EpisodeOfCare
Defines the ID Core constraints and extensions on the EpisodeOfCare resource for the minimal set of data to query and retrieve episode of care information.
Usage
This profile allows exchange of information about an association between a patient and an organisation / healthcare provider(s) during which time encounters may occur. The managing organisation assumes a level of responsibility for the individual during this time.
Relation with the Encounter
The EpisodeOfCare Resource contains information about an association of a Patient with a Healthcare Provider for a period of time under which related healthcare activities may occur.
In many cases, this represents a period of time where the Healthcare Provider has some level of responsibility for the care of the patient regarding a specific condition or problem, even if not currently participating in an encounter.
These resources are typically known in existing systems as:
- EpisodeOfCare: Case, Program, Problem, Episode
- Encounter: Visit, Contact.
URL
Type | URL |
---|---|
Canonical | https://fhir.kemkes.go.id/r4/StructureDefinition/EpisodeOfCare |
Structure
Snapshot
EpisodeOfCare | I | https://fhir.kemkes.go.id/r4/StructureDefinition/DomainResource | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
modifierExtension | ?! I | 0..* | Extension |
identifier | 0..* | Identifier | |
status | Σ ?! | 1..1 | codeBinding |
statusHistory | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
status | 1..1 | codeBinding | |
period | I | 1..1 | Period |
type | Σ | 0..* | CodeableConcept |
diagnosis | Σ | 0..* | BackboneElement |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
condition | Σ I | 1..1 | Reference(Condition) |
role | Σ | 0..1 | CodeableConceptBinding |
rank | Σ | 0..1 | positiveInt |
patient | Σ I | 1..1 | Reference(Patient) |
managingOrganization | Σ I | 0..1 | Reference(Organization) |
period | Σ I | 0..1 | Period |
referralRequest | I | 0..* | Reference(ServiceRequest) |
careManager | I | 0..1 | Reference(Practitioner | PractitionerRole) |
team | I | 0..* | Reference(CareTeam) |
account | I | 0..* | Reference(https://fhir.kemkes.go.id/r4/StructureDefinition/Account) |
Examples
Dictionary
EpisodeOfCare | |
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. |
Cardinality | 0...* |
Alias | Case Program Problem |
Invariants |
|
Mappings |
|
EpisodeOfCare.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
EpisodeOfCare.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
|
Mappings |
|
EpisodeOfCare.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Invariants |
|
Mappings |
|
EpisodeOfCare.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants |
|
Mappings |
|
EpisodeOfCare.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants |
|
Mappings |
|
EpisodeOfCare.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Mappings |
|
EpisodeOfCare.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
EpisodeOfCare.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
EpisodeOfCare.identifier | |
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. |
Cardinality | 0...* |
Type | Identifier |
Invariants |
|
Mappings |
|
EpisodeOfCare.status | |
Definition | planned | waitlist | active | onhold | finished | cancelled. |
Cardinality | 1...1 |
Type | code |
Binding | The status of the episode of care. |
Modifier | True |
Summary | True |
Comments | This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid. |
Invariants |
|
Mappings |
|
EpisodeOfCare.statusHistory | |
Definition | The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource). |
Cardinality | 0...* |
Type | BackboneElement |
Invariants |
|
Mappings |
|
EpisodeOfCare.statusHistory.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
EpisodeOfCare.statusHistory.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
EpisodeOfCare.statusHistory.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
|
Mappings |
|
EpisodeOfCare.statusHistory.status | |
Definition | planned | waitlist | active | onhold | finished | cancelled. |
Cardinality | 1...1 |
Type | code |
Binding | The status of the episode of care. |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
|
Mappings |
|
EpisodeOfCare.statusHistory.period | |
Definition | The period during this EpisodeOfCare that the specific status applied. |
Cardinality | 1...1 |
Type | Period |
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. |
Invariants |
|
Mappings |
|
EpisodeOfCare.type | |
Definition | A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The type of the episode of care. |
Summary | True |
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. |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis | |
Definition | The list of diagnosis relevant to this episode of care. |
Cardinality | 0...* |
Type | BackboneElement |
Summary | True |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
|
EpisodeOfCare.diagnosis.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis.condition | |
Definition | A list of conditions/problems/diagnoses that this episode of care is intended to be providing care for. |
Cardinality | 1...1 |
Type | Reference(Condition) |
Summary | True |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis.role | |
Definition | Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …). |
Cardinality | 0...1 |
Type | CodeableConcept |
Binding | The type of diagnosis this condition represents. |
Summary | True |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
|
Mappings |
|
EpisodeOfCare.diagnosis.rank | |
Definition | Ranking of the diagnosis (for each role type). |
Cardinality | 0...1 |
Type | positiveInt |
Summary | True |
Comments | 32 bit number; for values larger than this, use decimal |
Invariants |
|
Mappings |
|
EpisodeOfCare.patient | |
Definition | The patient who is the focus of this episode of care. |
Cardinality | 1...1 |
Type | Reference(Patient) |
Summary | True |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.managingOrganization | |
Definition | The organization that has assumed the specific responsibilities for the specified duration. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Summary | True |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.period | |
Definition | The interval during which the managing organization assumes the defined responsibility. |
Cardinality | 0...1 |
Type | Period |
Summary | True |
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. |
Invariants |
|
Mappings |
|
EpisodeOfCare.referralRequest | |
Definition | Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals. |
Cardinality | 0...* |
Type | Reference(ServiceRequest) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.careManager | |
Definition | The practitioner that is the care manager/care coordinator for this patient. |
Cardinality | 0...1 |
Type | Reference(Practitioner | PractitionerRole) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.team | |
Definition | The list of practitioners that may be facilitating this episode of care for specific purposes. |
Cardinality | 0...* |
Type | Reference(CareTeam) |
Alias | CareTeam |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
|
Mappings |
|
EpisodeOfCare.account | |
Definition | The set of accounts that may be used for billing for this EpisodeOfCare. |
Cardinality | 0...* |
Type | Reference(https://fhir.kemkes.go.id/r4/StructureDefinition/Account) |
Comments | The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules. |
Invariants |
|
Mappings |
|