Encounter

  • Profile status: Draft
  • Canonical URL: http://fhir.smart4health.eu/StructureDefinition/s4h-encounter

Use of resource in Smart4Health

The Encounter resource is used to capture information about an interaction between a patient and a healthcare provider, e.g. for a consultation with a general practitioner or an in-patient treatment. It can capture information such as the time of the encounter, who was involved, and where it took place.

Other resources can point to Encounter resources to indicate that the corresponding data (e.g. a blood pressure measurement or a diagnosis) arose from a given encounter. They can also link to other encounters. In the context of certain Smart4Health Citizen Use Cases (CUCs), this is used to represent recurring patterns of encounters (see below).

Relation to other Encounter profiles

The IPS implementation guide does not contain an Encounter profile. In designing the Smart4Health profile, we have therefore tried to align with the Encounter profile from the Trillium II project, a project that was closely aligned with the IPS.

Identifying back pain encounters for Citizen Use Cases (CUCs) 3-5 and 7-8

This guidance is specific for the back pain treatment and prevention use case from CUCs 3-5 and 7-8. It only applies to data ingestion via the Smart4Health partner ITTM and not to ingestion from other sources, such as hospital records.

Back pain training encounters (visits) ingested from ITTM typically form part of a longer treatment or prevention session that involve multiple visits. This particular structure is captured using a hierarchy of Encounter instances. Each training generates one Encounter instance. A training Encounter instance, in turn, links to an Encounter instance representing the session (case); the link is via a reference in the the Encounter.partOf element of the visit Encounter. The linkage and identification of the relevant Encounter instances work via ITTM-specific business IDs discussed below.

While EpisodeOfCare might have been a slightly more appropriate resource type for representing a session/case, it was decided to use only (linked) Encounters in the context of Smart4Health for simplicity.

Case and visit IDs

To identify encounters for individual visits that are part of a particular session, the ITTM system sending the data uses two identifiers. In the FHIR context, these corresponding code are identified by the following system URLs:

  • ITTM case ID (case encounters/treatment sessions): http://fhir.smart4health.eu/CodeSystem/ittm-case-id
  • ITTM visit ID (individual visit encounters): http://fhir.smart4health.eu/CodeSystem/ittm-visit-id

These code systems should only be used in this use case context and should only be assigned by ITTM.

Encounter types

Encounters ingested by ITTM as part of the Smart4Health CUCs 3-5 and 7-8 should be assigned an appropriate S4H encounter type (in Encounter.type). This type indicates the nature of the back pain encounter (e.g. prevention or treatment). The Smart4Health encounter types should be taken from the following code system:

These codes should only to be used in this use case context. In the Encounter profile illustrates the use of these identifiers by an optional slice on Encounter.type.

Mandatory and must-support data elements

A valid instance according to this profile must satisfy the following constraints:

  • have a status (element: status) - base constraint
  • have an encounter class (element: class) - base constrain
  • point to the patient that is the subject of the encounter (element: subject) - Smart4Health constraint, in line with the Encounter profile from the Trillium II IG
  • contain the time (span) the encounter took place (element: period) - Smart4Health constraint, in line with the Encounter profile from the Trillium II IG

In addition, 13 top-level elements are marked as must-support.

Example resources

Formal views of profile content

Differential view

Shows only differences relative to the base resource definition.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierS Σ0..*Identifier
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
periodI1..1Period
classS Σ1..1Coding with translationsBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
class1..1CodingBinding
periodI1..1Period
s4hPhysioBackPainΣ0..1CodeableConceptBinding
serviceTypeΣ0..1CodeableConcept
priority0..1CodeableConcept
subjectS Σ I1..1Reference(Group | S4hPatient)
episodeOfCareΣ I0..*Reference(EpisodeOfCare)
basedOnI0..*Reference(ServiceRequest)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
typeS Σ0..*Codeable Concept (IPS)Binding
periodI0..1Period
individualΣ I0..1Reference(RelatedPerson | Practitioner (IPS) | PractitionerRole (IPS))
appointmentΣ I0..*Reference(Appointment)
periodS I1..1Period
lengthI0..1Duration
reasonCodeS Σ0..*Codeable Concept (IPS)Binding
reasonReferenceS Σ I0..*Reference(Condition | Procedure | ImmunizationRecommendation | S4hObservationBase)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition | Procedure)
useS0..1Codeable Concept (IPS)Binding
rank0..1positiveInt
accountI0..*Reference(Account)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
preAdmissionIdentifier0..1Identifier
originI0..1Reference(Location | Organization)
admitSource0..1CodeableConceptBinding
reAdmission0..1CodeableConcept
dietPreference0..*CodeableConcept
specialCourtesy0..*CodeableConceptBinding
specialArrangement0..*CodeableConceptBinding
destinationI0..1Reference(Location | Organization)
dischargeDisposition0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
locationI1..1Reference(Location)
status0..1codeBinding
physicalTypeS0..1Codeable Concept (IPS)
periodI0..1Period
serviceProviderS I0..1Reference(Organization (IPS))
partOfS I0..1Reference(S4hEncounter)

Snapshot view

Shows all constraints, including those from underlying profiles and the base resource definition.

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierS Σ0..*Identifier
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
periodI1..1Period
classS Σ1..1Coding with translationsBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
class1..1CodingBinding
periodI1..1Period
s4hPhysioBackPainΣ0..1CodeableConceptBinding
serviceTypeΣ0..1CodeableConcept
priority0..1CodeableConcept
subjectS Σ I1..1Reference(Group | S4hPatient)
episodeOfCareΣ I0..*Reference(EpisodeOfCare)
basedOnI0..*Reference(ServiceRequest)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
typeS Σ0..*Codeable Concept (IPS)Binding
periodI0..1Period
individualΣ I0..1Reference(RelatedPerson | Practitioner (IPS) | PractitionerRole (IPS))
appointmentΣ I0..*Reference(Appointment)
periodS I1..1Period
lengthI0..1Duration
reasonCodeS Σ0..*Codeable Concept (IPS)Binding
reasonReferenceS Σ I0..*Reference(Condition | Procedure | ImmunizationRecommendation | S4hObservationBase)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition | Procedure)
useS0..1Codeable Concept (IPS)Binding
rank0..1positiveInt
accountI0..*Reference(Account)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
preAdmissionIdentifier0..1Identifier
originI0..1Reference(Location | Organization)
admitSource0..1CodeableConceptBinding
reAdmission0..1CodeableConcept
dietPreference0..*CodeableConcept
specialCourtesy0..*CodeableConceptBinding
specialArrangement0..*CodeableConceptBinding
destinationI0..1Reference(Location | Organization)
dischargeDisposition0..1CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
locationI1..1Reference(Location)
status0..1codeBinding
physicalTypeS0..1Codeable Concept (IPS)
periodI0..1Period
serviceProviderS I0..1Reference(Organization (IPS))
partOfS I0..1Reference(S4hEncounter)