- This version of the UK Core is a development copy.
- This contains BREAKING CHANGES as a result of the C&TA Sprint 7 Review, and STU2 Sequence ballot reconciliation.
- This version is not yet reviewed for implementation. Other versions are available on the UK Core Version History Guide
- Please follow the guidance on the Contact Us page if you need any assistance.
- A summary of changes is available on the STU3 Sequence Change Log
StructureDefinition UKCore-Encounter
| Canonical_URL | Status | Current_Version | Last_Updated | Description |
|---|---|---|---|---|
| https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter | active | 2.5.0 | 2023-12-12 | This profile defines the UK constraints and extensions on the International FHIR resource Encounter. |
| Profile_Purpose |
|---|
This profile allows exchange of information about an interaction between an individual and healthcare providers for the purpose of providing healthcare services or assessing the health status of an individual. |
Detailed Descriptions
| Encounter | |
| Definition | An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient. |
| Cardinality | 0...* |
| Alias | Visit |
| Invariants |
|
| Mappings |
|
| Encounter.id | |
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
| Cardinality | 0...1 |
| Type | string |
| Summary | True |
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
| Encounter.meta | |
| Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
| Cardinality | 0...1 |
| Type | Meta |
| Summary | True |
| Invariants |
|
| Mappings |
|
| Encounter.implicitRules | |
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Cardinality | 0...1 |
| Type | uri |
| Modifier | True |
| Summary | True |
| Comments | 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| Invariants |
|
| Mappings |
|
| Encounter.language | |
| Definition | The base language in which the resource is written. |
| Cardinality | 0...1 |
| Type | code |
| Binding | A human language. |
| Comments | 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). |
| Invariants |
|
| Mappings |
|
| Encounter.text | |
| Definition | A human-readable narrative that contains a summary of the resource and can 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. |
| Cardinality | 0...1 |
| Type | Narrative |
| Alias | narrative, html, xhtml, display |
| Comments | 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 information is added later. |
| Invariants |
|
| Mappings |
|
| Encounter.contained | |
| Definition | These 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. |
| Cardinality | 0...* |
| Type | Resource |
| Alias | inline resources, anonymous resources, contained resources |
| Comments | 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
| Mappings |
|
| Encounter.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.extension:dischargeMethod | |
| Definition | This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital. |
| Cardinality | 0...1 |
| Type | Extension(CodeableConcept) |
| Alias | extensions, user content |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.extension:emergencyCareDischargeStatus | |
| Definition | This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department. |
| Cardinality | 0...1 |
| Type | Extension(CodeableConcept) |
| Alias | extensions, user content |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.extension:legalStatus | |
| Definition | Information relating to a patient's legal status on admission or discharge. |
| Cardinality | 0...* |
| Type | Extension(Complex) |
| Alias | extensions, user content |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.extension:OutcomeOfAttendance | |
| Definition | This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance. |
| Cardinality | 0...1 |
| Type | Extension(CodeableConcept) |
| Alias | extensions, user content |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.modifierExtension | |
| Definition | May 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Alias | extensions, user content |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.identifier | |
| Definition | Identifier(s) by which this encounter is known. |
| Cardinality | 0...* |
| Type | Identifier |
| Must Support | True |
| Summary | True |
| Invariants |
|
| Mappings |
|
| Encounter.status | |
| Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +. |
| Cardinality | 1...1 |
| Type | code |
| Binding | Current state of the encounter. |
| Must Support | True |
| Modifier | True |
| Summary | True |
| Comments | Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes). |
| Invariants |
|
| Mappings |
|
| Encounter.statusHistory | |
| Definition | The 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. |
| Cardinality | 0...* |
| Type | BackboneElement |
| Comments | The current status is always found in the current version of the resource, not the status history. |
| Invariants |
|
| Mappings |
|
| Encounter.statusHistory.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.statusHistory.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.statusHistory.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.statusHistory.status | |
| Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +. |
| Cardinality | 1...1 |
| Type | code |
| Binding | Current state of the encounter. |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Invariants |
|
| Mappings |
|
| Encounter.statusHistory.period | |
| Definition | The time that the episode was in the specified status. |
| Cardinality | 1...1 |
| Type | Period |
| Comments | 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"). Period is not used for a duration (a measure of elapsed time). See Duration. |
| Invariants |
|
| Mappings |
|
| Encounter.class | |
| Definition | Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. |
| Cardinality | 1...1 |
| Type | Coding |
| Binding | Classification of the encounter. |
| Must Support | True |
| Summary | True |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.classHistory | |
| Definition | The 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 transitions 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 kind of discharge from emergency to inpatient. |
| Cardinality | 0...* |
| Type | BackboneElement |
| Invariants |
|
| Mappings |
|
| Encounter.classHistory.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.classHistory.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.classHistory.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.classHistory.class | |
| Definition | inpatient | outpatient | ambulatory | emergency +. |
| Cardinality | 1...1 |
| Type | Coding |
| Binding | Classification of the encounter. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.classHistory.period | |
| Definition | The time that the episode was in the specified class. |
| Cardinality | 1...1 |
| Type | Period |
| Comments | 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"). Period is not used for a duration (a measure of elapsed time). See Duration. |
| Invariants |
|
| Mappings |
|
| Encounter.type | |
| Definition | Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record). |
| Summary | True |
| Comments | Since there are many ways to further classify encounters, this element is 0..*. |
| Invariants |
|
| Mappings |
|
| Encounter.serviceType | |
| Definition | Broad categorization of the service that is to be provided (e.g. cardiology). |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102. |
| Summary | True |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.priority | |
| Definition | Indicates the urgency of the encounter. |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | Indicates the urgency of the encounter. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.subject | |
| Definition | The patient or group present at the encounter. |
| Cardinality | 0...1 |
| Type | Reference(Patient | Group) |
| Must Support | True |
| Summary | True |
| Alias | patient |
| Comments | While the encounter is always about the patient, the patient might 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). |
| Invariants |
|
| Mappings |
|
| Encounter.episodeOfCare | |
| Definition | Where 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). |
| Cardinality | 0...* |
| Type | Reference(EpisodeOfCare) |
| Summary | True |
| Comments | 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. |
| Invariants |
|
| Mappings |
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| Encounter.basedOn | |
| Definition | The request this encounter satisfies (e.g. incoming referral or procedure request). |
| Cardinality | 0...* |
| Type | Reference(ServiceRequest) |
| Alias | incomingReferral |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.participant | |
| Definition | The list of people responsible for providing the service. |
| Cardinality | 0...* |
| Type | BackboneElement |
| Must Support | True |
| Summary | True |
| Invariants |
|
| Mappings |
|
| Encounter.participant.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.participant.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.participant.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.participant.type | |
| Definition | Role of participant in encounter. |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | Role of participant in encounter. |
| Summary | True |
| Comments | The participant type indicates how an individual participates 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). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. |
| Invariants |
|
| Mappings |
|
| Encounter.participant.period | |
| Definition | The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. |
| Cardinality | 0...1 |
| Type | Period |
| Comments | 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"). Period is not used for a duration (a measure of elapsed time). See Duration. |
| Invariants |
|
| Mappings |
|
| Encounter.participant.individual | |
| Definition | Persons involved in the encounter other than the patient. |
| Cardinality | 0...1 |
| Type | Reference(Practitioner | PractitionerRole | RelatedPerson) |
| Summary | True |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.appointment | |
| Definition | The appointment that scheduled this encounter. |
| Cardinality | 0...* |
| Type | Reference(Appointment) |
| Summary | True |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.period | |
| Definition | The start and end time of the encounter. |
| Cardinality | 0...1 |
| Type | Period |
| Comments | If not (yet) known, the end of the Period may be omitted. |
| Invariants |
|
| Mappings |
|
| Encounter.length | |
| Definition | Quantity of time the encounter lasted. This excludes the time during leaves of absence. |
| Cardinality | 0...1 |
| Type | Duration |
| Comments | May differ from the time the Encounter.period lasted because of leave of absence. |
| Invariants |
|
| Mappings |
|
| Encounter.reasonCode | |
| Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | Reason why the encounter takes place. |
| Must Support | True |
| Summary | True |
| Alias | Indication, Admission diagnosis |
| Comments | 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). |
| Invariants |
|
| Mappings |
|
| Encounter.reasonReference | |
| Definition | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. |
| Cardinality | 0...* |
| Type | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) |
| Must Support | True |
| Summary | True |
| Alias | Indication, Admission diagnosis |
| Comments | 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). |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis | |
| Definition | The list of diagnosis relevant to this encounter. |
| Cardinality | 0...* |
| Type | BackboneElement |
| Summary | True |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.diagnosis.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis.condition | |
| Definition | 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. |
| Cardinality | 1...1 |
| Type | Reference(Condition | Procedure) |
| Summary | True |
| Alias | Admission diagnosis, discharge diagnosis, indication |
| Comments | 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). |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis.use | |
| Definition | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …). |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | The type of diagnosis this condition represents. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.diagnosis.rank | |
| Definition | Ranking of the diagnosis (for each role type). |
| Cardinality | 0...1 |
| Type | positiveInt |
| Comments | 32 bit number; for values larger than this, use decimal |
| Invariants |
|
| Mappings |
|
| Encounter.account | |
| Definition | The set of accounts that may be used for billing for this Encounter. |
| Cardinality | 0...* |
| Type | Reference(Account) |
| Comments | The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization | |
| Definition | Details about the admission to a healthcare service. |
| Cardinality | 0...1 |
| Type | BackboneElement |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.hospitalization.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.extension:admissionMethod | |
| Definition | This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital. |
| Cardinality | 0...1 |
| Type | Extension(CodeableConcept) |
| Alias | extensions, user content |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.preAdmissionIdentifier | |
| Definition | Pre-admission identifier. |
| Cardinality | 0...1 |
| Type | Identifier |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.origin | |
| Definition | The location/organization from which the patient came before admission. |
| Cardinality | 0...1 |
| Type | Reference(Location | Organization) |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.admitSource | |
| Definition | From where patient was admitted (physician referral, transfer). |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.reAdmission | |
| Definition | Whether this hospitalization is a readmission and why if known. |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | The reason for re-admission of this hospitalization encounter. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.dietPreference | |
| Definition | Diet preferences reported by the patient. |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | Medical, cultural or ethical food preferences to help with catering requirements. |
| Requirements | 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. |
| Comments | For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.specialCourtesy | |
| Definition | Special courtesies (VIP, board member). |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | Special courtesies. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.specialArrangement | |
| Definition | Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. |
| Cardinality | 0...* |
| Type | CodeableConcept |
| Binding | Special arrangements. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.destination | |
| Definition | Location/organization to which the patient is discharged. |
| Cardinality | 0...1 |
| Type | Reference(Location | Organization) |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.hospitalization.dischargeDisposition | |
| Definition | Category or kind of location after discharge. |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.location | |
| Definition | List of locations where the patient has been during this encounter. |
| Cardinality | 0...* |
| Type | BackboneElement |
| Comments | 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". |
| Invariants |
|
| Mappings |
|
| Encounter.location.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0...1 |
| Type | string |
| Mappings |
|
| Encounter.location.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Cardinality | 0...* |
| Type | Extension |
| Alias | extensions, user content |
| Comments | 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. |
| Slicing | Unordered, Open, by url(Value) |
| Invariants |
|
| Mappings |
|
| Encounter.location.modifierExtension | |
| Definition | May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Cardinality | 0...* |
| Type | Extension |
| Modifier | True |
| Summary | True |
| Alias | extensions, user content, modifiers |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.location.location | |
| Definition | The location where the encounter takes place. |
| Cardinality | 1...1 |
| Type | Reference(Location) |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.location.status | |
| Definition | The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time. |
| Cardinality | 0...1 |
| Type | code |
| Binding | The status of the location. |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.location.physicalType | |
| Definition | This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query. |
| Cardinality | 0...1 |
| Type | CodeableConcept |
| Binding | A set of codes that define the physical type of location where an encounter takes place. |
| Comments | This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query. There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario. |
| Invariants |
|
| Mappings |
|
| Encounter.location.period | |
| Definition | Time period during which the patient was present at the location. |
| Cardinality | 0...1 |
| Type | Period |
| Comments | 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"). Period is not used for a duration (a measure of elapsed time). See Duration. |
| Invariants |
|
| Mappings |
|
| Encounter.serviceProvider | |
| Definition | The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy. |
| Cardinality | 0...1 |
| Type | Reference(Organization) |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
| Encounter.partOf | |
| Definition | Another Encounter of which this encounter is a part of (administratively or in time). |
| Cardinality | 0...1 |
| Type | Reference(Encounter) |
| Comments | 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. |
| Invariants |
|
| Mappings |
|
Table View
| Encounter | .. | |
| Encounter.extension | Extension | .. |
| Encounter.extension | Extension | .. |
| Encounter.extension | Extension | .. |
| Encounter.extension | Extension | .. |
| Encounter.identifier | .. | |
| Encounter.status | .. | |
| Encounter.class | .. | |
| Encounter.type | .. | |
| Encounter.serviceType | .. | |
| Encounter.subject | .. | |
| Encounter.participant | .. | |
| Encounter.reasonCode | .. | |
| Encounter.reasonReference | .. | |
| Encounter.hospitalization | .. | |
| Encounter.hospitalization.extension | Extension | .. |
| Encounter.hospitalization.admitSource | .. | |
| Encounter.hospitalization.dischargeDisposition | .. | |
| Encounter.location | .. | |
| Encounter.location.physicalType | .. |
XML View
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="UKCore-Encounter" /> <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter" /> <version value="2.5.0" /> <name value="UKCoreEncounter" /> <title value="UK Core Encounter" /> <status value="active" /> <date value="2023-12-12" /> <publisher value="HL7 UK" /> <contact> <name value="HL7 UK" /> <telecom> <system value="email" /> <value value="ukcore@hl7.org.uk" /> <use value="work" /> <rank value="1" /> </telecom> </contact> <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Encounter](https://hl7.org/fhir/R4/Encounter.html)." /> <purpose value="This profile allows exchange of information about an interaction between an individual and healthcare providers for the purpose of providing healthcare services or assessing the health status of an individual." /> <copyright value="Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Encounter" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Encounter" /> <derivation value="constraint" /> <differential> <element id="Encounter.extension:dischargeMethod"> <path value="Encounter.extension" /> <sliceName value="dischargeMethod" /> <short value="An extension to support the method of discharge from a hospital." /> <definition value="This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital." /> <type> <code value="Extension" /> <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod" /> </type> </element> <element id="Encounter.extension:emergencyCareDischargeStatus"> <path value="Encounter.extension" /> <sliceName value="emergencyCareDischargeStatus" /> <short value="An extension to support the status of an individual on discharge from an Emergency Care Department." /> <definition value="This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department." /> <type> <code value="Extension" /> <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus" /> </type> </element> <element id="Encounter.extension:legalStatus"> <path value="Encounter.extension" /> <sliceName value="legalStatus" /> <short value="Information relating to a patient's legal status on admission or discharge." /> <definition value="Information relating to a patient's legal status on admission or discharge." /> <type> <code value="Extension" /> <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus" /> </type> </element> <element id="Encounter.extension:OutcomeOfAttendance"> <path value="Encounter.extension" /> <sliceName value="OutcomeOfAttendance" /> <short value="An extension to support the outcome of an Outpatient attendance." /> <definition value="This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance." /> <type> <code value="Extension" /> <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance" /> </type> </element> <element id="Encounter.identifier"> <path value="Encounter.identifier" /> <short value="Identifier(s) by which this encounter is known." /> <mustSupport value="true" /> </element> <element id="Encounter.status"> <path value="Encounter.status" /> <short value="The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown" /> <mustSupport value="true" /> </element> <element id="Encounter.class"> <path value="Encounter.class" /> <short value="Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations." /> <mustSupport value="true" /> </element> <element id="Encounter.type"> <path value="Encounter.type" /> <binding> <strength value="preferred" /> <description value="A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record)." /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType" /> </binding> </element> <element id="Encounter.serviceType"> <path value="Encounter.serviceType" /> <binding> <strength value="preferred" /> <description value="Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102." /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType" /> </binding> </element> <element id="Encounter.subject"> <path value="Encounter.subject" /> <short value="The patient or group present at the encounter." /> <mustSupport value="true" /> </element> <element id="Encounter.participant"> <path value="Encounter.participant" /> <short value="The list of people responsible for providing the service." /> <mustSupport value="true" /> </element> <element id="Encounter.reasonCode"> <path value="Encounter.reasonCode" /> <short value="Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis." /> <mustSupport value="true" /> </element> <element id="Encounter.reasonReference"> <path value="Encounter.reasonReference" /> <short value="Reason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation." /> <mustSupport value="true" /> </element> <element id="Encounter.hospitalization.extension:admissionMethod"> <path value="Encounter.hospitalization.extension" /> <sliceName value="admissionMethod" /> <short value="An extension to support the method by which an individual was admitted into hospital." /> <definition value="This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital." /> <type> <code value="Extension" /> <profile value="https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod" /> </type> <isModifier value="false" /> </element> <element id="Encounter.hospitalization.admitSource"> <path value="Encounter.hospitalization.admitSource" /> <binding> <strength value="preferred" /> <description value="The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home." /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-SourceOfAdmission" /> </binding> </element> <element id="Encounter.hospitalization.dischargeDisposition"> <path value="Encounter.hospitalization.dischargeDisposition" /> <binding> <strength value="preferred" /> <description value="The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth." /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-DischargeDestination" /> </binding> </element> <element id="Encounter.location.physicalType"> <path value="Encounter.location.physicalType" /> <binding> <strength value="preferred" /> <description value="A set of codes that define the physical type of location where an encounter takes place." /> <valueSet value="https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType" /> </binding> </element> </differential> </StructureDefinition>
JSON View
{ "resourceType": "StructureDefinition", "id": "UKCore-Encounter", "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter", "version": "2.5.0", "name": "UKCoreEncounter", "title": "UK Core Encounter", "status": "active", "date": "2023-12-12", "publisher": "HL7 UK", "contact": [ { "name": "HL7 UK", "telecom": [ { "system": "email", "value": "ukcore@hl7.org.uk", "use": "work", "rank": 1 } ] } ], "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Encounter](https://hl7.org/fhir/R4/Encounter.html).", "purpose": "This profile allows exchange of information about an interaction between an individual and healthcare providers for the purpose of providing healthcare services or assessing the health status of an individual.", "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Encounter", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Encounter", "derivation": "constraint", "differential": { "element": [ { "id": "Encounter.extension:dischargeMethod", "path": "Encounter.extension", "sliceName": "dischargeMethod", "short": "An extension to support the method of discharge from a hospital.", "definition": "This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod" ] } ] }, { "id": "Encounter.extension:emergencyCareDischargeStatus", "path": "Encounter.extension", "sliceName": "emergencyCareDischargeStatus", "short": "An extension to support the status of an individual on discharge from an Emergency Care Department.", "definition": "This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus" ] } ] }, { "id": "Encounter.extension:legalStatus", "path": "Encounter.extension", "sliceName": "legalStatus", "short": "Information relating to a patient's legal status on admission or discharge.", "definition": "Information relating to a patient's legal status on admission or discharge.", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus" ] } ] }, { "id": "Encounter.extension:OutcomeOfAttendance", "path": "Encounter.extension", "sliceName": "OutcomeOfAttendance", "short": "An extension to support the outcome of an Outpatient attendance.", "definition": "This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance" ] } ] }, { "id": "Encounter.identifier", "path": "Encounter.identifier", "short": "Identifier(s) by which this encounter is known.", "mustSupport": true }, { "id": "Encounter.status", "path": "Encounter.status", "short": "The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown", "mustSupport": true }, { "id": "Encounter.class", "path": "Encounter.class", "short": "Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.", "mustSupport": true }, { "id": "Encounter.type", "path": "Encounter.type", "binding": { "strength": "preferred", "description": "A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record).", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType" } }, { "id": "Encounter.serviceType", "path": "Encounter.serviceType", "binding": { "strength": "preferred", "description": "Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType" } }, { "id": "Encounter.subject", "path": "Encounter.subject", "short": "The patient or group present at the encounter.", "mustSupport": true }, { "id": "Encounter.participant", "path": "Encounter.participant", "short": "The list of people responsible for providing the service.", "mustSupport": true }, { "id": "Encounter.reasonCode", "path": "Encounter.reasonCode", "short": "Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.", "mustSupport": true }, { "id": "Encounter.reasonReference", "path": "Encounter.reasonReference", "short": "Reason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation.", "mustSupport": true }, { "id": "Encounter.hospitalization.extension:admissionMethod", "path": "Encounter.hospitalization.extension", "sliceName": "admissionMethod", "short": "An extension to support the method by which an individual was admitted into hospital.", "definition": "This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.", "type": [ { "code": "Extension", "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod" ] } ], "isModifier": false }, { "id": "Encounter.hospitalization.admitSource", "path": "Encounter.hospitalization.admitSource", "binding": { "strength": "preferred", "description": "The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home.", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-SourceOfAdmission" } }, { "id": "Encounter.hospitalization.dischargeDisposition", "path": "Encounter.hospitalization.dischargeDisposition", "binding": { "strength": "preferred", "description": "The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth.", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-DischargeDestination" } }, { "id": "Encounter.location.physicalType", "path": "Encounter.location.physicalType", "binding": { "strength": "preferred", "description": "A set of codes that define the physical type of location where an encounter takes place.", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType" } } ] } }
Feedback
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Examples
Admission Method- An example to illustrate the extension for an encounter to support the method by which an individual was admitted into hospital.
Example UKCore-Extension-AdmissionMethod
Discharge Method- An example to illustrate the extension for an encounter to support the method of discharge from a hospital.
Example UKCore-Extension-DischargeMethod
Emergency Care Discharge Status- An example to illustrate the extension which is used to indicate the status of an individual on discharge from an Emergency Care Department.
Example UKCore-Extension-EmergencyCareDischargeStatus
Inpatient Encounter - An example to illustrate an inpatient encounter.
Example UKCore-Encounter-InpatientEncounter
Legal Status- An example to illustrate the extension which is used to indicate a patient's legal status on admission or discharge.
Example UKCore-Extension-LegalStatus
Outcome of Attendance- An example to illustrate the extension which is used to indicate the outcome of an outpatient attendance.
Example UKCore-Extension-OutcomeOfAttendance
Example Usage Scenarios
The following are example usage scenarios for the UK Core Encounter profile:
- Query for a specific patient encounter
- Query for recent patient encounters
- Record or update an encounter
Profile Specific Implementation Guidance:
Mandatory and Must Support Data Elements
The following elements are identified as MustSupport, and it is expected that consumers and suppliers SHALL support these as per the MustSupport Guidance.
| Element | Reason |
|---|---|
Encounter.identifier | Identifier(s) by which this encounter is known. |
Encounter.status | The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown |
Encounter.class | Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. |
Encounter.subject | The patient or group present at the encounter. |
Encounter.participant | The list of people responsible for providing the service. |
Encounter.reasonCode | Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. |
Encounter.reasonReference | Reason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation. |
Extensions
More information about the extensions on the UKCore-Encounter profile can be found using the links below.
| Extension | Context | Link | Comment |
|---|---|---|---|
| dischargeMethod | Encounter.extension | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod | An extension to support the method of discharge from a hospital. |
| emergencyCareDischargeStatus | Encounter.extension | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus | An extension to support the status of an individual on discharge from an Emergency Care Department. |
| legalStatus | Encounter.extension | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus | Information relating to a patient's legal status on admission or discharge. |
| OutcomeOfAttendance | Encounter.extension | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance | An extension to support the outcome of an Outpatient attendance. |
| admissionMethod | Encounter.hospitalization.extension | https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod | An extension to support the method by which an individual was admitted into hospital. |
Bindings (differential)
More information about the bindings to UK Core ValueSets can be found below.
| Context | Strength | Link |
|---|---|---|
| Encounter.type | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType |
| Encounter.serviceType | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType |
| Encounter.hospitalization.admitSource | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-SourceOfAdmission |
| Encounter.hospitalization.dischargeDisposition | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-DischargeDestination |
| Encounter.location.physicalType | preferred | https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType |
| Encounter.extension:admissionMethod | preferred | ValueSet UKCore-AdmissionMethod |
| Encounter.extension:dischargeMethod | preferred | ValueSet UKCore-DischargeMethod |
| Encounter.extension:emergencyCareDischargeStatus | preferred | ValueSet UKCore-EmergencyCareDischargeStatus |
| Encounter.extension:legalStatus.extension:legalStatusClassification | preferred | ValueSet UKCore-LegalStatusClassification |
| Encounter.extension:legalStatus.extension:legalStatusContext | extensible | ValueSet UKCore-LegalStatusContext |
| Encounter.extension:outcomeOfAttendance | preferred | ValueSet UKCore-OutcomeOfAttendance |
class
This element SHALL be present and the following values must be used. However, an alternative CodeSystem may be used if no suitable code is listed below. The binding is to the International FHIR ValueSet v3 ActEncounterCode, and is shown expanded here due to the complexity of included and excluded codes.
| Code | Display | Definition |
|---|---|---|
| AMB | ambulatory | A comprehensive term for health care provided in a healthcare facility (e.g. a practitioners office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter. |
| EMER | emergency | A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.) |
| FLD | field | A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket. |
| HH | home health | Healthcare encounter that takes place in the residence of the patient or a designee |
| IMP | inpatient encounter | A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service. |
| ACUTE | inpatient acute | An acute inpatient encounter. |
| NONAC | inpatient | non-acute Any category of inpatient encounter except 'acute' |
| OBSENC | observation encounter | An encounter where the patient usually will start in different encounter, such as one in the emergency department (EMER) but then transition to this type of encounter because they require a significant period of treatment and monitoring to determine whether or not their condition warrants an inpatient admission or discharge. In the majority of cases the decision about admission or discharge will occur within a time period determined by local, regional or national regulation, often between 24 and 48 hours. |
| PRENC | pre-admission | A patient encounter where patient is scheduled or planned to receive service delivery in the future, and the patient is given a pre-admission account number. When the patient comes back for subsequent service, the pre-admission encounter is selected and is encapsulated into the service registration, and a new account number is generated. Usage Note: This is intended to be used in advance of encounter types such as ambulatory, inpatient encounter, virtual, etc. |
| SS | short stay | An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours. |
| VR | virtual | A patient encounter where the patient and the practitioner are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference. |
subject
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
episodeOfCare
Where possible, it is expected that the resource being referenced SHOULD conform to UKCore-EpisodeOfCare (draft).
basedOn
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-ServiceRequest.
participant
The Encounter.participant.type element SHOULD include the role of the participant in the encounter using the following values which may be extended. The binding is to the International FHIR ValueSet encounter-participant-type, which is shown expanded here due to the complexity of included codes and systems.
| Code | System | Display | Definition |
|---|---|---|---|
| ADM | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
admitter | The practitioner who is responsible for admitting a patient to a patient encounter. |
| ATND | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
attender | The practitioner that has responsibility for overseeing a patient's care during a patient encounter. |
| CALLBCK | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
callback contact | A person or organization who should be contacted for follow-up questions about the act in place of the author. |
| CON | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
consultant | An advisor participating in the service by performing evaluations and making recommendations. |
| DIS | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
discharger | The practitioner who is responsible for the discharge of a patient from a patient encounter. |
| ESC | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
escort | Only with Transportation services. A person who escorts the patient. |
| REF | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
referrer | A person having referred the subject of the service to the performer (referring physician). Typically, a referring physician will receive a report. |
| SPRF | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
secondary performer | A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be. |
| PPRF | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
primary performer | The principal or primary performer of the act. |
| PART | http://terminology.hl7.org/CodeSystem/v3-ParticipationType |
Participation | Indicates that the target of the participation is involved in some manner in the act, but does not qualify how. |
| translator | http://terminology.hl7.org/CodeSystem/participant-type |
Translator | A translator who is facilitating communication with the patient during the encounter. |
| emergency | http://terminology.hl7.org/CodeSystem/participant-type |
Emergency | A person to be contacted in case of an emergency during the encounter. |
Where possible, the Encounter.participant.individual is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
appointment
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Appointment.
reasonReference
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
- Profile UKCore-Condition
- Profile UKCore-Observation
- Profile UKCore-Procedure
- ImmunizationRecommendation Resource
diagnosis
Where possible, it is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:
hospitalization
Encounter.hospitalizationhas the UKCore extension Extension UKCore-AdmissionMethod.Encounter.hospitalization.originit is expected that the resource being referenced SHOULD conform to one of the following UK Core profiles:Encounter.hospitalization.destinationThe resource being referenced SHALL conform to one of the following:
location
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Location.
serviceProvider
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Organization.
partOf
Where possible, it is expected that the resource being referenced SHOULD conform to Profile UKCore-Encounter.