Profiles & Interactions Index > Profile: Encounter

Profile: Encounter

Simplifier project page: Encounter

Derived from: Encounter (R4)

Canonical_URLProfile_StatusProfile_VersionFHIR_Version
http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Encounteractive4.0.14.0.1

Formal Views of Profile Content

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

Differential View

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partOfI0..1Reference(Encounter)

Hybrid View

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partOfI0..1Reference(Encounter)

Snapshot View

idS Σ0..1string
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statusS Σ ?!1..1codeBindingFixed Value
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modifierExtensionΣ ?! I0..*Extension
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systemS Σ1..1uri
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codeS Σ1..1code
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id0..1string
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referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
episodeOfCareΣ I0..*Reference(EpisodeOfCare)
basedOnI0..*Reference(ServiceRequest)
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id0..1string
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referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
appointmentΣ I0..*Reference(Appointment)
id0..1string
extensionI0..*Extension
startS Σ I0..1dateTime
endS Σ I0..1dateTime
lengthI0..1Duration
reasonCodeΣ0..*CodeableConceptBinding
reasonReferenceΣ I0..*Reference(Condition | Procedure | Observation | ImmunizationRecommendation)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition | Procedure)
use0..1CodeableConceptBinding
rank0..1positiveInt
accountI0..*Reference(Account)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
preAdmissionIdentifier0..1Identifier
originI0..1Reference(Location | Organization)
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systemS Σ1..1uriFixed Value
versionΣ0..1string
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dietPreference0..*CodeableConcept
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destinationI0..1Reference(Location | Organization)
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userSelectedΣ0..1boolean
textΣ0..1string
periodI0..1Period
serviceProviderI0..1Reference(Organization)
partOfI0..1Reference(Encounter)

Table View

Encounter..
Encounter.id..
Encounter.meta1..
Encounter.meta.profile1..
Encounter.identifier1..1
Encounter.identifier.type1..
Encounter.identifier.type.coding1..1
Encounter.identifier.type.coding.system1..
Encounter.identifier.type.coding.code1..
Encounter.identifier.type.coding.display1..
Encounter.identifier.system1..
Encounter.identifier.value1..
Encounter.status..
Encounter.class..
Encounter.class.system1..
Encounter.class.code1..
Encounter.class.display1..
Encounter.type..1
Encounter.type.coding1..
Encounter.type.coding.system1..
Encounter.type.coding.code1..
Encounter.type.coding.display1..
Encounter.serviceType..
Encounter.serviceType.coding..
Encounter.serviceType.coding.system1..
Encounter.serviceType.coding.code1..
Encounter.serviceType.coding.display1..
Encounter.serviceType.text..
Encounter.priority..
Encounter.priority.coding1..1
Encounter.priority.coding.system1..
Encounter.priority.coding.code1..
Encounter.priority.coding.display1..
Encounter.subjectReference(Patient | Patient)1..
Encounter.subject.reference1..
Encounter.participant..
Encounter.participant.type1..1
Encounter.participant.type.coding1..1
Encounter.participant.type.coding.system1..
Encounter.participant.type.coding.code1..
Encounter.participant.type.coding.display1..
Encounter.participant.individualReference(Practitioner | Practitioner)1..
Encounter.participant.individual.reference1..
Encounter.period..
Encounter.period.start..
Encounter.period.end..
Encounter.hospitalization..
Encounter.hospitalization.admitSource..
Encounter.hospitalization.admitSource.coding1..1
Encounter.hospitalization.admitSource.coding.system1..
Encounter.hospitalization.admitSource.coding.code1..
Encounter.hospitalization.admitSource.coding.display1..
Encounter.hospitalization.dischargeDisposition..
Encounter.hospitalization.dischargeDisposition.coding1..1
Encounter.hospitalization.dischargeDisposition.coding.system1..
Encounter.hospitalization.dischargeDisposition.coding.code1..
Encounter.hospitalization.dischargeDisposition.coding.display1..
Encounter.location..
Encounter.location.locationReference(Location)..
Encounter.location.location.reference1..
Encounter.location.location.display..
Encounter.location.location.display.extensionExtension..1
Encounter.location.physicalType1..
Encounter.location.physicalType.coding1..1
Encounter.location.physicalType.coding.system1..
Encounter.location.physicalType.coding.code1..
Encounter.location.physicalType.coding.display1..

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "8ffc4bb2-fc6e-4e04-8740-4e1ba0d4c631",
    "meta": {
        "lastUpdated": "2024-08-13T14:46:31.3903996+00:00"
    },
    "text": {
        "status": "empty",
        --- We have skipped the narrative for better readability of the resource ---
    },
    "url": "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Encounter",
    "version": "4.0.1",
    "name": "Encounter",
    "title": "Encounter",
    "status": "active",
    "date": "2023-04-17T14:49:02.7032158+00:00",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "cdr-v2-data-in",
            "uri": "http://ehealthontario.ca"
        },
        {
            "identity": "virtual-visit",
            "name": "Virtual Visit Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Encounter",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Encounter",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Encounter.id",
                "path": "Encounter.id",
                "mustSupport": true
            },
            {
                "id": "Encounter.meta",
                "path": "Encounter.meta",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.meta.profile",
                "path": "Encounter.meta.profile",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier",
                "path": "Encounter.identifier",
                "min": 1,
                "max": "1",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.19 (visit number)"
                    },
                    {
                        "identity": "virtual-visit",
                        "map": "Event ID",
                        "comment": "Unique identifier for the Event to a single patient"
                    }
                ]
            },
            {
                "id": "Encounter.identifier.type",
                "path": "Encounter.identifier.type",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.type.coding",
                "path": "Encounter.identifier.type.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.type.coding.system",
                "path": "Encounter.identifier.type.coding.system",
                "min": 1,
                "fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0203",
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.type.coding.code",
                "path": "Encounter.identifier.type.coding.code",
                "min": 1,
                "fixedCode": "VN",
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.type.coding.display",
                "path": "Encounter.identifier.type.coding.display",
                "min": 1,
                "fixedString": "Visit number",
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.system",
                "path": "Encounter.identifier.system",
                "definition": "Establishes the namespace for the value - that is, a URL that describes a set values that are unique.\n\nIn this implementation, this will be the visit OID.",
                "comment": "Contains an OID in the urn format (urn:oid:xxxx)",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.19.4"
                    }
                ]
            },
            {
                "id": "Encounter.identifier.value",
                "path": "Encounter.identifier.value",
                "min": 1,
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.19.1"
                    }
                ]
            },
            {
                "id": "Encounter.status",
                "path": "Encounter.status",
                "fixedCode": "in-progress",
                "mustSupport": true
            },
            {
                "id": "Encounter.class",
                "path": "Encounter.class",
                "constraint":  [
                    {
                        "key": "elem-2",
                        "severity": "error",
                        "human": "Virtual Encounter class must have modality value"
                    }
                ],
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://ontariohealth.ca/fhir/ValueSet/acCDR-encounter-class"
                },
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.2"
                    },
                    {
                        "identity": "virtual-visit",
                        "map": "Modality",
                        "comment": "Primary modality or channel of the virtual care event as either Video, Secure Messaging, or both"
                    }
                ]
            },
            {
                "id": "Encounter.class.system",
                "path": "Encounter.class.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.class.code",
                "path": "Encounter.class.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.class.display",
                "path": "Encounter.class.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.type",
                "path": "Encounter.type",
                "max": "1",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ontariohealth.ca/fhir/ValueSet/local-PV1-4values"
                },
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.4"
                    },
                    {
                        "identity": "virtual-visit",
                        "map": "Event Type",
                        "comment": "Describes the nature of the communication between participants"
                    }
                ]
            },
            {
                "id": "Encounter.type.coding",
                "path": "Encounter.type.coding",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.type.coding.system",
                "path": "Encounter.type.coding.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.type.coding.code",
                "path": "Encounter.type.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.type.coding.display",
                "path": "Encounter.type.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.serviceType",
                "path": "Encounter.serviceType",
                "comment": "If hospitals send MOH defined codes, those codes will be returned in coding. If hospitals only support free text, only text field will be returned.",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "description of the Hospital Service",
                    "valueSet": "http://cihi.ca/fhir/ValueSet/aac-hospital-service"
                },
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.10",
                        "comment": "coding will be mapped to MOH codes in v2.6. Pre 2.6 will only support text"
                    }
                ]
            },
            {
                "id": "Encounter.serviceType.coding",
                "path": "Encounter.serviceType.coding",
                "mustSupport": true
            },
            {
                "id": "Encounter.serviceType.coding.system",
                "path": "Encounter.serviceType.coding.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.serviceType.coding.code",
                "path": "Encounter.serviceType.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.serviceType.coding.display",
                "path": "Encounter.serviceType.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.serviceType.text",
                "path": "Encounter.serviceType.text",
                "mustSupport": true
            },
            {
                "id": "Encounter.priority",
                "path": "Encounter.priority",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "https://fhir.infoway-inforoute.ca/ValueSet/canadiantriageacuityscale"
                }
            },
            {
                "id": "Encounter.priority.coding",
                "path": "Encounter.priority.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Encounter.priority.coding.system",
                "path": "Encounter.priority.coding.system",
                "min": 1,
                "fixedUri": "http://ctas-phctas.ca/CodeSystem/canadian-triage-acuity-scale",
                "mustSupport": true
            },
            {
                "id": "Encounter.priority.coding.code",
                "path": "Encounter.priority.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.priority.coding.display",
                "path": "Encounter.priority.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.subject",
                "path": "Encounter.subject",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Patient",
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Patient-submission"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Encounter.subject.reference",
                "path": "Encounter.subject.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.participant",
                "path": "Encounter.participant",
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.type",
                "path": "Encounter.participant.type",
                "definition": "Role of participant in encounter. For virtual visit encounter, use type \"ATND\" (attender) to indicate Host Practitioner",
                "min": 1,
                "max": "1",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://ontariohealth.ca/fhir/ValueSet/acCDR-encounter-participant-type"
                }
            },
            {
                "id": "Encounter.participant.type.coding",
                "path": "Encounter.participant.type.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.type.coding.system",
                "path": "Encounter.participant.type.coding.system",
                "min": 1,
                "fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.type.coding.code",
                "path": "Encounter.participant.type.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.type.coding.display",
                "path": "Encounter.participant.type.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.individual",
                "path": "Encounter.participant.individual",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Practitioner",
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Practitioner-submission"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.individual.reference",
                "path": "Encounter.participant.individual.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.period",
                "path": "Encounter.period",
                "mustSupport": true
            },
            {
                "id": "Encounter.period.start",
                "path": "Encounter.period.start",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.44"
                    }
                ]
            },
            {
                "id": "Encounter.period.end",
                "path": "Encounter.period.end",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.45"
                    }
                ]
            },
            {
                "id": "Encounter.hospitalization",
                "path": "Encounter.hospitalization",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource",
                "path": "Encounter.hospitalization.admitSource",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "indicates the last point of entry prior to being admitted as an inpatient to the reporting facility",
                    "valueSet": "http://cihi.ca/fhir/ValueSet/aac-admit-source"
                },
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.14",
                        "comment": "Only supported post 2.6"
                    }
                ]
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding",
                "path": "Encounter.hospitalization.admitSource.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding.system",
                "path": "Encounter.hospitalization.admitSource.coding.system",
                "min": 1,
                "fixedUri": "http://cihi.ca/fhir/CodeSystem/aac-admit-source",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding.code",
                "path": "Encounter.hospitalization.admitSource.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding.display",
                "path": "Encounter.hospitalization.admitSource.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition",
                "path": "Encounter.hospitalization.dischargeDisposition",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "description": "disposition of the patient at time of discharge (i.e., discharged to home, expired, etc.).",
                    "valueSet": "http://cihi.ca/fhir/ValueSet/aac-discharge-disposition"
                }
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding",
                "path": "Encounter.hospitalization.dischargeDisposition.coding",
                "min": 1,
                "max": "1",
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.36",
                        "comment": "This field is added in v2.6"
                    }
                ]
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding.system",
                "path": "Encounter.hospitalization.dischargeDisposition.coding.system",
                "min": 1,
                "fixedUri": "http://cihi.ca/fhir/CodeSystem/aac-discharge-disposition"
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding.code",
                "path": "Encounter.hospitalization.dischargeDisposition.coding.code",
                "min": 1
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding.display",
                "path": "Encounter.hospitalization.dischargeDisposition.coding.display",
                "min": 1
            },
            {
                "id": "Encounter.location",
                "path": "Encounter.location",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "cdr-v2-data-in",
                        "map": "PV1.3"
                    }
                ]
            },
            {
                "id": "Encounter.location.location",
                "path": "Encounter.location.location",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Location"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Encounter.location.location.reference",
                "path": "Encounter.location.location.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.location.location.display",
                "path": "Encounter.location.location.display",
                "mustSupport": true
            },
            {
                "id": "Encounter.location.location.display.extension:bed-type",
                "path": "Encounter.location.location.display.extension",
                "sliceName": "bed-type",
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ext-encounter-bed-type"
                        ]
                    }
                ],
                "mustSupport": true,
                "isModifier": false
            },
            {
                "id": "Encounter.location.physicalType",
                "path": "Encounter.location.physicalType",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Encounter.location.physicalType.coding",
                "path": "Encounter.location.physicalType.coding",
                "min": 1,
                "max": "1",
                "mustSupport": true
            },
            {
                "id": "Encounter.location.physicalType.coding.system",
                "path": "Encounter.location.physicalType.coding.system",
                "min": 1,
                "fixedUri": "http://terminology.hl7.org/CodeSystem/location-physical-type",
                "mustSupport": true
            },
            {
                "id": "Encounter.location.physicalType.coding.code",
                "path": "Encounter.location.physicalType.coding.code",
                "min": 1,
                "fixedCode": "si",
                "mustSupport": true
            },
            {
                "id": "Encounter.location.physicalType.coding.display",
                "path": "Encounter.location.physicalType.coding.display",
                "min": 1,
                "fixedString": "Site",
                "mustSupport": true
            }
        ]
    }
}

Usage

The Encounter resource captures information about a patient visit. This could be acute related or virtual visit. Some elements use different values for acute and virtual visits. Pelase see notes below.

Notes

.meta.profile

  • used to declare conformance to this profile
  • populate with a fixed value: http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-Encounter|4.0.1

.contained

  • if populated, this contains the resources referenced by the Encounter resource

.identifier

  • SHALL contain a visit number assigned by the source system. For hospital visits, this typically comes from hospital's HIS. For virtual visits, this will be the event ID generated by the source system.

.status

  • SHALL specify the status of the encounter (e.g "in-progress", "finished", "cancelled")

.type

  • May be present. If present, it specifies the visit type defined by local HIS.

.class

  • indicate the classification of the patient encounter
  • virtual visits SHALL use value "virtual"

.type

  • indicates the general type of the visit
  • for virtual visit, this captures the modalities defined by Infoway
  • for hospital visits, this contains the CIHI defined AAC category values

.serviceType

  • for inpatient visits, this captures the hospital service of the visit identified by MOH code
  • for virtual visits, this captures "therapeutic are of care/service" information defined by OTN

.subject

  • SHALL contains a reference to the patient resource

.participant

  • SHOULD contain the attending provider, admitting provider, and referring providers.
  • participant.type contains the code indicating the type of physician (attending, admitting). For virtual visit, use code "ATND" (attending) which represents the host
  • participant.individual contains the reference to the practitioner resource in the bundle

.period

  • SHOULD contain the start and end (if exists) of the visit. This applies for hospital and virtual visits.

Note: start and end fields SHALL use the same dateTime format (both with a timestamp or just dates).

.length

  • SHOULD contain the length of the visit. If present, will contain the value and unit.

.reasonCode

  • SHOULD contain the code or free text of the reason for the visit. If code exists, use code. If only free text is available, use "text" field.

.diagnosis.condition

  • SHOULD contain the diagnosis related to the visit. If a standardized code is available, the reference will contain an identifier for the code. If only free text is available, the reference display will contain the text value.

.hospitalization.admitSource

  • SHOULD contain the admit source information for inpatient visit. This element supports the CIHI admitSource values.

.hospitalization.dischargeDisposition

  • SHOULD contain the discharge disposition information, if applicable. This element supports the CIHI dischargeDisposition values.

.location

  • SHOULD contain the locations of the visit
  • if present, must at least support a location reference that identifies the hospital facility of the visit
  • location.physicalType will be fixed to si for Site
  • if information such as bed, room, floor is available, they will be provided as "display" of the location reference
  • if bed type is available, it will be populated in the "bed type" extension under location.display