NICE-Encounter
Description
This profile was derived to submit data related to the patient's admission to the hospital or ICU.
Click here to go to the NICE-Encounter Simplifier page
NICE data dictionary links
Source
This profile is used to submit encounter related information to the Dutch National Intensive Care Evaluation (NICE). It was derived from the Nictiz Health and Care Information Model (HCIM; Dutch: Zorginformatiebouwsteen or ZIB) Encounter, 2017 release version 3.1
Encounter | I | Encounter | There are no (further) constraints on this element Element idEncounter Encounter Alternate namesVisit, Contact DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idEncounter.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idEncounter.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idEncounter.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idEncounter.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..* | Identifier | Element idEncounter.identifier AdmissionID DefinitionIdentifier by which this encounter is known. This should be the (sub) admission ID/number. This element should never be changed because this will lead to unidentifiable records in the NICE registry. Hospitalnumber and ICU number -which are also part of the primary key- should be mapped on an organization resource. This resource is then being referred to by means of the serviceProvider element of this profile.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element idEncounter.status finished DefinitionFinished encounters are required for the NICE submission. Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes). This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid. Current state of the encounter EncounterStatus (required)Constraints
finished
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statusHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.statusHistory List of past encounter statuses DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them. The current status is always found in the current version of the resource, not the status history.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.statusHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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status | 1..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.statusHistory.status planned | arrived | triaged | in-progress | onleave | finished | cancelled + Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +. Note that FHIR strings may not exceed 1MB in size Current state of the encounter EncounterStatus (required)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.statusHistory.period The time that the episode was in the specified status DefinitionThe time that the episode was in the specified status. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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class | Σ | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.class ContactType Alternate namesContactType DefinitionThe type of contact. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Permitted Values ContactTypeCodelijst-to-ActEncounterCode Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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ContactTypeCodelist | I | 0..* | Extension(CodeableConcept) | Element idEncounter.class.extension:ContactTypeCodelist Contact type Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionThe type of contact. Five indications of admission types are processed by NICE:
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept Contacttype DefinitionThe contacttype as defined by Encounter.class.ContactTypeCodelist. ContactTypeCodelijst ContactTypeCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding Code defined by a terminology system DefinitionThe contacttype that is associated with the encounter. Codes from both the Nictiz and NICE Codelists can be used. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes Constraints
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contactTypeCodeListNICE | S Σ | 0..* | CodingBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding:contactTypeCodeListNICE ContactTypeCodeList DefinitionThe NICE-ContactType Codelist contains codes that further specifies the codes from the Nictiz Codelist. The NICE codes can be used to register the following contact types:
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ContactTypeCodeList NICE-ContactTypeCodeList (extensible)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.class.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element idEncounter.class.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idEncounter.class.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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classHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.classHistory List of past encounter classes DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.classHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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class | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.classHistory.class inpatient | outpatient | ambulatory | emergency + Definitioninpatient | outpatient | ambulatory | emergency +. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.classHistory.period The time that the episode was in the specified class DefinitionThe time that the episode was in the specified class. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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type | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.type Specific type of encounter DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). Since there are many ways to further classify encounters, this element is 0..*. The type of encounter EncounterType (example)Constraints
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priority | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.priority Indicates the urgency of the encounter DefinitionIndicates the urgency of the encounter. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the urgency of the encounter. v3 Code System ActPriority (example)Constraints
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subject | Σ I | 1..1 | Reference(NICE-Patient) | Element idEncounter.subject The patient present at the encounter Alternate namespatient DefinitionThe patient present at the encounter. While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).
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episodeOfCare | Σ I | 0..* | Reference(nl-core-episodeofcare) | There are no (further) constraints on this element Element idEncounter.episodeOfCare Episode(s) of care that this encounter should be recorded against DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-episodeofcare) Constraints
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incomingReferral | I | 0..* | Reference(ReferralRequest) | There are no (further) constraints on this element Element idEncounter.incomingReferral The ReferralRequest that initiated this encounter DefinitionThe referral request this encounter satisfies (incoming referral). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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participant | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.participant List of participants involved in the encounter DefinitionThe list of people responsible for providing the service.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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type | Σ | 0..* | CodeableConceptBinding | Element idEncounter.participant.type Role of participant in encounter DefinitionRole of participant in encounter. The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr, Referring etc.). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. Role of participant in encounter ParticipantType (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.type.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.participant.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by $this(Value) Constraints
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healthProfessionalRole | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idEncounter.participant.type.coding:healthProfessionalRole HealthProfessionalRole Alternate namesZorgverlenerRol DefinitionThe role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ZorgverlenerRolCodelijst (required) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.participant.period Period of time during the encounter that the participant participated DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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individual | Σ I | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual ContactWith Alternate namesContactMet DefinitionThe healthcare provider with whom the contact took place. The specialty and role of the healthcare provider can be entered in the HealthcareProvider information model as well. This shall be a reference to NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(NICE-PractitionerRole) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | S I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | Element idEncounter.participant.individual.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
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valueReference | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual.extension:practitionerRole.valueReference:valueReference Value of extension DefinitionThe reference to a NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. PractitionerRole allows being specific about the specialism and organization of a Practitioner. This extension leads to slight duplication: a reference to a Practitioner provided in the PractitionerRole will also be given in the original Reference. If only the specialism and/or organization are available, the Reference.extension.valueReference.display will be duplicated into the original Reference.display. Systems that do not know about the extension would thus still have access to the regular Reference to Practitioner and to Reference.display. Reference(NICE-PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.participant.individual.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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appointment | Σ I | 0..1 | Reference(Appointment) | There are no (further) constraints on this element Element idEncounter.appointment The appointment that scheduled this encounter DefinitionThe appointment that scheduled this encounter. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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period | I | 0..1 | Period | Element idEncounter.period The start and end time of the encounter DefinitionThe start and end time of the encounter. If not (yet) known, the end of the Period may be omitted.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.period.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.period.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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start | Σ I | 1..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.start StartDateTime Alternate namesBeginDatumTijd DefinitionThe date and time at which the contact took place. If the low element is missing, the meaning is that the low boundary is not known.
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end | Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.end EndDateTime Alternate namesEindDatumTijd DefinitionThe date and time at which the contact ended. If the contact takes place over a period of time, this indicates the end of the period, in the case of an admission, for example. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03. If the end of the period is missing, it means that the period is ongoing
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length | I | 0..1 | Duration | There are no (further) constraints on this element Element idEncounter.length Quantity of time the encounter lasted (less time absent) DefinitionQuantity of time the encounter lasted. This excludes the time during leaves of absence. May differ from the time the Encounter.period lasted because of leave of absence.
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reason | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.reason DeviatingResult Alternate namesIndication, Admission diagnosis, AfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reason why the encounter takes place. Encounter Reason Codes (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.reason.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.reason.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.text DeviatingResult Alternate namesAfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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diagnosis | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.diagnosis The list of diagnosis relevant to this encounter DefinitionThe list of diagnosis relevant to this encounter.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.diagnosis.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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condition | I | 1..1 | Reference(HCIM Procedure | HCIM Problem) | There are no (further) constraints on this element Element idEncounter.diagnosis.condition ContactReason Alternate namesAdmission diagnosis, discharge diagnosis, indication, Probleem, Procedure DefinitionThe problem that led to the contact or the procedure carried out during the contact. Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reference(HCIM Procedure | HCIM Problem) Constraints
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role | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.diagnosis.role Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The type of diagnosis this condition represents DiagnosisRole (preferred)Constraints
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rank | 0..1 | positiveInt | There are no (further) constraints on this element Element idEncounter.diagnosis.rank Ranking of the diagnosis (for each role type) DefinitionRanking of the diagnosis (for each role type). 32 bit number; for values larger than this, use decimal
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account | I | 0..* | Reference(Account) | There are no (further) constraints on this element Element idEncounter.account The set of accounts that may be used for billing for this Encounter DefinitionThe set of accounts that may be used for billing for this Encounter. The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.
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hospitalization | 0..1 | BackboneElement | There are no (further) constraints on this element Element idEncounter.hospitalization Details about the admission to a healthcare service DefinitionDetails about the admission to a healthcare service. An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included. The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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preAdmissionIdentifier | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.hospitalization.preAdmissionIdentifier Pre-admission identifier DefinitionPre-admission identifier.
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origin | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.origin The location from which the patient came before admission DefinitionThe location from which the patient came before admission. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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admitSource | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.admitSource Origin Alternate namesHerkomst DefinitionLocation from which the patient came before the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. HerkomstCodelijst HerkomstCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.admitSource.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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admitSourceCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.admitSource.coding:admitSourceCodelistNICE NICE admit source code list DefinitionNICE admission source codes. NICE codes 15 (Home) and 16 (Other) should be mapped on 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Admit source code list NICE-AdmitSourceCodeList (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reAdmission | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.reAdmission The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission DefinitionWhether this hospitalization is a readmission and why if known. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason for re-admission of this hospitalization encounter. v2 Re-Admission Indicator (example)Constraints
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dietPreference | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.dietPreference Diet preferences reported by the patient DefinitionDiet preferences reported by the patient. Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter. For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). Medical, cultural or ethical food preferences to help with catering requirements. Diet (example)Constraints
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specialCourtesy | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialCourtesy Special courtesies (VIP, board member) DefinitionSpecial courtesies (VIP, board member). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special courtesies SpecialCourtesy (preferred)Constraints
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specialArrangement | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialArrangement Wheelchair, translator, stretcher, etc. DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special arrangements SpecialArrangements (preferred)Constraints
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.destination Location to which the patient is discharged DefinitionLocation to which the patient is discharged. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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dischargeDisposition | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.dischargeDisposition Destination Alternate namesBestemming DefinitionLocation to which the patient will go after the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. BestemmingCodelijst BestemmingCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.dischargeDisposition.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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dischargeDispositionCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.dischargeDisposition.coding:dischargeDispositionCodelistNICE NICE discharge disposition DefinitionNICE discharge disposition codes. NICE codes 7 (Mortuary) and 8 (Home) and 9 (Other) should be mapped on 183676005 (SNOMED-CT) and 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Discharge disposition ?? (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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location | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.location List of locations where the patient has been DefinitionList of locations where the patient has been during this encounter. Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.location.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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location | I | 1..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.location.location Location the encounter takes place DefinitionThe location where the encounter takes place. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.location.status planned | active | reserved | completed DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time. When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed. The status of the location. EncounterLocationStatus (required)Constraints
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.location.period Time period during which the patient was present at the location DefinitionTime period during which the patient was present at the location. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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serviceProvider | I | 1..1 | Reference(nl-core-organization) | Element idEncounter.serviceProvider Location Alternate namesLocatie DefinitionThe physical location at which the contact took place. This should be used to indicate where the ICU contact took place . NICE needs this information in order to assign a unique number for the hospital and ICU department. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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partOf | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idEncounter.partOf Another Encounter this encounter is part of DefinitionAnother Encounter of which this encounter is a part of (administratively or in time). This is also used for associating a child's encounter back to the mother's encounter. Refer to the Notes section in the Patient resource for further details.
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Encounter | I | Encounter | There are no (further) constraints on this element Element idEncounter Encounter Alternate namesVisit, Contact DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idEncounter.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idEncounter.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idEncounter.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idEncounter.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..* | Identifier | Element idEncounter.identifier AdmissionID DefinitionIdentifier by which this encounter is known. This should be the (sub) admission ID/number. This element should never be changed because this will lead to unidentifiable records in the NICE registry. Hospitalnumber and ICU number -which are also part of the primary key- should be mapped on an organization resource. This resource is then being referred to by means of the serviceProvider element of this profile.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element idEncounter.status finished DefinitionFinished encounters are required for the NICE submission. Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes). This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid. Current state of the encounter EncounterStatus (required)Constraints
finished
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statusHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.statusHistory List of past encounter statuses DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them. The current status is always found in the current version of the resource, not the status history.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.statusHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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status | 1..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.statusHistory.status planned | arrived | triaged | in-progress | onleave | finished | cancelled + Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +. Note that FHIR strings may not exceed 1MB in size Current state of the encounter EncounterStatus (required)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.statusHistory.period The time that the episode was in the specified status DefinitionThe time that the episode was in the specified status. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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class | Σ | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.class ContactType Alternate namesContactType DefinitionThe type of contact. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Permitted Values ContactTypeCodelijst-to-ActEncounterCode Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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ContactTypeCodelist | I | 0..* | Extension(CodeableConcept) | Element idEncounter.class.extension:ContactTypeCodelist Contact type Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionThe type of contact. Five indications of admission types are processed by NICE:
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept Contacttype DefinitionThe contacttype as defined by Encounter.class.ContactTypeCodelist. ContactTypeCodelijst ContactTypeCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding Code defined by a terminology system DefinitionThe contacttype that is associated with the encounter. Codes from both the Nictiz and NICE Codelists can be used. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes Constraints
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contactTypeCodeListNICE | S Σ | 0..* | CodingBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding:contactTypeCodeListNICE ContactTypeCodeList DefinitionThe NICE-ContactType Codelist contains codes that further specifies the codes from the Nictiz Codelist. The NICE codes can be used to register the following contact types:
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ContactTypeCodeList NICE-ContactTypeCodeList (extensible)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.class.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element idEncounter.class.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idEncounter.class.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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classHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.classHistory List of past encounter classes DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.classHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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class | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.classHistory.class inpatient | outpatient | ambulatory | emergency + Definitioninpatient | outpatient | ambulatory | emergency +. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.classHistory.period The time that the episode was in the specified class DefinitionThe time that the episode was in the specified class. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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type | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.type Specific type of encounter DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). Since there are many ways to further classify encounters, this element is 0..*. The type of encounter EncounterType (example)Constraints
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priority | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.priority Indicates the urgency of the encounter DefinitionIndicates the urgency of the encounter. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the urgency of the encounter. v3 Code System ActPriority (example)Constraints
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subject | Σ I | 1..1 | Reference(NICE-Patient) | Element idEncounter.subject The patient present at the encounter Alternate namespatient DefinitionThe patient present at the encounter. While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).
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episodeOfCare | Σ I | 0..* | Reference(nl-core-episodeofcare) | There are no (further) constraints on this element Element idEncounter.episodeOfCare Episode(s) of care that this encounter should be recorded against DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-episodeofcare) Constraints
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incomingReferral | I | 0..* | Reference(ReferralRequest) | There are no (further) constraints on this element Element idEncounter.incomingReferral The ReferralRequest that initiated this encounter DefinitionThe referral request this encounter satisfies (incoming referral). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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participant | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.participant List of participants involved in the encounter DefinitionThe list of people responsible for providing the service.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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type | Σ | 0..* | CodeableConceptBinding | Element idEncounter.participant.type Role of participant in encounter DefinitionRole of participant in encounter. The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr, Referring etc.). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. Role of participant in encounter ParticipantType (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.type.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.participant.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by $this(Value) Constraints
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healthProfessionalRole | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idEncounter.participant.type.coding:healthProfessionalRole HealthProfessionalRole Alternate namesZorgverlenerRol DefinitionThe role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ZorgverlenerRolCodelijst (required) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.participant.period Period of time during the encounter that the participant participated DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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individual | Σ I | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual ContactWith Alternate namesContactMet DefinitionThe healthcare provider with whom the contact took place. The specialty and role of the healthcare provider can be entered in the HealthcareProvider information model as well. This shall be a reference to NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(NICE-PractitionerRole) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | S I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | Element idEncounter.participant.individual.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
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valueReference | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual.extension:practitionerRole.valueReference:valueReference Value of extension DefinitionThe reference to a NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. PractitionerRole allows being specific about the specialism and organization of a Practitioner. This extension leads to slight duplication: a reference to a Practitioner provided in the PractitionerRole will also be given in the original Reference. If only the specialism and/or organization are available, the Reference.extension.valueReference.display will be duplicated into the original Reference.display. Systems that do not know about the extension would thus still have access to the regular Reference to Practitioner and to Reference.display. Reference(NICE-PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.participant.individual.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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appointment | Σ I | 0..1 | Reference(Appointment) | There are no (further) constraints on this element Element idEncounter.appointment The appointment that scheduled this encounter DefinitionThe appointment that scheduled this encounter. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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period | I | 0..1 | Period | Element idEncounter.period The start and end time of the encounter DefinitionThe start and end time of the encounter. If not (yet) known, the end of the Period may be omitted.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.period.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.period.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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start | Σ I | 1..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.start StartDateTime Alternate namesBeginDatumTijd DefinitionThe date and time at which the contact took place. If the low element is missing, the meaning is that the low boundary is not known.
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end | Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.end EndDateTime Alternate namesEindDatumTijd DefinitionThe date and time at which the contact ended. If the contact takes place over a period of time, this indicates the end of the period, in the case of an admission, for example. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03. If the end of the period is missing, it means that the period is ongoing
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length | I | 0..1 | Duration | There are no (further) constraints on this element Element idEncounter.length Quantity of time the encounter lasted (less time absent) DefinitionQuantity of time the encounter lasted. This excludes the time during leaves of absence. May differ from the time the Encounter.period lasted because of leave of absence.
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reason | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.reason DeviatingResult Alternate namesIndication, Admission diagnosis, AfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reason why the encounter takes place. Encounter Reason Codes (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.reason.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.reason.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.text DeviatingResult Alternate namesAfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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diagnosis | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.diagnosis The list of diagnosis relevant to this encounter DefinitionThe list of diagnosis relevant to this encounter.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.diagnosis.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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condition | I | 1..1 | Reference(HCIM Procedure | HCIM Problem) | There are no (further) constraints on this element Element idEncounter.diagnosis.condition ContactReason Alternate namesAdmission diagnosis, discharge diagnosis, indication, Probleem, Procedure DefinitionThe problem that led to the contact or the procedure carried out during the contact. Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reference(HCIM Procedure | HCIM Problem) Constraints
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role | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.diagnosis.role Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The type of diagnosis this condition represents DiagnosisRole (preferred)Constraints
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rank | 0..1 | positiveInt | There are no (further) constraints on this element Element idEncounter.diagnosis.rank Ranking of the diagnosis (for each role type) DefinitionRanking of the diagnosis (for each role type). 32 bit number; for values larger than this, use decimal
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account | I | 0..* | Reference(Account) | There are no (further) constraints on this element Element idEncounter.account The set of accounts that may be used for billing for this Encounter DefinitionThe set of accounts that may be used for billing for this Encounter. The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.
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hospitalization | 0..1 | BackboneElement | There are no (further) constraints on this element Element idEncounter.hospitalization Details about the admission to a healthcare service DefinitionDetails about the admission to a healthcare service. An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included. The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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preAdmissionIdentifier | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.hospitalization.preAdmissionIdentifier Pre-admission identifier DefinitionPre-admission identifier.
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origin | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.origin The location from which the patient came before admission DefinitionThe location from which the patient came before admission. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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admitSource | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.admitSource Origin Alternate namesHerkomst DefinitionLocation from which the patient came before the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. HerkomstCodelijst HerkomstCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.admitSource.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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admitSourceCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.admitSource.coding:admitSourceCodelistNICE NICE admit source code list DefinitionNICE admission source codes. NICE codes 15 (Home) and 16 (Other) should be mapped on 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Admit source code list NICE-AdmitSourceCodeList (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reAdmission | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.reAdmission The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission DefinitionWhether this hospitalization is a readmission and why if known. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason for re-admission of this hospitalization encounter. v2 Re-Admission Indicator (example)Constraints
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dietPreference | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.dietPreference Diet preferences reported by the patient DefinitionDiet preferences reported by the patient. Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter. For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). Medical, cultural or ethical food preferences to help with catering requirements. Diet (example)Constraints
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specialCourtesy | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialCourtesy Special courtesies (VIP, board member) DefinitionSpecial courtesies (VIP, board member). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special courtesies SpecialCourtesy (preferred)Constraints
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specialArrangement | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialArrangement Wheelchair, translator, stretcher, etc. DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special arrangements SpecialArrangements (preferred)Constraints
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.destination Location to which the patient is discharged DefinitionLocation to which the patient is discharged. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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dischargeDisposition | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.dischargeDisposition Destination Alternate namesBestemming DefinitionLocation to which the patient will go after the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. BestemmingCodelijst BestemmingCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.dischargeDisposition.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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dischargeDispositionCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.dischargeDisposition.coding:dischargeDispositionCodelistNICE NICE discharge disposition DefinitionNICE discharge disposition codes. NICE codes 7 (Mortuary) and 8 (Home) and 9 (Other) should be mapped on 183676005 (SNOMED-CT) and 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Discharge disposition ?? (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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location | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.location List of locations where the patient has been DefinitionList of locations where the patient has been during this encounter. Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.location.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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location | I | 1..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.location.location Location the encounter takes place DefinitionThe location where the encounter takes place. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.location.status planned | active | reserved | completed DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time. When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed. The status of the location. EncounterLocationStatus (required)Constraints
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.location.period Time period during which the patient was present at the location DefinitionTime period during which the patient was present at the location. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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serviceProvider | I | 1..1 | Reference(nl-core-organization) | Element idEncounter.serviceProvider Location Alternate namesLocatie DefinitionThe physical location at which the contact took place. This should be used to indicate where the ICU contact took place . NICE needs this information in order to assign a unique number for the hospital and ICU department. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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partOf | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idEncounter.partOf Another Encounter this encounter is part of DefinitionAnother Encounter of which this encounter is a part of (administratively or in time). This is also used for associating a child's encounter back to the mother's encounter. Refer to the Notes section in the Patient resource for further details.
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Encounter | I | Encounter | There are no (further) constraints on this element Element idEncounter Encounter Alternate namesVisit, Contact DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idEncounter.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idEncounter.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idEncounter.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idEncounter.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..* | Identifier | Element idEncounter.identifier AdmissionID DefinitionIdentifier by which this encounter is known. This should be the (sub) admission ID/number. This element should never be changed because this will lead to unidentifiable records in the NICE registry. Hospitalnumber and ICU number -which are also part of the primary key- should be mapped on an organization resource. This resource is then being referred to by means of the serviceProvider element of this profile.
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status | Σ ?! | 1..1 | codeBindingFixed Value | Element idEncounter.status finished DefinitionFinished encounters are required for the NICE submission. Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes). This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid. Current state of the encounter EncounterStatus (required)Constraints
finished
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statusHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.statusHistory List of past encounter statuses DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them. The current status is always found in the current version of the resource, not the status history.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.statusHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.statusHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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status | 1..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.statusHistory.status planned | arrived | triaged | in-progress | onleave | finished | cancelled + Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +. Note that FHIR strings may not exceed 1MB in size Current state of the encounter EncounterStatus (required)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.statusHistory.period The time that the episode was in the specified status DefinitionThe time that the episode was in the specified status. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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class | Σ | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.class ContactType Alternate namesContactType DefinitionThe type of contact. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Permitted Values ContactTypeCodelijst-to-ActEncounterCode Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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ContactTypeCodelist | I | 0..* | Extension(CodeableConcept) | Element idEncounter.class.extension:ContactTypeCodelist Contact type Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet. DefinitionThe type of contact. Five indications of admission types are processed by NICE:
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/code-specification
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valueCodeableConcept | 1..1 | CodeableConceptBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept Contacttype DefinitionThe contacttype as defined by Encounter.class.ContactTypeCodelist. ContactTypeCodelijst ContactTypeCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding Code defined by a terminology system DefinitionThe contacttype that is associated with the encounter. Codes from both the Nictiz and NICE Codelists can be used. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes Constraints
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contactTypeCodeListNICE | S Σ | 0..* | CodingBinding | Element idEncounter.class.extension:ContactTypeCodelist.valueCodeableConcept:valueCodeableConcept.coding:contactTypeCodeListNICE ContactTypeCodeList DefinitionThe NICE-ContactType Codelist contains codes that further specifies the codes from the Nictiz Codelist. The NICE codes can be used to register the following contact types:
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ContactTypeCodeList NICE-ContactTypeCodeList (extensible)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.extension:ContactTypeCodelist.value[x]:valueCodeableConcept.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idEncounter.class.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | code | There are no (further) constraints on this element Element idEncounter.class.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.class.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idEncounter.class.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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classHistory | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.classHistory List of past encounter classes DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.classHistory.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.classHistory.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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class | 1..1 | CodingBinding | There are no (further) constraints on this element Element idEncounter.classHistory.class inpatient | outpatient | ambulatory | emergency + Definitioninpatient | outpatient | ambulatory | emergency +. Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Classification of the encounter ActEncounterCode (extensible)Constraints
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period | I | 1..1 | Period | There are no (further) constraints on this element Element idEncounter.classHistory.period The time that the episode was in the specified class DefinitionThe time that the episode was in the specified class. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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type | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.type Specific type of encounter DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). Since there are many ways to further classify encounters, this element is 0..*. The type of encounter EncounterType (example)Constraints
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priority | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.priority Indicates the urgency of the encounter DefinitionIndicates the urgency of the encounter. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Indicates the urgency of the encounter. v3 Code System ActPriority (example)Constraints
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subject | Σ I | 1..1 | Reference(NICE-Patient) | Element idEncounter.subject The patient present at the encounter Alternate namespatient DefinitionThe patient present at the encounter. While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).
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episodeOfCare | Σ I | 0..* | Reference(nl-core-episodeofcare) | There are no (further) constraints on this element Element idEncounter.episodeOfCare Episode(s) of care that this encounter should be recorded against DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-episodeofcare) Constraints
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incomingReferral | I | 0..* | Reference(ReferralRequest) | There are no (further) constraints on this element Element idEncounter.incomingReferral The ReferralRequest that initiated this encounter DefinitionThe referral request this encounter satisfies (incoming referral). References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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participant | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.participant List of participants involved in the encounter DefinitionThe list of people responsible for providing the service.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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type | Σ | 0..* | CodeableConceptBinding | Element idEncounter.participant.type Role of participant in encounter DefinitionRole of participant in encounter. The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr, Referring etc.). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. Role of participant in encounter ParticipantType (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.type.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.participant.type.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by $this(Value) Constraints
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healthProfessionalRole | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idEncounter.participant.type.coding:healthProfessionalRole HealthProfessionalRole Alternate namesZorgverlenerRol DefinitionThe role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. ZorgverlenerRolCodelijst (required) Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.type.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.participant.period Period of time during the encounter that the participant participated DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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individual | Σ I | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual ContactWith Alternate namesContactMet DefinitionThe healthcare provider with whom the contact took place. The specialty and role of the healthcare provider can be entered in the HealthcareProvider information model as well. This shall be a reference to NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(NICE-PractitionerRole) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | S I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | Element idEncounter.participant.individual.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idEncounter.participant.individual.extension:practitionerRole.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
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valueReference | 0..1 | Reference(NICE-PractitionerRole) | Element idEncounter.participant.individual.extension:practitionerRole.valueReference:valueReference Value of extension DefinitionThe reference to a NICE-PractitionerRole. In NICE-PractitionerRole the specialty is registered which can be used together with participant.type.coding.healthProfessionalRole to identify the referring specialty. PractitionerRole allows being specific about the specialism and organization of a Practitioner. This extension leads to slight duplication: a reference to a Practitioner provided in the PractitionerRole will also be given in the original Reference. If only the specialism and/or organization are available, the Reference.extension.valueReference.display will be duplicated into the original Reference.display. Systems that do not know about the extension would thus still have access to the regular Reference to Practitioner and to Reference.display. Reference(NICE-PractitionerRole) Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.participant.individual.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.participant.individual.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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appointment | Σ I | 0..1 | Reference(Appointment) | There are no (further) constraints on this element Element idEncounter.appointment The appointment that scheduled this encounter DefinitionThe appointment that scheduled this encounter. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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period | I | 0..1 | Period | Element idEncounter.period The start and end time of the encounter DefinitionThe start and end time of the encounter. If not (yet) known, the end of the Period may be omitted.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.period.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.period.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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start | Σ I | 1..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.start StartDateTime Alternate namesBeginDatumTijd DefinitionThe date and time at which the contact took place. If the low element is missing, the meaning is that the low boundary is not known.
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end | Σ I | 0..1 | dateTime | There are no (further) constraints on this element Element idEncounter.period.end EndDateTime Alternate namesEindDatumTijd DefinitionThe date and time at which the contact ended. If the contact takes place over a period of time, this indicates the end of the period, in the case of an admission, for example. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03. If the end of the period is missing, it means that the period is ongoing
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length | I | 0..1 | Duration | There are no (further) constraints on this element Element idEncounter.length Quantity of time the encounter lasted (less time absent) DefinitionQuantity of time the encounter lasted. This excludes the time during leaves of absence. May differ from the time the Encounter.period lasted because of leave of absence.
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reason | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.reason DeviatingResult Alternate namesIndication, Admission diagnosis, AfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reason why the encounter takes place. Encounter Reason Codes (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.reason.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idEncounter.reason.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.reason.text DeviatingResult Alternate namesAfwijkendeUitslag DefinitionA deviating result which serves as the reason for the contact. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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diagnosis | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.diagnosis The list of diagnosis relevant to this encounter DefinitionThe list of diagnosis relevant to this encounter.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.diagnosis.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.diagnosis.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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condition | I | 1..1 | Reference(HCIM Procedure | HCIM Problem) | There are no (further) constraints on this element Element idEncounter.diagnosis.condition ContactReason Alternate namesAdmission diagnosis, discharge diagnosis, indication, Probleem, Procedure DefinitionThe problem that led to the contact or the procedure carried out during the contact. Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reference(HCIM Procedure | HCIM Problem) Constraints
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role | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.diagnosis.role Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The type of diagnosis this condition represents DiagnosisRole (preferred)Constraints
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rank | 0..1 | positiveInt | There are no (further) constraints on this element Element idEncounter.diagnosis.rank Ranking of the diagnosis (for each role type) DefinitionRanking of the diagnosis (for each role type). 32 bit number; for values larger than this, use decimal
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account | I | 0..* | Reference(Account) | There are no (further) constraints on this element Element idEncounter.account The set of accounts that may be used for billing for this Encounter DefinitionThe set of accounts that may be used for billing for this Encounter. The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.
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hospitalization | 0..1 | BackboneElement | There are no (further) constraints on this element Element idEncounter.hospitalization Details about the admission to a healthcare service DefinitionDetails about the admission to a healthcare service. An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included. The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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preAdmissionIdentifier | 0..1 | Identifier | There are no (further) constraints on this element Element idEncounter.hospitalization.preAdmissionIdentifier Pre-admission identifier DefinitionPre-admission identifier.
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origin | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.origin The location from which the patient came before admission DefinitionThe location from which the patient came before admission. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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admitSource | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.admitSource Origin Alternate namesHerkomst DefinitionLocation from which the patient came before the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. HerkomstCodelijst HerkomstCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.admitSource.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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admitSourceCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.admitSource.coding:admitSourceCodelistNICE NICE admit source code list DefinitionNICE admission source codes. NICE codes 15 (Home) and 16 (Other) should be mapped on 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Admit source code list NICE-AdmitSourceCodeList (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.admitSource.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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reAdmission | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.reAdmission The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission DefinitionWhether this hospitalization is a readmission and why if known. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The reason for re-admission of this hospitalization encounter. v2 Re-Admission Indicator (example)Constraints
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dietPreference | 0..* | CodeableConcept | There are no (further) constraints on this element Element idEncounter.hospitalization.dietPreference Diet preferences reported by the patient DefinitionDiet preferences reported by the patient. Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter. For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). Medical, cultural or ethical food preferences to help with catering requirements. Diet (example)Constraints
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specialCourtesy | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialCourtesy Special courtesies (VIP, board member) DefinitionSpecial courtesies (VIP, board member). Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special courtesies SpecialCourtesy (preferred)Constraints
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specialArrangement | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element idEncounter.hospitalization.specialArrangement Wheelchair, translator, stretcher, etc. DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Special arrangements SpecialArrangements (preferred)Constraints
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destination | I | 0..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.hospitalization.destination Location to which the patient is discharged DefinitionLocation to which the patient is discharged. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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dischargeDisposition | 0..1 | CodeableConceptBinding | Element idEncounter.hospitalization.dischargeDisposition Destination Alternate namesBestemming DefinitionLocation to which the patient will go after the encounter. The coding is extended (sliced) with codes that are defined in the NICE datadictionary:
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. BestemmingCodelijst BestemmingCodelijst (extensible)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | Element idEncounter.hospitalization.dischargeDisposition.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by Slice in order to differentiate between Nictiz and NICE-codes. Constraints
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dischargeDispositionCodelistNICE | S Σ | 0..1 | CodingBinding | Element idEncounter.hospitalization.dischargeDisposition.coding:dischargeDispositionCodelistNICE NICE discharge disposition DefinitionNICE discharge disposition codes. NICE codes 7 (Mortuary) and 8 (Home) and 9 (Other) should be mapped on 183676005 (SNOMED-CT) and 264362003 (SNOMED-CT) and OTH (NullFlavor) resp. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Discharge disposition ?? (required)Constraints
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idEncounter.hospitalization.dischargeDisposition.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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location | 0..* | BackboneElement | There are no (further) constraints on this element Element idEncounter.location List of locations where the patient has been DefinitionList of locations where the patient has been during this encounter. Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
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id | 0..1 | string | There are no (further) constraints on this element Element idEncounter.location.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idEncounter.location.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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location | I | 1..1 | Reference(Location) | There are no (further) constraints on this element Element idEncounter.location.location Location the encounter takes place DefinitionThe location where the encounter takes place. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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status | 0..1 | codeBinding | There are no (further) constraints on this element Element idEncounter.location.status planned | active | reserved | completed DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time. When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed. The status of the location. EncounterLocationStatus (required)Constraints
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period | I | 0..1 | Period | There are no (further) constraints on this element Element idEncounter.location.period Time period during which the patient was present at the location DefinitionTime period during which the patient was present at the location. This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.
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serviceProvider | I | 1..1 | Reference(nl-core-organization) | Element idEncounter.serviceProvider Location Alternate namesLocatie DefinitionThe physical location at which the contact took place. This should be used to indicate where the ICU contact took place . NICE needs this information in order to assign a unique number for the hospital and ICU department. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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partOf | I | 0..1 | Reference(Encounter) | There are no (further) constraints on this element Element idEncounter.partOf Another Encounter this encounter is part of DefinitionAnother Encounter of which this encounter is a part of (administratively or in time). This is also used for associating a child's encounter back to the mother's encounter. Refer to the Notes section in the Patient resource for further details.
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Mapping FHIR profile NICE data dictionary
Path | identity | map | comment |
---|---|---|---|
Encounter.identifier | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#17 | Admission number |
Encounter.class.extension:ContactTypeCodelist | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#16 | Admission type |
Encounter.class.extension:ContactTypeCodelist | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#241 | Planned admission |
Encounter.participant.type | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#356 | Referring Specialism |
Encounter.participant.individual | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#356 | Referring Specialism |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#11 | Hospital admission date |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#12 | IC admission date |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#12 | IC admission time |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#86 | Hospital discharge date |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#87 | IC discharge date |
Encounter.period | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#89 | IC discharge time |
Encounter.hospitalization.admitSource | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#14 | Origin |
Encounter.hospitalization.dischargeDisposition | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#82 | Patient died in hospital |
Encounter.hospitalization.dischargeDisposition | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#90 | ICU Discharge destination |
Encounter.serviceProvider | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#150 | Hospital number |
Encounter.serviceProvider | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#155 | ICU number |
{ "resourceType": "Observation", "id": "NICE-BloodPressure-Example-01", "meta": { "profile": [ "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-BloodPressure-2022Q1" ] }, "text": { "status": "generated", --- We have skipped the narrative for better readability of the resource --- }, "extension": [ { "url": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1", "valueCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/ValueSet/v2-0532", "code": "Y", "display": "Yes" } ] } }, { "url": "https://simplifier.net/nicefhirproject/nice-scoreday", "valueInteger": 1 } ], "modifierExtension": [ { "url": "https://simplifier.net/nicefhirproject/nice-ExtremeValueType.structuredefinition", "valueCodeableConcept": { "coding": [ { "code": "H" } ] } } ], "status": "final", "category": [ { "coding": [ { "system": "http://hl7.org/fhir/observation-category", "code": "vital-signs" } ] } ], "code": { "coding": [ { "system": "http://loinc.org", "code": "85354-9", "display": "Blood pressure panel with all children optional" } ] }, "subject": { "reference": "Patient/NICE-Patient-01", "display": "P. Petersen" }, "context": { "reference": "Encounter/NICE-Encounter-01" }, "effectiveDateTime": "2022-01-08T08:43:00+02:00", "component": [ { "code": { "coding": [ { "system": "http://loinc.org", "code": "8480-6", "display": "Systolic blood pressure" } ] }, "valueQuantity": { "value": 142.0, "unit": "mm[Hg]", "system": "http://unitsofmeasure.org", "code": "mm[Hg]" } } ] }
<Observation xmlns="http://hl7.org/fhir"> <id value="NICE-BloodPressure-Example-01" /> <meta> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-BloodPressure-2022Q1" /> </meta> <text> <status value="generated" /> --- We have skipped the narrative for better readability of the resource --- </text> <extension url="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/ValueSet/v2-0532" /> <code value="Y" /> <display value="Yes" /> </coding> </valueCodeableConcept> </extension> <extension url="https://simplifier.net/nicefhirproject/nice-scoreday"> <valueInteger value="1" /> </extension> <modifierExtension url="https://simplifier.net/nicefhirproject/nice-ExtremeValueType.structuredefinition"> <valueCodeableConcept> <coding> <code value="H" /> </coding> </valueCodeableConcept> </modifierExtension> <status value="final" /> <category> <coding> <system value="http://hl7.org/fhir/observation-category" /> <code value="vital-signs" /> </coding> </category> <code> <coding> <system value="http://loinc.org" /> <code value="85354-9" /> <display value="Blood pressure panel with all children optional" /> </coding> </code> <subject> <reference value="Patient/NICE-Patient-01" /> <display value="P. Petersen" /> </subject> <context> <reference value="Encounter/NICE-Encounter-01" /> </context> <effectiveDateTime value="2022-01-08T08:43:00+02:00" /> <component> <code> <coding> <system value="http://loinc.org" /> <code value="8480-6" /> <display value="Systolic blood pressure" /> </coding> </code> <valueQuantity> <value value="142.0" /> <unit value="mm[Hg]" /> <system value="http://unitsofmeasure.org" /> <code value="mm[Hg]" /> </valueQuantity> </component> </Observation>