GP Connect Data Model | FHIR STU3 Representation

Notice: This guidance is under active development by NHS England and content may be added or updated on a regular basis.

Profile: CareConnect-EpisodeOfCare-1

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
textC0..1Narrative
contained0..*Resource
extensionC0..*Extension
modifierExtension?! C0..*Extension
id0..1string
extensionC0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ C0..1Period
assignerΣ C0..1Reference(CareConnect-Organization-1)
statusΣ ?!1..1codeBinding
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
status1..1codeBinding
periodC1..1Period
typeΣ0..*CodeableConcept
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
conditionΣ C1..1Reference(CareConnect-Condition-1)
roleΣ0..1CodeableConceptBinding
rankΣ0..1positiveInt
patientΣ C1..1Reference(CareConnect-Patient-1)
managingOrganizationΣ C0..1Reference(CareConnect-Organization-1)
periodΣ C0..1Period
referralRequestC0..*Reference(CareConnect-ReferralRequest-1)
careManagerC0..1Reference(CareConnect-Practitioner-1)
teamC0..*Reference(CareConnect-CareTeam-1)
accountC0..*Reference(Account)
EpisodeOfCareC
ShortAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
Definition

An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

Cardinality0..*
AliasCase Program Problem
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.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
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: n/a
  • w5: workflow.encounter
EpisodeOfCare.idΣ
ShortLogical 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.

Cardinality0..1
Typeid
SummaryTrue
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.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.metaΣ
ShortMetadata about the resource
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
EpisodeOfCare.implicitRulesΣ ?!
ShortA 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.

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

Common Languages (extensible)

Binding extensions
maxValueSetAll Languages
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).

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.textC
ShortText summary of the resource, for human interpretation
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1, dom-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
EpisodeOfCare.contained
ShortContained, inline 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.

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
EpisodeOfCare.extensionC
ShortAdditional Content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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() | (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
EpisodeOfCare.modifierExtension?! C
ShortExtensions that cannot be ignored
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. Usually modifier elements provide negation or qualification. In order 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.

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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() | (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
EpisodeOfCare.identifier
ShortBusiness Identifier(s) relevant for this EpisodeOfCare
Definition

The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

Cardinality0..*
TypeIdentifier
ConditionsThe 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() | (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 - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. 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
  • w5: id
EpisodeOfCare.identifier.id
Shortxml:id (or equivalent in JSON)
Definition

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

Cardinality0..1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.identifier.extensionC
ShortAdditional Content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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() | (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
EpisodeOfCare.identifier.useΣ ?!
Shortusual | official | temp | secondary (If known)
Definition

The purpose of this identifier.

Cardinality0..1
Typecode
Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

ModifierTrue
SummaryTrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: N/A
  • rim: Role.code or implied by context
EpisodeOfCare.identifier.typeΣ
ShortDescription of identifier
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Cardinality0..1
TypeCodeableConcept
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Identifier Type Codes (extensible)

SummaryTrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: CX.5
  • rim: Role.code or implied by context
EpisodeOfCare.identifier.systemΣ
ShortThe namespace for the identifier value
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Cardinality0..1
Typeuri
SummaryTrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

see http://en.wikipedia.org/wiki/Uniform_resource_identifier

ConditionsThe 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() | (children().count() > id.count())
ExamplesGeneral
http://www.acme.com/identifiers/patient
Mappings
  • rim: n/a
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
EpisodeOfCare.identifier.valueΣ
ShortThe value that is unique
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Cardinality0..1
Typestring
SummaryTrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.

ConditionsThe 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() | (children().count() > id.count())
ExamplesGeneral
123456
Mappings
  • rim: n/a
  • v2: CX.1 / EI.1
  • rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
  • servd: ./Value
EpisodeOfCare.identifier.periodΣ C
ShortTime period when id is/was valid for use
Definition

Time period during which identifier is/was valid for use.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.

ConditionsThe 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() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() 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: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
EpisodeOfCare.identifier.assignerΣ C
ShortOrganization that issued id (may be just text)
Definition

Organization that issued/manages the identifier.

Cardinality0..1
TypeReference(CareConnect-Organization-1)
SummaryTrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: CX.4 / (CX.4,CX.9,CX.10)
  • rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
  • servd: ./IdentifierIssuingAuthority
EpisodeOfCare.statusΣ ?!
Shortplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Definition

planned | waitlist | active | onhold | finished | cancelled.

Cardinality1..1
Typecode
Binding

The status of the episode of care.

EpisodeOfCareStatus (required)

ModifierTrue
SummaryTrue
Comments

This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: status
EpisodeOfCare.statusHistory
ShortPast list of status codes (the current status may be included to cover the start date of the status)
Definition

The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

Cardinality0..*
TypeBackboneElement
ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.statusHistory.id
Shortxml:id (or equivalent in JSON)
Definition

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

Cardinality0..1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.statusHistory.extensionC
ShortAdditional Content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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() | (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
EpisodeOfCare.statusHistory.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe 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() | (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
EpisodeOfCare.statusHistory.status
Shortplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
Definition

planned | waitlist | active | onhold | finished | cancelled.

Cardinality1..1
Typecode
Binding

The status of the episode of care.

EpisodeOfCareStatus (required)

Comments

Note that FHIR strings may not exceed 1MB in size

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.statusHistory.periodC
ShortDuration the EpisodeOfCare was in the specified status
Definition

The period during this EpisodeOfCare that the specific status applied.

Cardinality1..1
TypePeriod
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.

ConditionsThe 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() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() 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"]
EpisodeOfCare.typeΣ
ShortType/class - e.g. specialist referral, disease management
Definition

A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

Cardinality0..*
TypeCodeableConcept
Binding

The type of the episode of care

EpisodeOfCareType (example)

SummaryTrue
Comments

The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: class
EpisodeOfCare.diagnosisΣ
ShortThe list of diagnosis relevant to this episode of care
Definition

The list of diagnosis relevant to this episode of care.

Cardinality0..*
TypeBackboneElement
SummaryTrue
ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.diagnosis.id
Shortxml:id (or equivalent in JSON)
Definition

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

Cardinality0..1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.diagnosis.extensionC
ShortAdditional Content defined by implementations
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Cardinality0..*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe 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() | (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
EpisodeOfCare.diagnosis.modifierExtensionΣ ?! C
ShortExtensions that cannot be ignored
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Cardinality0..*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
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.

ConditionsThe 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() | (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
EpisodeOfCare.diagnosis.conditionΣ C
ShortConditions/problems/diagnoses this episode of care is for
Definition

A list of conditions/problems/diagnoses that this episode of care is intended to be providing care for.

Cardinality1..1
TypeReference(CareConnect-Condition-1)
SummaryTrue
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: what
EpisodeOfCare.diagnosis.roleΣ
ShortRole that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
Definition

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

Cardinality0..1
TypeCodeableConcept
Binding

The type of diagnosis this condition represents

DiagnosisRole (preferred)

SummaryTrue
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.

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
EpisodeOfCare.diagnosis.rankΣ
ShortRanking of the diagnosis (for each role type)
Definition

Ranking of the diagnosis (for each role type).

Cardinality0..1
TypepositiveInt
SummaryTrue
Comments

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

ConditionsThe 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() | (children().count() > id.count())
Mappings
  • rim: n/a
EpisodeOfCare.patientΣ C
ShortThe patient who is the focus of this episode of care
Definition

The patient who is the focus of this episode of care.

Cardinality1..1
TypeReference(CareConnect-Patient-1)
SummaryTrue
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: who.focus
EpisodeOfCare.managingOrganizationΣ C
ShortOrganization that assumes care
Definition

The organization that has assumed the specific responsibilities for the specified duration.

Cardinality0..1
TypeReference(CareConnect-Organization-1)
SummaryTrue
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
EpisodeOfCare.periodΣ C
ShortInterval during responsibility is assumed
Definition

The interval during which the managing organization assumes the defined responsibility.

Cardinality0..1
TypePeriod
SummaryTrue
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.

ConditionsThe 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() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() 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"]
  • w5: when.init
EpisodeOfCare.referralRequestC
ShortOriginating Referral Request(s)
Definition

Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

Cardinality0..*
TypeReference(CareConnect-ReferralRequest-1)
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
EpisodeOfCare.careManagerC
ShortCare manager/care co-ordinator for the patient
Definition

The practitioner that is the care manager/care co-ordinator for this patient.

Cardinality0..1
TypeReference(CareConnect-Practitioner-1)
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
EpisodeOfCare.teamC
ShortOther practitioners facilitating this episode of care
Definition

The list of practitioners that may be facilitating this episode of care for specific purposes.

Cardinality0..*
TypeReference(CareConnect-CareTeam-1)
AliasCareTeam
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.

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
EpisodeOfCare.accountC
ShortThe set of accounts that may be used for billing for this EpisodeOfCare
Definition

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

Cardinality0..*
TypeReference(Account)
Comments

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

ConditionsThe 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() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
<StructureDefinition xmlns="http://hl7.org/fhir">
<url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1" />
<version value="1.0.0" />
<name value="CareConnect-EpisodeOfCare-1" />
<status value="draft" />
<date value="2019-03-04T14:44:34.123+00:00" />
<publisher value="NHS Digital" />
<name value="Interoperability Team" />
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
</telecom>
</contact>
<description value="An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time." />
<purpose value="[NOT CURATED BY INTEROPEN see: http://www.interopen.org/careconnect-curation-methodology/] Initial development for the Digital Maternity programme" />
<copyright value="Copyright © 2016 HL7 UK\n \n Licensed under the Apache License, Version 2.0 (the "License"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n \n http://www.apache.org/licenses/LICENSE-2.0\n \n Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n \n HL7® FHIR® standard Copyright © 2011+ HL7\n \n The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n \n https://www.hl7.org/fhir/license.html" />
<fhirVersion value="3.0.2" />
<kind value="resource" />
<abstract value="false" />
<type value="EpisodeOfCare" />
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" />
<derivation value="constraint" />
<element id="EpisodeOfCare.identifier.assigner">
<path value="EpisodeOfCare.identifier.assigner" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" />
</type>
</element>
<element id="EpisodeOfCare.diagnosis.condition">
<path value="EpisodeOfCare.diagnosis.condition" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1" />
</type>
</element>
<element id="EpisodeOfCare.patient">
<path value="EpisodeOfCare.patient" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1" />
</type>
</element>
<element id="EpisodeOfCare.managingOrganization">
<path value="EpisodeOfCare.managingOrganization" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1" />
</type>
</element>
<element id="EpisodeOfCare.referralRequest">
<path value="EpisodeOfCare.referralRequest" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ReferralRequest-1" />
</type>
</element>
<element id="EpisodeOfCare.careManager">
<path value="EpisodeOfCare.careManager" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1" />
</type>
</element>
<element id="EpisodeOfCare.team">
<path value="EpisodeOfCare.team" />
<code value="Reference" />
<targetProfile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-CareTeam-1" />
</type>
</element>
</differential>
</StructureDefinition>
{
"resourceType": "StructureDefinition",
"url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1",
"version": "1.0.0",
"name": "CareConnect-EpisodeOfCare-1",
"status": "draft",
"date": "2019-03-04T14:44:34.123+00:00",
"publisher": "NHS Digital",
"contact": [
{
"name": "Interoperability Team",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work"
}
]
}
],
"description": "An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.",
"purpose": "[NOT CURATED BY INTEROPEN see: http://www.interopen.org/careconnect-curation-methodology/] Initial development for the Digital Maternity programme",
"copyright": "Copyright © 2016 HL7 UK\n \n Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at\n \n http://www.apache.org/licenses/LICENSE-2.0\n \n Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.\n \n HL7® FHIR® standard Copyright © 2011+ HL7\n \n The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at\n \n https://www.hl7.org/fhir/license.html",
"fhirVersion": "3.0.2",
"kind": "resource",
"abstract": false,
"type": "EpisodeOfCare",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare",
"derivation": "constraint",
"element": [
{
"id": "EpisodeOfCare.identifier.assigner",
"path": "EpisodeOfCare.identifier.assigner",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
}
]
},
{
"id": "EpisodeOfCare.diagnosis.condition",
"path": "EpisodeOfCare.diagnosis.condition",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Condition-1"
}
]
},
{
"id": "EpisodeOfCare.patient",
"path": "EpisodeOfCare.patient",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
}
]
},
{
"id": "EpisodeOfCare.managingOrganization",
"path": "EpisodeOfCare.managingOrganization",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Organization-1"
}
]
},
{
"id": "EpisodeOfCare.referralRequest",
"path": "EpisodeOfCare.referralRequest",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-ReferralRequest-1"
}
]
},
{
"id": "EpisodeOfCare.careManager",
"path": "EpisodeOfCare.careManager",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Practitioner-1"
}
]
},
{
"id": "EpisodeOfCare.team",
"path": "EpisodeOfCare.team",
"type": [
{
"code": "Reference",
"targetProfile": "https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-CareTeam-1"
}
]
}
]
}
}
Command 'details' could not render: There is no placeholder called 'details'


Reference

Canonical URI: https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-EpisodeOfCare-1

The canonical URI is the stable FHIR identifier for this profile and is not currently available as a browsable web page.

Data model element usage

Element Use CareConnect (STU3) UK Core (R4)
identifier
status
statusHistory
type
diagnosis
patient
managingOrganization
period
referralRequest
careManager
team
account

identifier

Usage

Required

Guidance

External Id(s) for this record

Example
<identifier>
    <system value="https://foo.bar/id/familymemberhistory" />
    <value value="fef26348-ccd1-440b-940e-ba1ec058cf21" />
</identifier>


status

Usage

Optional

Guidance

The status of the Spisode of Care

e.g. planned | waitlist | active | onhold | finished | cancelled | entered-in-error.

Example
    <status>
        <code value="cancelled" />
        <display value="cancelled" />
    </status>



statusHistory

Usage

Optional

Guidance

This element does not need to be populated.

Example
<statusHistory>
    <status value="in-progress" />
    <period>
        <start value="2022-10-28T08:06:00+00:00" />
        <end value="2022-10-28T08:14:00+00:00" />
    </period>
</statusHistory>


type

Usage

Optional

Guidance

Type/class - e.g. specialist referral, disease management Binding (example): The type of the episode of care
( https://hl7.org/fhir/stu3/valueset-episodeofcare-type.html )

Example
<coding>
    <system value="https://hl7.org/fhir/stu3/valueset-episodeofcare-type.html" />
    <code value="hacc" />
    <display value="Home and Community Care" />
</coding>


diagnosis

Usage

Mandatory

Guidance

Originating Referral Request(s) Constraint (ref-1): SHALL have a contained resource if a local reference is provided

Profile: CareConnect-GPC-Condition-1

Example
<diagnosis>
    <condition value="RR4455433" />
</diagnosis>


patient

Usage

Mandatory

Guidance

A reference to the patient who the episode of care relates to

Profile: CareConnect-GPC-Patient-1

Example
<patient>
    <reference value="patient-9929alp" />
</patient>


managingOrganization

Usage

Required

Guidance

A reference to the 'managing' organisation. For locations that are managed by GP practices, see Branch surgeries for more details.

Example
<managingOrganization>
    <reference value="organisation-9929alp" />
</managingOrganization>


period

Usage

Required

Guidance

The period element is a required element which means it MUST be populated with values when they are known to the provider system.

  • The period.start represents the date and time when the consultation started.
  • The period.end reperesents the date when populated and the duration is known.
Example
<period>
    <start value="2022-10-28T13:38:00+00:00" />
    <end value="2022-10-28T13:53:00+00:00" />
</period>


referralRequest

Usage

Mandatory

Guidance

Originating Referral Request(s) Constraint (ref-1): SHALL have a contained resource if a local reference is provided

Profile: CareConnect-GPC-ReferralRequest-1

Example
<referralrequest>
    <reference value="RR4455433" />
</referralrequest>


careManager

Usage

Mandatory

Guidance

Care manager/care co-ordinator for the patient Constraint (ref-1): SHALL have a contained resource if a local reference is provided`

Profile: CareConnect-GPC-Practitioner-1

Example
<practitioner>
    <actor>
        <reference value="practitioner-9093012" />
    </actor>
</practitioner>


team

Usage

Mandatory

Guidance

Other practitioners facilitating this episode of care Constraint (ref-1): SHALL have a contained resource if a local reference is provided

Command 'pagelink' could not render: Page not found.

Example
<careteam>
    <member>
        <reference value="practitioner-9093012" />
    </member>
</careteam>


account

Usage

Optional

Guidance

The set of accounts that may be used for billing for this EpisodeOfCare Constraint (ref-1): SHALL have a contained resource if a local reference is provided

A use-case for population of this element within GP connect has yet to be defined.

Example
<account>
    <reference value="account-p8827akl" />
</account>


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