Wales FHIR Implementation Guide

DataStandardsWales-Encounter

Overview

The Encounter resource is used to describe a patient’s attendance at a healthcare facility. Encounters can take place in many forms, such as:

An emergency or scheduled hospital admission
An outpatient consultation
A visit to the GP, or virtual attendance via video link
Attendance at a mobile breast cancer screening clinic
Attendance at a mass vaccination centre to receive a vaccination
A visit from a health care professional to the patient’s home

The DataStandardsWales-Encounter profile is derived from the UK Core Encounter Profile and is therefore listed as experimental. It defines additional rules for use within health and care organisations in Wales.

A direct link to the Data Standards Wales asset can be accessed here - Data Standards Wales Encounter

Formal Views of Profile Content

Snapshot View
Differential View
Hybrid View
Examples

DataStandardsWalesEncounter (Encounter)

UKCoreEncounter

There are no (further) constraints on this element

Element id

Encounter

Short description

An interaction during which services are provided to the patient

Alternate names

Visit

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.

Data type

UKCoreEncounter

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Encounter[@moodCode='EVN']

0..1

string

There are no (further) constraints on this element

Element id

Encounter.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

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.

Data type

string

Meta

There are no (further) constraints on this element

Element id

Encounter.meta

Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Encounter.implicitRules

Short description

A set of rules under which this content was created

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.

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.

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Encounter.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

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.

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.

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Encounter.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

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.

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.

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

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.

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

dischargeMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:dischargeMethod

Short description

An extension to support the method of discharge from a hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

emergencyCareDischargeStatus

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:emergencyCareDischargeStatus

Short description

An extension to support the status of an individual on discharge from an Emergency Care Department.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

legalStatus

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Encounter.extension:legalStatus

Short description

Information relating to a patient's legal status on admission or discharge.

Alternate names

extensions, user content

Definition

Information relating to a patient's legal status on admission or discharge.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

OutcomeOfAttendance

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:OutcomeOfAttendance

Short description

An extension to support the outcome of an Outpatient attendance.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Speciality

S C

0..*

Extension(CodeableConcept)

Element id

Encounter.extension:Speciality

Short description

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Alternate names

extensions, user content

Definition

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.nhs.wales/StructureDefinition/Extension-DataStandardsWales-Speciality

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

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).

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

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

S Σ

0..*

Identifier

There are no (further) constraints on this element

Element id

Encounter.identifier

Short description

Identifier(s) by which this encounter is known

Definition

Identifier(s) by which this encounter is known.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
v2: PV1-19
rim: .id

status

S Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.status

Short description

Definition

Comments

Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status
v2: No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
rim: .statusCode

statusHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.statusHistory

Short description

List of past encounter statuses

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.

Comments

The current status is always found in the current version of the resource, not the status history.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.statusHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

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.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

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).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

status

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.statusHistory.status

Short description

Definition

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.statusHistory.period

Short description

The time that the episode was in the specified status

Definition

The time that the episode was in the specified status.

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.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

class

S Σ

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.class

Short description

Classification of patient encounter

Definition

Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
w5: FiveWs.class
v2: PV1-2
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code

classHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.classHistory

Short description

List of past encounter classes

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.classHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

class

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.classHistory.class

Short description

inpatient | outpatient | ambulatory | emergency +

Definition

inpatient | outpatient | ambulatory | emergency +.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.classHistory.period

Short description

The time that the episode was in the specified class

Definition

The time that the episode was in the specified class.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.type

Short description

Specific type of encounter

Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

Comments

Since there are many ways to further classify encounters, this element is 0..*.

Data 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).

UKCoreEncounterType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
w5: FiveWs.class
v2: PV1-4 / PV1-18
rim: .code

serviceType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.serviceType

Short description

Specific type of service

Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

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.

Data 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.

UKCoreCareSettingType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: PV1-10

priority

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.priority

Short description

Indicates the urgency of the encounter

Definition

Indicates the urgency of the encounter.

Comments

Data type

CodeableConcept

Binding

Indicates the urgency of the encounter.

v3.ActPriority (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
w5: FiveWs.grade
v2: PV2-25
rim: .priorityCode

subject

S Σ C

0..1

Reference(Group | DataStandardsWalesPatient)

Element id

Encounter.subject

Short description

The patient or group present at the encounter

Alternate names

patient

Definition

The patient or group present at the encounter.

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).

Data type

Reference(Group | DataStandardsWalesPatient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ]/role[classCode=PAT]
w5: FiveWs.subject

episodeOfCare

Σ C

0..*

Reference(EpisodeOfCare)

There are no (further) constraints on this element

Element id

Encounter.episodeOfCare

Short description

Episode(s) of care that this encounter should be recorded against

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).

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.

Data type

Reference(EpisodeOfCare)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
w5: FiveWs.context
v2: PV1-54, PV1-53

basedOn

0..*

Reference(DataStandardsWalesServiceRequest)

Element id

Encounter.basedOn

Short description

The ServiceRequest that initiated this encounter

Alternate names

incomingReferral

Definition

The request this encounter satisfies (e.g. incoming referral or procedure request).

Comments

Data type

Reference(DataStandardsWalesServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
rim: .reason.ClinicalDocument

participant

S Σ

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.participant

Short description

List of participants involved in the encounter

Definition

The list of people responsible for providing the service.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: ROL
rim: .participation[typeCode=PFM]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.participant.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.participant.type

Short description

Role of participant in encounter

Definition

Role of participant in encounter.

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.

Data type

CodeableConcept

Binding

Role of participant in encounter.

ParticipantType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.function
v2: ROL-3 (or maybe PRT-4)
rim: .functionCode

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.participant.period

Short description

Period of time during the encounter that the participant participated

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: ROL-5, ROL-6 (or maybe PRT-5)
rim: .time

individual

Σ C

0..1

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Element id

Encounter.participant.individual

Short description

Persons involved in the encounter other than the patient

Definition

Persons involved in the encounter other than the patient.

Comments

Data type

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
w5: FiveWs.who
v2: ROL-4
rim: .role

appointment

Σ C

0..*

Reference(DataStandardsWalesAppointment)

Element id

Encounter.appointment

Short description

The appointment that scheduled this encounter

Definition

The appointment that scheduled this encounter.

Comments

Data type

Reference(DataStandardsWalesAppointment)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: SCH-1 / SCH-2
rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.period

Short description

The start and end time of the encounter

Definition

The start and end time of the encounter.

Comments

If not (yet) known, the end of the Period may be omitted.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
v2: PV1-44, PV1-45
rim: .effectiveTime (low & high)

length

0..1

Duration

There are no (further) constraints on this element

Element id

Encounter.length

Short description

Quantity of time the encounter lasted (less time absent)

Definition

Quantity of time the encounter lasted. This excludes the time during leaves of absence.

Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
workflow: Event.occurrence[x]
v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
rim: .lengthOfStayQuantity

reasonCode

S Σ

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.reasonCode

Short description

Coded reason the encounter takes place

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

CodeableConcept

Binding

Reason why the encounter takes place.

EncounterReasonCodes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

reasonReference

S Σ C

0..*

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Element id

Encounter.reasonReference

Short description

Reason the encounter takes place (reference)

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

diagnosis

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.diagnosis

Short description

The list of diagnosis relevant to this encounter

Definition

The list of diagnosis relevant to this encounter.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.diagnosis.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

condition

Σ C

1..1

Reference(UKCoreCondition | UKCoreProcedure)

Element id

Encounter.diagnosis.condition

Short description

The diagnosis or procedure relevant to the encounter

Alternate names

Admission diagnosis, discharge diagnosis, indication

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.

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).

Data type

Reference(UKCoreCondition | UKCoreProcedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
v2: Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
rim: .outboundRelationship[typeCode=RSON].target

use

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.diagnosis.use

Short description

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)

Definition

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

Comments

Data type

CodeableConcept

Binding

The type of diagnosis this condition represents.

DiagnosisRole (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rank

0..1

positiveInt

There are no (further) constraints on this element

Element id

Encounter.diagnosis.rank

Short description

Ranking of the diagnosis (for each role type)

Definition

Ranking of the diagnosis (for each role type).

Comments

32 bit number; for values larger than this, use decimal

Data type

positiveInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON].priority

account

0..*

Reference(Account)

There are no (further) constraints on this element

Element id

Encounter.account

Short description

The set of accounts that may be used for billing for this Encounter

Definition

The set of accounts that may be used for billing for this Encounter.

Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Data type

Reference(Account)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .pertains.A_Account

hospitalization

0..1

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.hospitalization

Short description

Details about the admission to a healthcare service

Definition

Details about the admission to a healthcare service.

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.hospitalization.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

admissionMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.hospitalization.extension:admissionMethod

Short description

An extension to support the method by which an individual was admitted into hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

preAdmissionIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

Encounter.hospitalization.preAdmissionIdentifier

Short description

Pre-admission identifier

Definition

Pre-admission identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
v2: PV1-5
rim: .id

origin

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.origin

Short description

The location/organization from which the patient came before admission

Definition

The location/organization from which the patient came before admission.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .participation[typeCode=ORG].role

admitSource

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.admitSource

Short description

From where patient was admitted (physician referral, transfer)

Definition

From where patient was admitted (physician referral, transfer).

Comments

Data 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.

UKCoreSourceOfAdmission (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-14
rim: .admissionReferralSourceCode

reAdmission

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.reAdmission

Short description

The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission

Definition

Whether this hospitalization is a readmission and why if known.

Comments

Data type

CodeableConcept

Binding

The reason for re-admission of this hospitalization encounter.

v2.0092 (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-13

dietPreference

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dietPreference

Short description

Diet preferences reported by the patient

Definition

Diet preferences reported by the patient.

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).

Data type

CodeableConcept

Binding

Medical, cultural or ethical food preferences to help with catering requirements.

Diet (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-38
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]

specialCourtesy

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialCourtesy

Short description

Special courtesies (VIP, board member)

Definition

Special courtesies (VIP, board member).

Comments

Data type

CodeableConcept

Binding

Special courtesies.

SpecialCourtesy (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-16
rim: .specialCourtesiesCode

specialArrangement

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialArrangement

Short description

Wheelchair, translator, stretcher, etc.

Definition

Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

Comments

Data type

CodeableConcept

Binding

Special arrangements.

SpecialArrangements (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-15 / OBR-30 / OBR-43
rim: .specialArrangementCode

destination

S C

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.destination

Short description

Location/organization to which the patient is discharged

Definition

Location/organization to which the patient is discharged.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PV1-37
rim: .participation[typeCode=DST]

dischargeDisposition

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dischargeDisposition

Short description

Category or kind of location after discharge

Definition

Category or kind of location after discharge.

Comments

Data 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.

UKCoreDischargeDestination (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-36
rim: .dischargeDispositionCode

location

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.location

Short description

List of locations where the patient has been

Definition

List of locations where the patient has been during this encounter.

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".

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=LOC]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.location.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

location

1..1

Reference(DataStandardsWalesLocation)

Element id

Encounter.location.location

Short description

Location the encounter takes place

Definition

The location where the encounter takes place.

Comments

Data type

Reference(DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.location
w5: FiveWs.where[x]
v2: PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
rim: .role

status

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.location.status

Short description

planned | active | reserved | completed

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.

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.

Data type

code

Binding

The status of the location.

EncounterLocationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .role.statusCode

physicalType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.location.physicalType

Short description

The physical type of the location (usually the level in the location hierachy - bed room ward etc.)

Definition

This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

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.

Data type

CodeableConcept

Binding

A set of codes that define the physical type of location where an encounter takes place.

UKCoreEncounterLocationType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.location.period

Short description

Time period during which the patient was present at the location

Definition

Time period during which the patient was present at the location.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
rim: .time

serviceProvider

S C

0..1

Reference(DataStandardsWalesOrganization)

Element id

Encounter.serviceProvider

Short description

The organization (facility) responsible for this encounter

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.

Comments

Data type

Reference(DataStandardsWalesOrganization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PL.6 & PL.1
rim: .particiaption[typeCode=PFM].role

partOf

0..1

Reference(DataStandardsWalesEncounter)

Element id

Encounter.partOf

Short description

Another Encounter this encounter is part of

Definition

Another Encounter of which this encounter is a part of (administratively or in time).

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.

Data type

Reference(DataStandardsWalesEncounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.partOf
rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]

DataStandardsWalesEncounter (Encounter)

UKCoreEncounter

There are no (further) constraints on this element

Element id

Encounter

Short description

An interaction during which services are provided to the patient

Alternate names

Visit

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.

Data type

UKCoreEncounter

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Encounter[@moodCode='EVN']

0..1

string

There are no (further) constraints on this element

Element id

Encounter.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

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.

Data type

string

Meta

There are no (further) constraints on this element

Element id

Encounter.meta

Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Encounter.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Encounter.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Encounter.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

dischargeMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:dischargeMethod

Short description

An extension to support the method of discharge from a hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

emergencyCareDischargeStatus

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:emergencyCareDischargeStatus

Short description

An extension to support the status of an individual on discharge from an Emergency Care Department.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

legalStatus

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Encounter.extension:legalStatus

Short description

Information relating to a patient's legal status on admission or discharge.

Alternate names

extensions, user content

Definition

Information relating to a patient's legal status on admission or discharge.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

OutcomeOfAttendance

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:OutcomeOfAttendance

Short description

An extension to support the outcome of an Outpatient attendance.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Speciality

S C

0..*

Extension(CodeableConcept)

Element id

Encounter.extension:Speciality

Short description

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Alternate names

extensions, user content

Definition

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.nhs.wales/StructureDefinition/Extension-DataStandardsWales-Speciality

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

S Σ

0..*

Identifier

There are no (further) constraints on this element

Element id

Encounter.identifier

Short description

Identifier(s) by which this encounter is known

Definition

Identifier(s) by which this encounter is known.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
v2: PV1-19
rim: .id

status

S Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.status

Short description

Definition

Comments

Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status
v2: No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
rim: .statusCode

statusHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.statusHistory

Short description

List of past encounter statuses

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.

Comments

The current status is always found in the current version of the resource, not the status history.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.statusHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

status

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.statusHistory.status

Short description

Definition

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.statusHistory.period

Short description

The time that the episode was in the specified status

Definition

The time that the episode was in the specified status.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

class

S Σ

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.class

Short description

Classification of patient encounter

Definition

Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
w5: FiveWs.class
v2: PV1-2
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code

classHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.classHistory

Short description

List of past encounter classes

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.classHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

class

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.classHistory.class

Short description

inpatient | outpatient | ambulatory | emergency +

Definition

inpatient | outpatient | ambulatory | emergency +.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.classHistory.period

Short description

The time that the episode was in the specified class

Definition

The time that the episode was in the specified class.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.type

Short description

Specific type of encounter

Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

Comments

Since there are many ways to further classify encounters, this element is 0..*.

Data 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).

UKCoreEncounterType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
w5: FiveWs.class
v2: PV1-4 / PV1-18
rim: .code

serviceType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.serviceType

Short description

Specific type of service

Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

Comments

Data 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.

UKCoreCareSettingType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: PV1-10

priority

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.priority

Short description

Indicates the urgency of the encounter

Definition

Indicates the urgency of the encounter.

Comments

Data type

CodeableConcept

Binding

Indicates the urgency of the encounter.

v3.ActPriority (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
w5: FiveWs.grade
v2: PV2-25
rim: .priorityCode

subject

S Σ C

0..1

Reference(Group | DataStandardsWalesPatient)

Element id

Encounter.subject

Short description

The patient or group present at the encounter

Alternate names

patient

Definition

The patient or group present at the encounter.

Comments

Data type

Reference(Group | DataStandardsWalesPatient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ]/role[classCode=PAT]
w5: FiveWs.subject

episodeOfCare

Σ C

0..*

Reference(EpisodeOfCare)

There are no (further) constraints on this element

Element id

Encounter.episodeOfCare

Short description

Episode(s) of care that this encounter should be recorded against

Definition

Comments

Data type

Reference(EpisodeOfCare)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
w5: FiveWs.context
v2: PV1-54, PV1-53

basedOn

0..*

Reference(DataStandardsWalesServiceRequest)

Element id

Encounter.basedOn

Short description

The ServiceRequest that initiated this encounter

Alternate names

incomingReferral

Definition

The request this encounter satisfies (e.g. incoming referral or procedure request).

Comments

Data type

Reference(DataStandardsWalesServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
rim: .reason.ClinicalDocument

participant

S Σ

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.participant

Short description

List of participants involved in the encounter

Definition

The list of people responsible for providing the service.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: ROL
rim: .participation[typeCode=PFM]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.participant.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.participant.type

Short description

Role of participant in encounter

Definition

Role of participant in encounter.

Comments

Data type

CodeableConcept

Binding

Role of participant in encounter.

ParticipantType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.function
v2: ROL-3 (or maybe PRT-4)
rim: .functionCode

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.participant.period

Short description

Period of time during the encounter that the participant participated

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: ROL-5, ROL-6 (or maybe PRT-5)
rim: .time

individual

Σ C

0..1

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Element id

Encounter.participant.individual

Short description

Persons involved in the encounter other than the patient

Definition

Persons involved in the encounter other than the patient.

Comments

Data type

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
w5: FiveWs.who
v2: ROL-4
rim: .role

appointment

Σ C

0..*

Reference(DataStandardsWalesAppointment)

Element id

Encounter.appointment

Short description

The appointment that scheduled this encounter

Definition

The appointment that scheduled this encounter.

Comments

Data type

Reference(DataStandardsWalesAppointment)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: SCH-1 / SCH-2
rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.period

Short description

The start and end time of the encounter

Definition

The start and end time of the encounter.

Comments

If not (yet) known, the end of the Period may be omitted.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
v2: PV1-44, PV1-45
rim: .effectiveTime (low & high)

length

0..1

Duration

There are no (further) constraints on this element

Element id

Encounter.length

Short description

Quantity of time the encounter lasted (less time absent)

Definition

Quantity of time the encounter lasted. This excludes the time during leaves of absence.

Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
workflow: Event.occurrence[x]
v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
rim: .lengthOfStayQuantity

reasonCode

S Σ

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.reasonCode

Short description

Coded reason the encounter takes place

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

CodeableConcept

Binding

Reason why the encounter takes place.

EncounterReasonCodes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

reasonReference

S Σ C

0..*

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Element id

Encounter.reasonReference

Short description

Reason the encounter takes place (reference)

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

diagnosis

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.diagnosis

Short description

The list of diagnosis relevant to this encounter

Definition

The list of diagnosis relevant to this encounter.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.diagnosis.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

condition

Σ C

1..1

Reference(UKCoreCondition | UKCoreProcedure)

Element id

Encounter.diagnosis.condition

Short description

The diagnosis or procedure relevant to the encounter

Alternate names

Admission diagnosis, discharge diagnosis, indication

Definition

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).

Data type

Reference(UKCoreCondition | UKCoreProcedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
v2: Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
rim: .outboundRelationship[typeCode=RSON].target

use

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.diagnosis.use

Short description

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)

Definition

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

Comments

Data type

CodeableConcept

Binding

The type of diagnosis this condition represents.

DiagnosisRole (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rank

0..1

positiveInt

There are no (further) constraints on this element

Element id

Encounter.diagnosis.rank

Short description

Ranking of the diagnosis (for each role type)

Definition

Ranking of the diagnosis (for each role type).

Comments

32 bit number; for values larger than this, use decimal

Data type

positiveInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON].priority

account

0..*

Reference(Account)

There are no (further) constraints on this element

Element id

Encounter.account

Short description

The set of accounts that may be used for billing for this Encounter

Definition

The set of accounts that may be used for billing for this Encounter.

Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Data type

Reference(Account)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .pertains.A_Account

hospitalization

0..1

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.hospitalization

Short description

Details about the admission to a healthcare service

Definition

Details about the admission to a healthcare service.

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.hospitalization.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

admissionMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.hospitalization.extension:admissionMethod

Short description

An extension to support the method by which an individual was admitted into hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

preAdmissionIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

Encounter.hospitalization.preAdmissionIdentifier

Short description

Pre-admission identifier

Definition

Pre-admission identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
v2: PV1-5
rim: .id

origin

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.origin

Short description

The location/organization from which the patient came before admission

Definition

The location/organization from which the patient came before admission.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .participation[typeCode=ORG].role

admitSource

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.admitSource

Short description

From where patient was admitted (physician referral, transfer)

Definition

From where patient was admitted (physician referral, transfer).

Comments

Data 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.

UKCoreSourceOfAdmission (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-14
rim: .admissionReferralSourceCode

reAdmission

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.reAdmission

Short description

The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission

Definition

Whether this hospitalization is a readmission and why if known.

Comments

Data type

CodeableConcept

Binding

The reason for re-admission of this hospitalization encounter.

v2.0092 (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-13

dietPreference

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dietPreference

Short description

Diet preferences reported by the patient

Definition

Diet preferences reported by the patient.

Requirements

Comments

For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Data type

CodeableConcept

Binding

Medical, cultural or ethical food preferences to help with catering requirements.

Diet (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-38
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]

specialCourtesy

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialCourtesy

Short description

Special courtesies (VIP, board member)

Definition

Special courtesies (VIP, board member).

Comments

Data type

CodeableConcept

Binding

Special courtesies.

SpecialCourtesy (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-16
rim: .specialCourtesiesCode

specialArrangement

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialArrangement

Short description

Wheelchair, translator, stretcher, etc.

Definition

Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

Comments

Data type

CodeableConcept

Binding

Special arrangements.

SpecialArrangements (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-15 / OBR-30 / OBR-43
rim: .specialArrangementCode

destination

S C

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.destination

Short description

Location/organization to which the patient is discharged

Definition

Location/organization to which the patient is discharged.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PV1-37
rim: .participation[typeCode=DST]

dischargeDisposition

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dischargeDisposition

Short description

Category or kind of location after discharge

Definition

Category or kind of location after discharge.

Comments

Data 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.

UKCoreDischargeDestination (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-36
rim: .dischargeDispositionCode

location

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.location

Short description

List of locations where the patient has been

Definition

List of locations where the patient has been during this encounter.

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".

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=LOC]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.location.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

location

1..1

Reference(DataStandardsWalesLocation)

Element id

Encounter.location.location

Short description

Location the encounter takes place

Definition

The location where the encounter takes place.

Comments

Data type

Reference(DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.location
w5: FiveWs.where[x]
v2: PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
rim: .role

status

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.location.status

Short description

planned | active | reserved | completed

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.

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.

Data type

code

Binding

The status of the location.

EncounterLocationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .role.statusCode

physicalType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.location.physicalType

Short description

The physical type of the location (usually the level in the location hierachy - bed room ward etc.)

Definition

This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

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.

Data type

CodeableConcept

Binding

A set of codes that define the physical type of location where an encounter takes place.

UKCoreEncounterLocationType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.location.period

Short description

Time period during which the patient was present at the location

Definition

Time period during which the patient was present at the location.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
rim: .time

serviceProvider

S C

0..1

Reference(DataStandardsWalesOrganization)

Element id

Encounter.serviceProvider

Short description

The organization (facility) responsible for this encounter

Definition

Comments

Data type

Reference(DataStandardsWalesOrganization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PL.6 & PL.1
rim: .particiaption[typeCode=PFM].role

partOf

0..1

Reference(DataStandardsWalesEncounter)

Element id

Encounter.partOf

Short description

Another Encounter this encounter is part of

Definition

Another Encounter of which this encounter is a part of (administratively or in time).

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.

Data type

Reference(DataStandardsWalesEncounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.partOf
rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]

DataStandardsWalesEncounter (Encounter)

UKCoreEncounter

There are no (further) constraints on this element

Element id

Encounter

Short description

An interaction during which services are provided to the patient

Alternate names

Visit

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.

Data type

UKCoreEncounter

Constraints

dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management
text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
contained.meta.security.empty()

Mappings

rim: Entity. Role, or Act
workflow: Event
rim: Encounter[@moodCode='EVN']

0..1

string

There are no (further) constraints on this element

Element id

Encounter.id

Short description

Logical id of this artifact

Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

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.

Data type

string

Meta

There are no (further) constraints on this element

Element id

Encounter.meta

Short description

Metadata about the resource

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.

Data type

Meta

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Encounter.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Encounter.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: N/A
rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Encounter.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: Entity. Role, or Act
rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

dischargeMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:dischargeMethod

Short description

An extension to support the method of discharge from a hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

emergencyCareDischargeStatus

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:emergencyCareDischargeStatus

Short description

An extension to support the status of an individual on discharge from an Emergency Care Department.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

legalStatus

0..*

Extension(Complex)

There are no (further) constraints on this element

Element id

Encounter.extension:legalStatus

Short description

Information relating to a patient's legal status on admission or discharge.

Alternate names

extensions, user content

Definition

Information relating to a patient's legal status on admission or discharge.

Comments

Data type

Extension(Complex)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

OutcomeOfAttendance

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.extension:OutcomeOfAttendance

Short description

An extension to support the outcome of an Outpatient attendance.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

Speciality

S C

0..*

Extension(CodeableConcept)

Element id

Encounter.extension:Speciality

Short description

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Alternate names

extensions, user content

Definition

The specialty of a practitioner that would be required to perform the service requested in this appointmen

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.nhs.wales/StructureDefinition/Extension-DataStandardsWales-Speciality

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

identifier

S Σ

0..*

Identifier

There are no (further) constraints on this element

Element id

Encounter.identifier

Short description

Identifier(s) by which this encounter is known

Definition

Identifier(s) by which this encounter is known.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
workflow: Event.identifier
w5: FiveWs.identifier
v2: PV1-19
rim: .id

status

S Σ ?!

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.status

Short description

Definition

Comments

Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.status
w5: FiveWs.status
v2: No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
rim: .statusCode

statusHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.statusHistory

Short description

List of past encounter statuses

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.

Comments

The current status is always found in the current version of the resource, not the status history.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.statusHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.statusHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

status

1..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.statusHistory.status

Short description

Definition

Comments

Note that FHIR strings SHALL NOT exceed 1MB in size

Data type

code

Binding

Current state of the encounter.

EncounterStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.statusHistory.period

Short description

The time that the episode was in the specified status

Definition

The time that the episode was in the specified status.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

class

S Σ

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.class

Short description

Classification of patient encounter

Definition

Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding
w5: FiveWs.class
v2: PV1-2
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code

classHistory

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.classHistory

Short description

List of past encounter classes

Definition

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

0..1

string

There are no (further) constraints on this element

Element id

Encounter.classHistory.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.classHistory.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

class

1..1

CodingBinding

There are no (further) constraints on this element

Element id

Encounter.classHistory.class

Short description

inpatient | outpatient | ambulatory | emergency +

Definition

inpatient | outpatient | ambulatory | emergency +.

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.

Data type

Coding

Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

period

1..1

Period

There are no (further) constraints on this element

Element id

Encounter.classHistory.period

Short description

The time that the episode was in the specified class

Definition

The time that the episode was in the specified class.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.type

Short description

Specific type of encounter

Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

Comments

Since there are many ways to further classify encounters, this element is 0..*.

Data 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).

UKCoreEncounterType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
w5: FiveWs.class
v2: PV1-4 / PV1-18
rim: .code

serviceType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.serviceType

Short description

Specific type of service

Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

Comments

Data 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.

UKCoreCareSettingType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.code
v2: PV1-10

priority

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.priority

Short description

Indicates the urgency of the encounter

Definition

Indicates the urgency of the encounter.

Comments

Data type

CodeableConcept

Binding

Indicates the urgency of the encounter.

v3.ActPriority (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
w5: FiveWs.grade
v2: PV2-25
rim: .priorityCode

subject

S Σ C

0..1

Reference(Group | DataStandardsWalesPatient)

Element id

Encounter.subject

Short description

The patient or group present at the encounter

Alternate names

patient

Definition

The patient or group present at the encounter.

Comments

Data type

Reference(Group | DataStandardsWalesPatient)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ]/role[classCode=PAT]
w5: FiveWs.subject

episodeOfCare

Σ C

0..*

Reference(EpisodeOfCare)

There are no (further) constraints on this element

Element id

Encounter.episodeOfCare

Short description

Episode(s) of care that this encounter should be recorded against

Definition

Comments

Data type

Reference(EpisodeOfCare)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.context
w5: FiveWs.context
v2: PV1-54, PV1-53

basedOn

0..*

Reference(DataStandardsWalesServiceRequest)

Element id

Encounter.basedOn

Short description

The ServiceRequest that initiated this encounter

Alternate names

incomingReferral

Definition

The request this encounter satisfies (e.g. incoming referral or procedure request).

Comments

Data type

Reference(DataStandardsWalesServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
rim: .reason.ClinicalDocument

participant

S Σ

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.participant

Short description

List of participants involved in the encounter

Definition

The list of people responsible for providing the service.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
workflow: Event.performer
v2: ROL
rim: .participation[typeCode=PFM]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.participant.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.participant.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

type

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.participant.type

Short description

Role of participant in encounter

Definition

Role of participant in encounter.

Comments

Data type

CodeableConcept

Binding

Role of participant in encounter.

ParticipantType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.performer.function
v2: ROL-3 (or maybe PRT-4)
rim: .functionCode

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.participant.period

Short description

Period of time during the encounter that the participant participated

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.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
v2: ROL-5, ROL-6 (or maybe PRT-5)
rim: .time

individual

Σ C

0..1

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Element id

Encounter.participant.individual

Short description

Persons involved in the encounter other than the patient

Definition

Persons involved in the encounter other than the patient.

Comments

Data type

Reference(DataStandardsWalesPractitioner | DataStandardsWalesPractitionerRole | DataStandardsWalesRelatedPerson)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
w5: FiveWs.who
v2: ROL-4
rim: .role

appointment

Σ C

0..*

Reference(DataStandardsWalesAppointment)

Element id

Encounter.appointment

Short description

The appointment that scheduled this encounter

Definition

The appointment that scheduled this encounter.

Comments

Data type

Reference(DataStandardsWalesAppointment)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.basedOn
v2: SCH-1 / SCH-2
rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.period

Short description

The start and end time of the encounter

Definition

The start and end time of the encounter.

Comments

If not (yet) known, the end of the Period may be omitted.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
workflow: Event.occurrence[x]
w5: FiveWs.done[x]
v2: PV1-44, PV1-45
rim: .effectiveTime (low & high)

length

0..1

Duration

There are no (further) constraints on this element

Element id

Encounter.length

Short description

Quantity of time the encounter lasted (less time absent)

Definition

Quantity of time the encounter lasted. This excludes the time during leaves of absence.

Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Data type

Duration

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present
code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
code.exists() implies ((system = %ucum) and value.exists())

Mappings

rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
workflow: Event.occurrence[x]
v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
rim: .lengthOfStayQuantity

reasonCode

S Σ

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.reasonCode

Short description

Coded reason the encounter takes place

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

CodeableConcept

Binding

Reason why the encounter takes place.

EncounterReasonCodes (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

reasonReference

S Σ C

0..*

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Element id

Encounter.reasonReference

Short description

Reason the encounter takes place (reference)

Alternate names

Indication, Admission diagnosis

Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded 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).

Data type

Reference(DataStandardsWalesObservation | UKCoreCondition | UKCoreProcedure | DataStandardsWales-ImmunizationRecommendation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
rim: .reasonCode

diagnosis

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.diagnosis

Short description

The list of diagnosis relevant to this encounter

Definition

The list of diagnosis relevant to this encounter.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.diagnosis.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.diagnosis.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

condition

Σ C

1..1

Reference(UKCoreCondition | UKCoreProcedure)

Element id

Encounter.diagnosis.condition

Short description

The diagnosis or procedure relevant to the encounter

Alternate names

Admission diagnosis, discharge diagnosis, indication

Definition

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).

Data type

Reference(UKCoreCondition | UKCoreProcedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
v2: Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
rim: .outboundRelationship[typeCode=RSON].target

use

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.diagnosis.use

Short description

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)

Definition

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

Comments

Data type

CodeableConcept

Binding

The type of diagnosis this condition represents.

DiagnosisRole (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

rank

0..1

positiveInt

There are no (further) constraints on this element

Element id

Encounter.diagnosis.rank

Short description

Ranking of the diagnosis (for each role type)

Definition

Ranking of the diagnosis (for each role type).

Comments

32 bit number; for values larger than this, use decimal

Data type

positiveInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=RSON].priority

account

0..*

Reference(Account)

There are no (further) constraints on this element

Element id

Encounter.account

Short description

The set of accounts that may be used for billing for this Encounter

Definition

The set of accounts that may be used for billing for this Encounter.

Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Data type

Reference(Account)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .pertains.A_Account

hospitalization

0..1

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.hospitalization

Short description

Details about the admission to a healthcare service

Definition

Details about the admission to a healthcare service.

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.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.hospitalization.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

admissionMethod

S C

0..1

Extension(CodeableConcept)

Element id

Encounter.hospitalization.extension:admissionMethod

Short description

An extension to support the method by which an individual was admitted into hospital.

Alternate names

extensions, user content

Definition

This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.

Comments

Data type

Extension(CodeableConcept)

Extension URL

https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.hospitalization.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

preAdmissionIdentifier

0..1

Identifier

There are no (further) constraints on this element

Element id

Encounter.hospitalization.preAdmissionIdentifier

Short description

Pre-admission identifier

Definition

Pre-admission identifier.

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
servd: Identifier
v2: PV1-5
rim: .id

origin

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.origin

Short description

The location/organization from which the patient came before admission

Definition

The location/organization from which the patient came before admission.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
rim: .participation[typeCode=ORG].role

admitSource

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.admitSource

Short description

From where patient was admitted (physician referral, transfer)

Definition

From where patient was admitted (physician referral, transfer).

Comments

Data 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.

UKCoreSourceOfAdmission (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-14
rim: .admissionReferralSourceCode

reAdmission

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.reAdmission

Short description

The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission

Definition

Whether this hospitalization is a readmission and why if known.

Comments

Data type

CodeableConcept

Binding

The reason for re-admission of this hospitalization encounter.

v2.0092 (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-13

dietPreference

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dietPreference

Short description

Diet preferences reported by the patient

Definition

Diet preferences reported by the patient.

Requirements

Comments

For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Data type

CodeableConcept

Binding

Medical, cultural or ethical food preferences to help with catering requirements.

Diet (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-38
rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]

specialCourtesy

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialCourtesy

Short description

Special courtesies (VIP, board member)

Definition

Special courtesies (VIP, board member).

Comments

Data type

CodeableConcept

Binding

Special courtesies.

SpecialCourtesy (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-16
rim: .specialCourtesiesCode

specialArrangement

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.specialArrangement

Short description

Wheelchair, translator, stretcher, etc.

Definition

Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

Comments

Data type

CodeableConcept

Binding

Special arrangements.

SpecialArrangements (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-15 / OBR-30 / OBR-43
rim: .specialArrangementCode

destination

S C

0..1

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Element id

Encounter.hospitalization.destination

Short description

Location/organization to which the patient is discharged

Definition

Location/organization to which the patient is discharged.

Comments

Data type

Reference(DataStandardsWalesOrganization | DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: PV1-37
rim: .participation[typeCode=DST]

dischargeDisposition

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.hospitalization.dischargeDisposition

Short description

Category or kind of location after discharge

Definition

Category or kind of location after discharge.

Comments

Data 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.

UKCoreDischargeDestination (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
v2: PV1-36
rim: .dischargeDispositionCode

location

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Encounter.location

Short description

List of locations where the patient has been

Definition

List of locations where the patient has been during this encounter.

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".

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .participation[typeCode=LOC]

0..1

string

There are no (further) constraints on this element

Element id

Encounter.location.id

Short description

Unique id for inter-element referencing

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Encounter.location.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Requirements

Comments

Data type

Extension

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()

Mappings

rim: n/a
rim: N/A

location

1..1

Reference(DataStandardsWalesLocation)

Element id

Encounter.location.location

Short description

Location the encounter takes place

Definition

The location where the encounter takes place.

Comments

Data type

Reference(DataStandardsWalesLocation)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.location
w5: FiveWs.where[x]
v2: PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
rim: .role

status

0..1

codeBinding

There are no (further) constraints on this element

Element id

Encounter.location.status

Short description

planned | active | reserved | completed

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.

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.

Data type

code

Binding

The status of the location.

EncounterLocationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
rim: .role.statusCode

physicalType

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Encounter.location.physicalType

Short description

The physical type of the location (usually the level in the location hierachy - bed room ward etc.)

Definition

This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

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.

Data type

CodeableConcept

Binding

A set of codes that define the physical type of location where an encounter takes place.

UKCoreEncounterLocationType (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD

period

0..1

Period

There are no (further) constraints on this element

Element id

Encounter.location.period

Short description

Time period during which the patient was present at the location

Definition

Time period during which the patient was present at the location.

Comments

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Period

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
per-1: If present, start SHALL have a lower value than end
start.hasValue().not() or end.hasValue().not() or (start <= end)

Mappings

rim: n/a
v2: DR
rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
rim: .time

serviceProvider

S C

0..1

Reference(DataStandardsWalesOrganization)

Element id

Encounter.serviceProvider

Short description

The organization (facility) responsible for this encounter

Definition

Comments

Data type

Reference(DataStandardsWalesOrganization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.performer.actor
v2: PL.6 & PL.1
rim: .particiaption[typeCode=PFM].role

partOf

0..1

Reference(DataStandardsWalesEncounter)

Element id

Encounter.partOf

Short description

Another Encounter this encounter is part of

Definition

Another Encounter of which this encounter is a part of (administratively or in time).

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.

Data type

Reference(DataStandardsWalesEncounter)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.partOf
rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]

Emergency Admission

In-Progress Emergency Admission

Mandatory and Must Support Data Elements

Refer to the Mandatory and Must Support page for guidance on how these elements should be interpreted.

Each Encounter must have:

A status
A class (e.g. inpatient, emergency etc)

Each Encounter must support:

An identifier
A subject
Participant(s) in the encounter
Hospitalization information
Admission source
Discharge destination
Admission method *
Discharge method *
Emergency care discharge status *
Outcome of attendance *

*see Implementation Guidance on UK Core extensions for the Encounter resource below

The Encounter.status field SHALL be populated with one of the following values defined by the FHIR standard:

planned
arrived
triaged
in-progress
onleave
finished
cancelled
entered-in-error
unknown

The Encounter.class field SHALL be populated using the values defined by the FHIR standard

Extensions

The extensions listed below allow a number of the data elements listed above to be supported where not currently supported by the FHIR standard:

Data Standards Wales extensions
- Extension Data Standards Wales Speciality supports the capture of the specialty of a practitioner that would be required to perform the service at this encounter
UK Core extensions
- UKCore STU2-AdmissionMethod supports the exchange of information representing the method by which a patient was admitted to hospital.
- UKCore STU2-DichargeMethod supports the exchange of information representing the method by which a patient was discharged from hospital.
- UKCore STU2-EmergencyCareDischargeStatus supports the exchange of information representing the status of a patient on discharge from an Emergency Care Department.
- UKCore STU2-OutcomeOfAttendance supports the exchange of information representing the outcome of an Outpatient attendance.