Work in progress.
This section of the Implementation Guide is subject to change.

Profile EEBaseEpisodeOfCare


Profile Purpose

EpisodeOfCare is an administrative FHIR resource intended for documenting related activities provided to the subject (patient) by the healthcare provider over a period of time. More specifically, EpisodeOfCare acts as a container resource that links a series of Encounters together for problems/issues (specific condition).

Example Usage Scenarios

  • Query for care episodes based on specific condition using the query parameter EpisodeOfCare.diagnosis.condition
  • Query for care episodes created for specific patient over time using the query parameter EpisodeOfCare.patient
  • Exchange EpisodeOfCare information within a FHIR document or message


Snapshot View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierS0..*Identifier
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
periodI1..1Period
typeS Σ0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition)
roleΣ0..1CodeableConceptBinding
rankΣ0..1positiveInt
patientS Σ I1..1Reference(EEBase Patient)
managingOrganizationS Σ I0..1Reference(EEBase Organization)
periodS Σ I0..1Period
referralRequestI0..*Reference(ServiceRequest)
careManagerI0..1Reference(EEBase Practitioner | EEBase PractitionerRole)
teamI0..*Reference(CareTeam)
accountI0..*Reference(Account)

Differential View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierS0..*Identifier
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
periodI1..1Period
typeS Σ0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition)
roleΣ0..1CodeableConceptBinding
rankΣ0..1positiveInt
patientS Σ I1..1Reference(EEBase Patient)
managingOrganizationS Σ I0..1Reference(EEBase Organization)
periodS Σ I0..1Period
referralRequestI0..*Reference(ServiceRequest)
careManagerI0..1Reference(EEBase Practitioner | EEBase PractitionerRole)
teamI0..*Reference(CareTeam)
accountI0..*Reference(Account)

Hybrid View

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierS0..*Identifier
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
periodI1..1Period
typeS Σ0..*CodeableConcept
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ I1..1Reference(Condition)
roleΣ0..1CodeableConceptBinding
rankΣ0..1positiveInt
patientS Σ I1..1Reference(EEBase Patient)
managingOrganizationS Σ I0..1Reference(EEBase Organization)
periodS Σ I0..1Period
referralRequestI0..*Reference(ServiceRequest)
careManagerI0..1Reference(EEBase Practitioner | EEBase PractitionerRole)
teamI0..*Reference(CareTeam)
accountI0..*Reference(Account)

Table View

EpisodeOfCare..
EpisodeOfCare.identifier..
EpisodeOfCare.status..
EpisodeOfCare.type..
EpisodeOfCare.patientReference(EEBase Patient)..
EpisodeOfCare.managingOrganizationReference(EEBase Organization)..
EpisodeOfCare.period..
EpisodeOfCare.careManagerReference(EEBase Practitioner | EEBase PractitionerRole)..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="EEBase-EpisodeOfCare" />
    <url value="https://hl7.ee/fhir/StructureDefinition/EEBase-EpisodeOfCare" />
    <version value="1.0.0" />
    <name value="EEBaseEpisodeOfCare" />
    <title value="EEBase EpisodeOfCare" />
    <status value="draft" />
    <date value="2022-06-28T15:25:50.3742229+00:00" />
    <publisher value="HL7 EE" />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="EpisodeOfCare" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
    <derivation value="constraint" />
    <differential>
        <element id="EpisodeOfCare.identifier">
            <path value="EpisodeOfCare.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.status">
            <path value="EpisodeOfCare.status" />
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.type">
            <path value="EpisodeOfCare.type" />
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.patient">
            <path value="EpisodeOfCare.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://hl7.ee/fhir/StructureDefinition/EEBase-Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.managingOrganization">
            <path value="EpisodeOfCare.managingOrganization" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://hl7.ee/fhir/StructureDefinition/EEBase-Organization" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.period">
            <path value="EpisodeOfCare.period" />
            <mustSupport value="true" />
        </element>
        <element id="EpisodeOfCare.careManager">
            <path value="EpisodeOfCare.careManager" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://hl7.ee/fhir/StructureDefinition/EEBase-Practitioner" />
                <targetProfile value="https://hl7.ee/fhir/StructureDefinition/EEBase-PractitionerRole" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "EEBase-EpisodeOfCare",
    "url": "https://hl7.ee/fhir/StructureDefinition/EEBase-EpisodeOfCare",
    "version": "1.0.0",
    "name": "EEBaseEpisodeOfCare",
    "title": "EEBase EpisodeOfCare",
    "status": "draft",
    "date": "2022-06-28T15:25:50.3742229+00:00",
    "publisher": "HL7 EE",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "EpisodeOfCare",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "EpisodeOfCare.identifier",
                "path": "EpisodeOfCare.identifier",
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.status",
                "path": "EpisodeOfCare.status",
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.type",
                "path": "EpisodeOfCare.type",
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.patient",
                "path": "EpisodeOfCare.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://hl7.ee/fhir/StructureDefinition/EEBase-Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.managingOrganization",
                "path": "EpisodeOfCare.managingOrganization",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://hl7.ee/fhir/StructureDefinition/EEBase-Organization"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.period",
                "path": "EpisodeOfCare.period",
                "mustSupport": true
            },
            {
                "id": "EpisodeOfCare.careManager",
                "path": "EpisodeOfCare.careManager",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://hl7.ee/fhir/StructureDefinition/EEBase-Practitioner",
                            "https://hl7.ee/fhir/StructureDefinition/EEBase-PractitionerRole"
                        ]
                    }
                ]
            }
        ]
    }
}


identifier (Must Support)

Business identifier(s) for which this specific EpisodeOfCare is known.


status (Must Support)

This is a mandatory data element.

A coded value of the considered status of this episode of care.
The required ValueSet used in this case is episode-of-care-status, meaning these values MUST be exchanged. Local value sets SHOULD be mapped to the required ValueSet.


HTML View

This code system http://hl7.org/fhir/episode-of-care-status defines the following codes:

CodeDisplayDefinition
plannedPlannedThis episode of care is planned to start at the date specified in the period.start. During this status, an organization may perform assessments to determine if the patient is eligible to receive services, or be organizing to make resources available to provide care services.
waitlistWaitlistThis episode has been placed on a waitlist, pending the episode being made active (or cancelled).
activeActiveThis episode of care is current.
onholdOn HoldThis episode of care is on hold; the organization has limited responsibility for the patient (such as while on respite).
finishedFinishedThis episode of care is finished and the organization is not expecting to be providing further care to the patient. Can also be known as "closed", "completed" or other similar terms.
cancelledCancelledThe episode of care was cancelled, or withdrawn from service, often selected during the planned stage as the patient may have gone elsewhere, or the circumstances have changed and the organization is unable to provide the care. It indicates that services terminated outside the planned/expected workflow.
entered-in-errorEntered in ErrorThis instance should not have been part of this patient's medical record.

Table View

CodeSystem.id[0]episode-of-care-status
CodeSystem.meta[0].lastUpdated[0]2019-11-01T09:29:23.356+11:00
CodeSystem.extension[0].url[0]http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
CodeSystem.extension[0].value[0]pa
CodeSystem.extension[1].url[0]http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
CodeSystem.extension[1].value[0]trial-use
CodeSystem.extension[2].url[0]http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
CodeSystem.extension[2].value[0]2
CodeSystem.url[0]http://hl7.org/fhir/episode-of-care-status
CodeSystem.identifier[0].system[0]urn:ietf:rfc:3986
CodeSystem.identifier[0].value[0]urn:oid:2.16.840.1.113883.4.642.4.665
CodeSystem.version[0]4.0.1
CodeSystem.name[0]EpisodeOfCareStatus
CodeSystem.title[0]EpisodeOfCareStatus
CodeSystem.status[0]draft
CodeSystem.experimental[0]False
CodeSystem.date[0]2019-11-01T09:29:23+11:00
CodeSystem.publisher[0]HL7 (FHIR Project)
CodeSystem.contact[0].telecom[0].system[0]url
CodeSystem.contact[0].telecom[0].value[0]http://hl7.org/fhir
CodeSystem.contact[0].telecom[1].system[0]email
CodeSystem.contact[0].telecom[1].value[0]fhir@lists.hl7.org
CodeSystem.description[0]The status of the episode of care.
CodeSystem.caseSensitive[0]True
CodeSystem.valueSet[0]http://hl7.org/fhir/ValueSet/episode-of-care-status
CodeSystem.content[0]complete
CodeSystem.concept[0].code[0]planned
CodeSystem.concept[0].display[0]Planned
CodeSystem.concept[0].definition[0]This episode of care is planned to start at the date specified in the period.start. During this status, an organization may perform assessments to determine if the patient is eligible to receive services, or be organizing to make resources available to provide care services.
CodeSystem.concept[1].code[0]waitlist
CodeSystem.concept[1].display[0]Waitlist
CodeSystem.concept[1].definition[0]This episode has been placed on a waitlist, pending the episode being made active (or cancelled).
CodeSystem.concept[2].code[0]active
CodeSystem.concept[2].display[0]Active
CodeSystem.concept[2].definition[0]This episode of care is current.
CodeSystem.concept[3].code[0]onhold
CodeSystem.concept[3].display[0]On Hold
CodeSystem.concept[3].definition[0]This episode of care is on hold; the organization has limited responsibility for the patient (such as while on respite).
CodeSystem.concept[4].code[0]finished
CodeSystem.concept[4].display[0]Finished
CodeSystem.concept[4].definition[0]This episode of care is finished and the organization is not expecting to be providing further care to the patient. Can also be known as "closed", "completed" or other similar terms.
CodeSystem.concept[5].code[0]cancelled
CodeSystem.concept[5].display[0]Cancelled
CodeSystem.concept[5].definition[0]The episode of care was cancelled, or withdrawn from service, often selected during the planned stage as the patient may have gone elsewhere, or the circumstances have changed and the organization is unable to provide the care. It indicates that services terminated outside the planned/expected workflow.
CodeSystem.concept[6].code[0]entered-in-error
CodeSystem.concept[6].display[0]Entered in Error
CodeSystem.concept[6].definition[0]This instance should not have been part of this patient's medical record.

XML View

<CodeSystem xmlns="http://hl7.org/fhir">
    <id value="episode-of-care-status" />
    <meta>
        <lastUpdated value="2019-11-01T09:29:23.356+11:00" />
    </meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="pa" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use" />
    </extension>
    <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="2" />
    </extension>
    <url value="http://hl7.org/fhir/episode-of-care-status" />
    <identifier>
        <system value="urn:ietf:rfc:3986" />
        <value value="urn:oid:2.16.840.1.113883.4.642.4.665" />
    </identifier>
    <version value="4.0.1" />
    <name value="EpisodeOfCareStatus" />
    <title value="EpisodeOfCareStatus" />
    <status value="draft" />
    <experimental value="false" />
    <date value="2019-11-01T09:29:23+11:00" />
    <publisher value="HL7 (FHIR Project)" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="http://hl7.org/fhir" />
        </telecom>
        <telecom>
            <system value="email" />
            <value value="fhir@lists.hl7.org" />
        </telecom>
    </contact>
    <description value="The status of the episode of care." />
    <caseSensitive value="true" />
    <valueSet value="http://hl7.org/fhir/ValueSet/episode-of-care-status" />
    <content value="complete" />
    <concept>
        <code value="planned" />
        <display value="Planned" />
        <definition value="This episode of care is planned to start at the date specified in the period.start. During this status, an organization may perform assessments to determine if the patient is eligible to receive services, or be organizing to make resources available to provide care services." />
    </concept>
    <concept>
        <code value="waitlist" />
        <display value="Waitlist" />
        <definition value="This episode has been placed on a waitlist, pending the episode being made active (or cancelled)." />
    </concept>
    <concept>
        <code value="active" />
        <display value="Active" />
        <definition value="This episode of care is current." />
    </concept>
    <concept>
        <code value="onhold" />
        <display value="On Hold" />
        <definition value="This episode of care is on hold; the organization has limited responsibility for the patient (such as while on respite)." />
    </concept>
    <concept>
        <code value="finished" />
        <display value="Finished" />
        <definition value="This episode of care is finished and the organization is not expecting to be providing further care to the patient. Can also be known as &quot;closed&quot;, &quot;completed&quot; or other similar terms." />
    </concept>
    <concept>
        <code value="cancelled" />
        <display value="Cancelled" />
        <definition value="The episode of care was cancelled, or withdrawn from service, often selected during the planned stage as the patient may have gone elsewhere, or the circumstances have changed and the organization is unable to provide the care. It indicates that services terminated outside the planned/expected workflow." />
    </concept>
    <concept>
        <code value="entered-in-error" />
        <display value="Entered in Error" />
        <definition value="This instance should not have been part of this patient&#39;s medical record." />
    </concept>
</CodeSystem>

JSON View

{
    "resourceType": "CodeSystem",
    "id": "episode-of-care-status",
    "meta": {
        "lastUpdated": "2019-11-01T09:29:23.356+11:00"
    },
    "extension":  [
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
            "valueCode": "pa"
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
            "valueCode": "trial-use"
        },
        {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
            "valueInteger": 2
        }
    ],
    "url": "http://hl7.org/fhir/episode-of-care-status",
    "identifier":  [
        {
            "system": "urn:ietf:rfc:3986",
            "value": "urn:oid:2.16.840.1.113883.4.642.4.665"
        }
    ],
    "version": "4.0.1",
    "name": "EpisodeOfCareStatus",
    "title": "EpisodeOfCareStatus",
    "status": "draft",
    "experimental": false,
    "date": "2019-11-01T09:29:23+11:00",
    "publisher": "HL7 (FHIR Project)",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "http://hl7.org/fhir"
                },
                {
                    "system": "email",
                    "value": "fhir@lists.hl7.org"
                }
            ]
        }
    ],
    "description": "The status of the episode of care.",
    "caseSensitive": true,
    "valueSet": "http://hl7.org/fhir/ValueSet/episode-of-care-status",
    "content": "complete",
    "concept":  [
        {
            "code": "planned",
            "display": "Planned",
            "definition": "This episode of care is planned to start at the date specified in the period.start. During this status, an organization may perform assessments to determine if the patient is eligible to receive services, or be organizing to make resources available to provide care services."
        },
        {
            "code": "waitlist",
            "display": "Waitlist",
            "definition": "This episode has been placed on a waitlist, pending the episode being made active (or cancelled)."
        },
        {
            "code": "active",
            "display": "Active",
            "definition": "This episode of care is current."
        },
        {
            "code": "onhold",
            "display": "On Hold",
            "definition": "This episode of care is on hold; the organization has limited responsibility for the patient (such as while on respite)."
        },
        {
            "code": "finished",
            "display": "Finished",
            "definition": "This episode of care is finished and the organization is not expecting to be providing further care to the patient. Can also be known as \"closed\", \"completed\" or other similar terms."
        },
        {
            "code": "cancelled",
            "display": "Cancelled",
            "definition": "The episode of care was cancelled, or withdrawn from service, often selected during the planned stage as the patient may have gone elsewhere, or the circumstances have changed and the organization is unable to provide the care. It indicates that services terminated outside the planned/expected workflow."
        },
        {
            "code": "entered-in-error",
            "display": "Entered in Error",
            "definition": "This instance should not have been part of this patient's medical record."
        }
    ]
}


statusHistory

The list of status codes this EpisodeOfCare has been attributed with in the past. Usually the care episode changes its status over time, so a period of start and end time indicative of the duration of a particular status should be populated.

The required ValueSet used in this case is episode-of-care-status, meaning these values MUST be exchanged. Local value sets SHOULD be mapped to the required ValueSet.


type (Must Support)

This value set for this data element is currently in development.
Classification of the type of EpisodeOfCare.

The ValueSet used in this case is EEBaseEpisodeOfCareType. As a value set with Example binding, using this value set is not strictly expected.

diagnosis

Please note that this data element includes a reference to Condition resource which has not been covered (profiled) in this Implementation Guide.
The list of diagnosis relevant to this EpisodeOfCare. If populated, reference to Condition resource MUST be provided.

patient (Must Support)

This is a mandatory data element.

The patient subject to this episode of care by reference to EEBasePatient.


managingOrganization (Must Support)

The organization responsible for healthcare activities provided for the specified duration by reference to EEBaseOrganization.


period (Must Support)

The time period healthcare activities are/were being provided by the managing organization responsible (managingOrganization).


referralRequest

Please note that this data element includes a reference to ServiceRequest resource which has not been covered (profiled)in this Implementation Guide.
Reference(s) to incoming referral(s) that are fulfilled by this EpisodeOfCare.

careManager

The practitioner fulfilling the role of care manager/care coordinator in relation to this EpisodeOfCare by reference to EEBasePractitioner or EEBasePractitionerRole.


team

Please note that this data element includes a reference to CareTeam resource which has not been covered (profiled) in this Implementation Guide.
The list of practitioners who have presumed a participatory role in this EpisodeOfCare.

account

Please note that this data element includes a reference to Account resource which has not been covered (profiled) in this Implementation Guide.
The list of accounts ("container" resource against which charges, payments, and adjustments are applied) that may be used for billing for this EpisodeOfCare.