated=[date]&_lastUpdated=[date]]&...)

    GET [base]/Encounter?patient={Type/}[id]&_lastUpdated={gt|lt|ge|le}[date]{&_lastUpdated={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Encounter?patient=1137192&_lastUpdated=ge2024-01-01T00:00:00Z

    Implementation Notes: Fetches a bundle of all Encounter resources for the specified patient and _lastUpdated. See the US Core General Guidance page for Searching Using lastUpdated. (how to search by reference and how to search by date)