Encounter

Description

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, or a hospital admission.

Patient finder splits Encounters into Admissions, Admission Periods and Appointments, which are loaded into separate search categories in our application. This split is based on checking if class.code or class.coding.code == 'IMP' to determine that we are dealing with an admission. Other encounters will be loaded as Appointments.

Admissions and Admission Periods

Admissions and Admission Periods both reflect the stay of a patient in a hospital, but they represent a different level of granularity:

  • Admissions reflect the full stay of the patient in the hospital
  • Admission Periods reflect all the different steps within the admission (admissions to different wards, bed transfers) within that stay.

The distinction between Admissions and Admission Periods is made with the partOf attribute. Each Admission Period should reference the Admission that it is part of. And each Admission should be referenced by at least one Admission Period.

Both Admissions and Admission periods should have class.code or class.coding.code == 'IMP'.

Instances

An example of an Encounter resource representing an Admission can be found here: Encounter for Patient/patient-1

An example of an Encounter resource representing an Appointment can be found here: Encounter for Patient/patient-1

Profile

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
departmentS I0..1Extension(Reference(Organization))
specialtyS I0..1Extension(Reference(Organization))
modifierExtension?! I0..*Extension
id0..1string
extensionI0..*Extension
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemΣ0..1uri
valueS Σ0..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
statusS Σ ?!1..1codeBinding
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
status1..1codeBinding
period1..1Period
id0..1string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeS Σ0..1code
displayS Σ0..1string
userSelectedΣ0..1boolean
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
class1..1CodingBinding
period1..1Period
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeS Σ0..1code
displayS Σ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
serviceTypeΣ0..1CodeableConcept
priority0..1CodeableConcept
subjectS Σ0..1Reference(Patient)
episodeOfCareS Σ0..*Reference(EpisodeOfCare)
basedOn0..*Reference(ServiceRequest)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
typeΣ0..*CodeableConceptBinding
period0..1Period
individualS Σ0..1Reference(Practitioner)
appointmentΣ0..*Reference(Appointment)
id0..1string
extensionI0..*Extension
startS Σ I0..1dateTime
endS Σ I0..1dateTime
lengthS0..1Duration
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeS Σ0..1code
displayS Σ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
reasonReferenceΣ0..*Reference(Condition | Procedure | Observation | ImmunizationRecommendation)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
conditionΣ1..1Reference(Condition | Procedure)
use0..1CodeableConceptBinding
rank0..1positiveInt
account0..*Reference(Account)
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
preAdmissionIdentifier0..1Identifier
origin0..1Reference(Location | Organization)
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeS Σ0..1code
displayS Σ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
reAdmission0..1CodeableConcept
dietPreference0..*CodeableConcept
specialCourtesy0..*CodeableConceptBinding
specialArrangement0..*CodeableConceptBinding
destination0..1Reference(Location | Organization)
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uri
versionΣ0..1string
codeS Σ0..1code
displayS Σ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
locationS1..1Reference(Location)
status0..1codeBinding
physicalType0..1CodeableConcept
period0..1Period
serviceProviderS0..1Reference(Organization)
partOfS0..1Reference(Encounter)
<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="pf-Encounter" />
    <url value="https://fhir.iqvia.com/patientfinder/StructureDefinition/pf-encounter" />
    <name value="PatientFinderEncounter" />
    <title value="Encounter" />
    <status value="draft" />
    <description value="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, or a hospital admission. Patient finder splits Encounters into Admissions, Admission Periods and Appointments, which are loaded into separate search categories in our application. This split is based on checking if class.code or class.coding.code == &#39;IMP&#39; to determine that we are dealing with an admission/admission period. Other codes will be loaded as Appointments." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="fhir-patient-finder-mapping" />
        <name value="FHIR to Patient Finder Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Encounter" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Encounter" />
    <derivation value="constraint" />
    <differential>
        <element id="Encounter.extension">
            <path value="Encounter.extension" />
            <slicing>
                <discriminator>
                    <type value="value" />
                    <path value="url" />
                </discriminator>
                <ordered value="false" />
                <rules value="open" />
            </slicing>
        </element>
        <element id="Encounter.extension:department">
            <path value="Encounter.extension" />
            <sliceName value="department" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.iqvia.com/patientfinder/extension/department-organization" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) admission department" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) admission period department" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) appointment department" />
            </mapping>
        </element>
        <element id="Encounter.extension:specialty">
            <path value="Encounter.extension" />
            <sliceName value="specialty" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://fhir.iqvia.com/patientfinder/extension/specialism-organization" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) appointment specialism" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) appointment specialism" />
            </mapping>
        </element>
        <element id="Encounter.identifier">
            <path value="Encounter.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.identifier.value">
            <path value="Encounter.identifier.value" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission source id" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period source id" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment source id" />
            </mapping>
        </element>
        <element id="Encounter.status">
            <path value="Encounter.status" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission status" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period status" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment status" />
            </mapping>
        </element>
        <element id="Encounter.class">
            <path value="Encounter.class" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.class.code">
            <path value="Encounter.class.code" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="for admission: &#39;IMP&#39;" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="for admission period: &#39;IMP&#39;" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment code" />
            </mapping>
        </element>
        <element id="Encounter.class.display">
            <path value="Encounter.class.display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="for admission: &#39;inpatient encounter&#39;" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="for admission: period &#39;inpatient encounter&#39;" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment description" />
            </mapping>
        </element>
        <element id="Encounter.type">
            <path value="Encounter.type" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.type.coding.code">
            <path value="Encounter.type.coding.code" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment type code" />
            </mapping>
        </element>
        <element id="Encounter.type.coding.display">
            <path value="Encounter.type.coding.display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission type" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period type" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment type description" />
            </mapping>
        </element>
        <element id="Encounter.subject">
            <path value="Encounter.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Patient) admission patient" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Patient) admission period patient" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Patient) Patient" />
            </mapping>
        </element>
        <element id="Encounter.episodeOfCare">
            <path value="Encounter.episodeOfCare" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(EpisodeOfCare) related episode of care" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(EpisodeOfCare) related episode of care" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(EpisodeOfCare) Related Episode of Care" />
            </mapping>
        </element>
        <element id="Encounter.participant">
            <path value="Encounter.participant" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.participant.individual">
            <path value="Encounter.participant.individual" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
            </type>
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Practitioner) admission care provider" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Practitioner) admission period care provider" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Practitioner) appointment care provider" />
            </mapping>
        </element>
        <element id="Encounter.period">
            <path value="Encounter.period" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.period.start">
            <path value="Encounter.period.start" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission start date/time" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period start date/time" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment start date/time" />
            </mapping>
        </element>
        <element id="Encounter.period.end">
            <path value="Encounter.period.end" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission end date/time" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period end date/time" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment end date/time" />
            </mapping>
        </element>
        <element id="Encounter.length">
            <path value="Encounter.length" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission length of stay" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period length of stay" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment duration" />
            </mapping>
        </element>
        <element id="Encounter.reasonCode">
            <path value="Encounter.reasonCode" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.reasonCode.coding.code">
            <path value="Encounter.reasonCode.coding.code" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.reasonCode.coding.display">
            <path value="Encounter.reasonCode.coding.display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission reason" />
            </mapping>
        </element>
        <element id="Encounter.hospitalization">
            <path value="Encounter.hospitalization" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.hospitalization.admitSource">
            <path value="Encounter.hospitalization.admitSource" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.hospitalization.admitSource.coding.code">
            <path value="Encounter.hospitalization.admitSource.coding.code" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.hospitalization.admitSource.coding.display">
            <path value="Encounter.hospitalization.admitSource.coding.display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission origin" />
            </mapping>
        </element>
        <element id="Encounter.hospitalization.dischargeDisposition">
            <path value="Encounter.hospitalization.dischargeDisposition" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.hospitalization.dischargeDisposition.coding.code">
            <path value="Encounter.hospitalization.dischargeDisposition.coding.code" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.hospitalization.dischargeDisposition.coding.display">
            <path value="Encounter.hospitalization.dischargeDisposition.coding.display" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission discharge destination" />
            </mapping>
        </element>
        <element id="Encounter.location">
            <path value="Encounter.location" />
            <mustSupport value="true" />
        </element>
        <element id="Encounter.location.location">
            <path value="Encounter.location.location" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission location" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="admission period location" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="appointment location" />
            </mapping>
        </element>
        <element id="Encounter.serviceProvider">
            <path value="Encounter.serviceProvider" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) admission service provider" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) admission period service provider" />
            </mapping>
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Organization) appointment service provider" />
            </mapping>
        </element>
        <element id="Encounter.partOf">
            <path value="Encounter.partOf" />
            <mustSupport value="true" />
            <mapping>
                <identity value="fhir-patient-finder-mapping" />
                <map value="(Encounter) reference to the admission that the admission period is part of" />
            </mapping>
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "pf-Encounter",
    "url": "https://fhir.iqvia.com/patientfinder/StructureDefinition/pf-encounter",
    "name": "PatientFinderEncounter",
    "title": "Encounter",
    "status": "draft",
    "description": "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, or a hospital admission. Patient finder splits Encounters into Admissions, Admission Periods and Appointments, which are loaded into separate search categories in our application. This split is based on checking if class.code or class.coding.code == 'IMP' to determine that we are dealing with an admission/admission period. Other codes will be loaded as Appointments.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "fhir-patient-finder-mapping",
            "name": "FHIR to Patient Finder Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Encounter",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Encounter",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Encounter.extension",
                "path": "Encounter.extension",
                "slicing": {
                    "discriminator":  [
                        {
                            "type": "value",
                            "path": "url"
                        }
                    ],
                    "ordered": false,
                    "rules": "open"
                }
            },
            {
                "id": "Encounter.extension:department",
                "path": "Encounter.extension",
                "sliceName": "department",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.iqvia.com/patientfinder/extension/department-organization"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) admission department"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) admission period department"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) appointment department"
                    }
                ]
            },
            {
                "id": "Encounter.extension:specialty",
                "path": "Encounter.extension",
                "sliceName": "specialty",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://fhir.iqvia.com/patientfinder/extension/specialism-organization"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) appointment specialism"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) appointment specialism"
                    }
                ]
            },
            {
                "id": "Encounter.identifier",
                "path": "Encounter.identifier",
                "mustSupport": true
            },
            {
                "id": "Encounter.identifier.value",
                "path": "Encounter.identifier.value",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission source id"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period source id"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment source id"
                    }
                ]
            },
            {
                "id": "Encounter.status",
                "path": "Encounter.status",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission status"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period status"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment status"
                    }
                ]
            },
            {
                "id": "Encounter.class",
                "path": "Encounter.class",
                "mustSupport": true
            },
            {
                "id": "Encounter.class.code",
                "path": "Encounter.class.code",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "for admission: 'IMP'"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "for admission period: 'IMP'"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment code"
                    }
                ]
            },
            {
                "id": "Encounter.class.display",
                "path": "Encounter.class.display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "for admission: 'inpatient encounter'"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "for admission: period 'inpatient encounter'"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment description"
                    }
                ]
            },
            {
                "id": "Encounter.type",
                "path": "Encounter.type",
                "mustSupport": true
            },
            {
                "id": "Encounter.type.coding.code",
                "path": "Encounter.type.coding.code",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment type code"
                    }
                ]
            },
            {
                "id": "Encounter.type.coding.display",
                "path": "Encounter.type.coding.display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission type"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period type"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment type description"
                    }
                ]
            },
            {
                "id": "Encounter.subject",
                "path": "Encounter.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Patient) admission patient"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Patient) admission period patient"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Patient) Patient"
                    }
                ]
            },
            {
                "id": "Encounter.episodeOfCare",
                "path": "Encounter.episodeOfCare",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(EpisodeOfCare) related episode of care"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(EpisodeOfCare) related episode of care"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(EpisodeOfCare) Related Episode of Care"
                    }
                ]
            },
            {
                "id": "Encounter.participant",
                "path": "Encounter.participant",
                "mustSupport": true
            },
            {
                "id": "Encounter.participant.individual",
                "path": "Encounter.participant.individual",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Practitioner"
                        ]
                    }
                ],
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Practitioner) admission care provider"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Practitioner) admission period care provider"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Practitioner) appointment care provider"
                    }
                ]
            },
            {
                "id": "Encounter.period",
                "path": "Encounter.period",
                "mustSupport": true
            },
            {
                "id": "Encounter.period.start",
                "path": "Encounter.period.start",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission start date/time"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period start date/time"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment start date/time"
                    }
                ]
            },
            {
                "id": "Encounter.period.end",
                "path": "Encounter.period.end",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission end date/time"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period end date/time"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment end date/time"
                    }
                ]
            },
            {
                "id": "Encounter.length",
                "path": "Encounter.length",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission length of stay"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period length of stay"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment duration"
                    }
                ]
            },
            {
                "id": "Encounter.reasonCode",
                "path": "Encounter.reasonCode",
                "mustSupport": true
            },
            {
                "id": "Encounter.reasonCode.coding.code",
                "path": "Encounter.reasonCode.coding.code",
                "mustSupport": true
            },
            {
                "id": "Encounter.reasonCode.coding.display",
                "path": "Encounter.reasonCode.coding.display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission reason"
                    }
                ]
            },
            {
                "id": "Encounter.hospitalization",
                "path": "Encounter.hospitalization",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource",
                "path": "Encounter.hospitalization.admitSource",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding.code",
                "path": "Encounter.hospitalization.admitSource.coding.code",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.admitSource.coding.display",
                "path": "Encounter.hospitalization.admitSource.coding.display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission origin"
                    }
                ]
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition",
                "path": "Encounter.hospitalization.dischargeDisposition",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding.code",
                "path": "Encounter.hospitalization.dischargeDisposition.coding.code",
                "mustSupport": true
            },
            {
                "id": "Encounter.hospitalization.dischargeDisposition.coding.display",
                "path": "Encounter.hospitalization.dischargeDisposition.coding.display",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission discharge destination"
                    }
                ]
            },
            {
                "id": "Encounter.location",
                "path": "Encounter.location",
                "mustSupport": true
            },
            {
                "id": "Encounter.location.location",
                "path": "Encounter.location.location",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission location"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "admission period location"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "appointment location"
                    }
                ]
            },
            {
                "id": "Encounter.serviceProvider",
                "path": "Encounter.serviceProvider",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) admission service provider"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) admission period service provider"
                    },
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Organization) appointment service provider"
                    }
                ]
            },
            {
                "id": "Encounter.partOf",
                "path": "Encounter.partOf",
                "mustSupport": true,
                "mapping":  [
                    {
                        "identity": "fhir-patient-finder-mapping",
                        "map": "(Encounter) reference to the admission that the admission period is part of"
                    }
                ]
            }
        ]
    }
}
Encounter
DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
Cardinality0...*
AliasVisit
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.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-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-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
Mappings
  • rim: Entity. Role, or Act
  • workflow: Event
  • rim: Encounter[@moodCode='EVN']
Encounter.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typestring
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.

Encounter.meta
DefinitionThe 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.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Encounter.implicitRules
DefinitionA 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.
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. 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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Encounter.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

CommonLanguages (preferred)
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
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Encounter.text
DefinitionA 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.
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 information is added later.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: Act.text?
Encounter.contained
DefinitionThese 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Mappings
  • rim: N/A
Encounter.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.extension:department
DefinitionThe organization representing the department.
Cardinality0...1
TypeExtension(Reference(Organization))
Must SupportTrue
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.

Invariants
  • 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
  • fhir-patient-finder-mapping: (Organization) admission department
  • fhir-patient-finder-mapping: (Organization) admission period department
  • fhir-patient-finder-mapping: (Organization) appointment department
Encounter.extension:specialty
DefinitionThe organization representing the specialism.
Cardinality0...1
TypeExtension(Reference(Organization))
Must SupportTrue
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.

Invariants
  • 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
  • fhir-patient-finder-mapping: (Organization) appointment specialism
  • fhir-patient-finder-mapping: (Organization) appointment specialism
Encounter.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, 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.

Invariants
  • 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
Encounter.identifier
DefinitionIdentifier(s) by which this encounter is known.
Cardinality0...*
TypeIdentifier
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.identifier
  • w5: FiveWs.identifier
  • v2: PV1-19
  • rim: .id
Encounter.identifier.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.identifier.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.identifier.use
DefinitionThe 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

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: N/A
  • rim: Role.code or implied by context
Encounter.identifier.type
DefinitionA 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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.5
  • rim: Role.code or implied by context
Encounter.identifier.system
DefinitionEstablishes 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

Identifier.system is always case sensitive.

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

http://www.acme.com/identifiers/patient


Mappings
  • v2: CX.4 / EI-2-4
  • rim: II.root or Role.id.root
  • servd: ./IdentifierType
Encounter.identifier.value
DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system.
Cardinality0...1
Typestring
Must SupportTrue
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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

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

123456


Mappings
  • 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
  • fhir-patient-finder-mapping: admission source id
  • fhir-patient-finder-mapping: admission period source id
  • fhir-patient-finder-mapping: appointment source id
Encounter.identifier.period
DefinitionTime period during which identifier is/was valid for use.
Cardinality0...1
TypePeriod
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: CX.7 + CX.8
  • rim: Role.effectiveTime or implied by context
  • servd: ./StartDate and ./EndDate
Encounter.identifier.assigner
DefinitionOrganization that issued/manages the identifier.
Cardinality0...1
TypeReference(Organization)
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
Encounter.status
Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Cardinality1...1
Typecode
Binding

Current state of the encounter.

EncounterStatus (required)
Must SupportTrue
ModifierTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
  • fhir-patient-finder-mapping: admission status
  • fhir-patient-finder-mapping: admission period status
  • fhir-patient-finder-mapping: appointment status
Encounter.statusHistory
DefinitionThe 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.
Cardinality0...*
TypeBackboneElement
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.statusHistory.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.statusHistory.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.statusHistory.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.statusHistory.status
Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Cardinality1...1
Typecode
Binding

Current state of the encounter.

EncounterStatus (required)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.statusHistory.period
DefinitionThe time that the episode was in the specified status.
Cardinality1...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.class
DefinitionConcepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.
Cardinality1...1
TypeCoding
Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.class
  • v2: PV1-2
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code
Encounter.class.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.class.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.class.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Encounter.class.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Encounter.class.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • fhir-patient-finder-mapping: for admission: 'IMP'
  • fhir-patient-finder-mapping: for admission period: 'IMP'
  • fhir-patient-finder-mapping: appointment code
Encounter.class.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • fhir-patient-finder-mapping: for admission: 'inpatient encounter'
  • fhir-patient-finder-mapping: for admission: period 'inpatient encounter'
  • fhir-patient-finder-mapping: appointment description
Encounter.class.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Encounter.classHistory
DefinitionThe 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.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.classHistory.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.classHistory.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.classHistory.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.classHistory.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality1...1
TypeCoding
Binding

Classification of the encounter.

v3.ActEncounterCode (extensible)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.classHistory.period
DefinitionThe time that the episode was in the specified class.
Cardinality1...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.type
DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Cardinality0...*
TypeCodeableConcept
Binding

The type of encounter.

EncounterType (example)
Must SupportTrue
SummaryTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • w5: FiveWs.class
  • v2: PV1-4 / PV1-18
  • rim: .code
Encounter.type.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.type.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.type.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Encounter.type.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.type.coding.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.type.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Encounter.type.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Encounter.type.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
  • fhir-patient-finder-mapping: appointment type code
Encounter.type.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • fhir-patient-finder-mapping: admission type
  • fhir-patient-finder-mapping: admission period type
  • fhir-patient-finder-mapping: appointment type description
Encounter.type.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Encounter.type.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Encounter.serviceType
DefinitionBroad categorization of the service that is to be provided (e.g. cardiology).
Cardinality0...1
TypeCodeableConcept
Binding

Broad categorization of the service that is to be provided.

ServiceType (example)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.code
  • v2: PV1-10
  • rim: n/a
Encounter.priority
DefinitionIndicates the urgency of the encounter.
Cardinality0...1
TypeCodeableConcept
Binding

Indicates the urgency of the encounter.

v3.ActPriority (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • w5: FiveWs.grade
  • v2: PV2-25
  • rim: .priorityCode
Encounter.subject
DefinitionThe patient or group present at the encounter.
Cardinality0...1
TypeReference(Patient)
Must SupportTrue
SummaryTrue
Aliaspatient
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.subject
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .participation[typeCode=SBJ]/role[classCode=PAT]
  • w5: FiveWs.subject
  • fhir-patient-finder-mapping: (Patient) admission patient
  • fhir-patient-finder-mapping: (Patient) admission period patient
  • fhir-patient-finder-mapping: (Patient) Patient
Encounter.episodeOfCare
DefinitionWhere 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).
Cardinality0...*
TypeReference(EpisodeOfCare)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.context
  • w5: FiveWs.context
  • v2: PV1-54, PV1-53
  • rim: n/a
  • fhir-patient-finder-mapping: (EpisodeOfCare) related episode of care
  • fhir-patient-finder-mapping: (EpisodeOfCare) related episode of care
  • fhir-patient-finder-mapping: (EpisodeOfCare) Related Episode of Care
Encounter.basedOn
DefinitionThe request this encounter satisfies (e.g. incoming referral or procedure request).
Cardinality0...*
TypeReference(ServiceRequest)
AliasincomingReferral
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • rim: .reason.ClinicalDocument
Encounter.participant
DefinitionThe list of people responsible for providing the service.
Cardinality0...*
TypeBackboneElement
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer
  • v2: ROL
  • rim: .participation[typeCode=PFM]
Encounter.participant.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.participant.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.participant.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.participant.type
DefinitionRole of participant in encounter.
Cardinality0...*
TypeCodeableConcept
Binding

Role of participant in encounter.

ParticipantType (extensible)
SummaryTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.function
  • v2: ROL-3 (or maybe PRT-4)
  • rim: .functionCode
Encounter.participant.period
DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.
Cardinality0...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: ROL-5, ROL-6 (or maybe PRT-5)
  • rim: .time
Encounter.participant.individual
DefinitionPersons involved in the encounter other than the patient.
Cardinality0...1
TypeReference(Practitioner)
Must SupportTrue
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • w5: FiveWs.who
  • v2: ROL-4
  • rim: .role
  • fhir-patient-finder-mapping: (Practitioner) admission care provider
  • fhir-patient-finder-mapping: (Practitioner) admission period care provider
  • fhir-patient-finder-mapping: (Practitioner) appointment care provider
Encounter.appointment
DefinitionThe appointment that scheduled this encounter.
Cardinality0...*
TypeReference(Appointment)
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.basedOn
  • v2: SCH-1 / SCH-2
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]
Encounter.period
DefinitionThe start and end time of the encounter.
Cardinality0...1
TypePeriod
Must SupportTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.occurrence[x]
  • w5: FiveWs.done[x]
  • v2: PV1-44, PV1-45
  • rim: .effectiveTime (low & high)
Encounter.period.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.period.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.period.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
Must SupportTrue
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: DR.1
  • rim: ./low
  • fhir-patient-finder-mapping: admission start date/time
  • fhir-patient-finder-mapping: admission period start date/time
  • fhir-patient-finder-mapping: appointment start date/time
Encounter.period.end
DefinitionThe end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality0...1
TypedateTime
Must SupportTrue
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: DR.2
  • rim: ./high
  • fhir-patient-finder-mapping: admission end date/time
  • fhir-patient-finder-mapping: admission period end date/time
  • fhir-patient-finder-mapping: appointment end date/time
Encounter.length
DefinitionQuantity of time the encounter lasted. This excludes the time during leaves of absence.
Cardinality0...1
TypeDuration
Must SupportTrue
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
  • fhir-patient-finder-mapping: admission length of stay
  • fhir-patient-finder-mapping: admission period length of stay
  • fhir-patient-finder-mapping: appointment duration
Encounter.reasonCode
DefinitionReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Cardinality0...*
TypeCodeableConcept
Binding

Reason why the encounter takes place.

EncounterReasonCodes (preferred)
Must SupportTrue
SummaryTrue
AliasIndication, 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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
Encounter.reasonCode.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.reasonCode.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.reasonCode.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Encounter.reasonCode.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.reasonCode.coding.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.reasonCode.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Encounter.reasonCode.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Encounter.reasonCode.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Encounter.reasonCode.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • fhir-patient-finder-mapping: admission reason
Encounter.reasonCode.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Encounter.reasonCode.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Encounter.reasonReference
DefinitionReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Cardinality0...*
TypeReference(Condition | Procedure | Observation | ImmunizationRecommendation)
SummaryTrue
AliasIndication, 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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
Encounter.diagnosis
DefinitionThe list of diagnosis relevant to this encounter.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=RSON]
Encounter.diagnosis.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.diagnosis.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.diagnosis.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.diagnosis.condition
DefinitionReason 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.
Cardinality1...1
TypeReference(Condition | Procedure)
SummaryTrue
AliasAdmission diagnosis, discharge diagnosis, indication
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • 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
Encounter.diagnosis.use
DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Cardinality0...1
TypeCodeableConcept
Binding

The type of diagnosis this condition represents.

DiagnosisRole (preferred)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.diagnosis.rank
DefinitionRanking of the diagnosis (for each role type).
Cardinality0...1
TypepositiveInt
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=RSON].priority
Encounter.account
DefinitionThe set of accounts that may be used for billing for this Encounter.
Cardinality0...*
TypeReference(Account)
Comments

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

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .pertains.A_Account
Encounter.hospitalization
DefinitionDetails about the admission to a healthcare service.
Cardinality0...1
TypeBackboneElement
Must SupportTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]
Encounter.hospitalization.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.hospitalization.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.hospitalization.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.hospitalization.preAdmissionIdentifier
DefinitionPre-admission identifier.
Cardinality0...1
TypeIdentifier
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-5
  • rim: .id
Encounter.hospitalization.origin
DefinitionThe location/organization from which the patient came before admission.
Cardinality0...1
TypeReference(Location | Organization)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=ORG].role
Encounter.hospitalization.admitSource
DefinitionFrom where patient was admitted (physician referral, transfer).
Cardinality0...1
TypeCodeableConcept
Binding

From where the patient was admitted.

AdmitSource (preferred)
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-14
  • rim: .admissionReferralSourceCode
Encounter.hospitalization.admitSource.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.hospitalization.admitSource.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.hospitalization.admitSource.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Encounter.hospitalization.admitSource.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.hospitalization.admitSource.coding.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.hospitalization.admitSource.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Encounter.hospitalization.admitSource.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Encounter.hospitalization.admitSource.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Encounter.hospitalization.admitSource.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • fhir-patient-finder-mapping: admission origin
Encounter.hospitalization.admitSource.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Encounter.hospitalization.admitSource.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Encounter.hospitalization.reAdmission
DefinitionWhether this hospitalization is a readmission and why if known.
Cardinality0...1
TypeCodeableConcept
Binding

The reason for re-admission of this hospitalization encounter.

v2.0092 (example)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-13
  • rim: n/a
Encounter.hospitalization.dietPreference
DefinitionDiet preferences reported by the patient.
Cardinality0...*
TypeCodeableConcept
Binding

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

Diet (example)
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).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-38
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]
Encounter.hospitalization.specialCourtesy
DefinitionSpecial courtesies (VIP, board member).
Cardinality0...*
TypeCodeableConcept
Binding

Special courtesies.

SpecialCourtesy (preferred)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-16
  • rim: .specialCourtesiesCode
Encounter.hospitalization.specialArrangement
DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.
Cardinality0...*
TypeCodeableConcept
Binding

Special arrangements.

SpecialArrangements (preferred)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-15 / OBR-30 / OBR-43
  • rim: .specialArrangementCode
Encounter.hospitalization.destination
DefinitionLocation/organization to which the patient is discharged.
Cardinality0...1
TypeReference(Location | Organization)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-37
  • rim: .participation[typeCode=DST]
Encounter.hospitalization.dischargeDisposition
DefinitionCategory or kind of location after discharge.
Cardinality0...1
TypeCodeableConcept
Binding

Discharge Disposition.

DischargeDisposition (example)
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: PV1-36
  • rim: .dischargeDispositionCode
Encounter.hospitalization.dischargeDisposition.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.hospitalization.dischargeDisposition.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.hospitalization.dischargeDisposition.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality0...*
TypeCoding
SummaryTrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

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. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1-8, C*E.10-22
  • rim: union(., ./translation)
  • orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Encounter.hospitalization.dischargeDisposition.coding.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.hospitalization.dischargeDisposition.coding.extension
DefinitionMay 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.
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.

SlicingUnordered, Open, by url(Value)
Invariants
  • 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
Encounter.hospitalization.dischargeDisposition.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality0...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.3
  • rim: ./codeSystem
  • orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
Encounter.hospitalization.dischargeDisposition.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...1
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.7
  • rim: ./codeSystemVersion
  • orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Encounter.hospitalization.dischargeDisposition.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality0...1
Typecode
Must SupportTrue
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.1
  • rim: ./code
  • orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
Encounter.hospitalization.dischargeDisposition.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality0...1
Typestring
Must SupportTrue
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.2 - but note this is not well followed
  • rim: CV.displayName
  • orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
  • fhir-patient-finder-mapping: admission discharge destination
Encounter.hospitalization.dischargeDisposition.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Cardinality0...1
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: Sometimes implied by being first
  • rim: CD.codingRationale
  • orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Encounter.hospitalization.dischargeDisposition.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • v2: C*E.9. But note many systems use C*E.2 for this
  • rim: ./originalText[mediaType/code="text/plain"]/data
  • orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Encounter.location
DefinitionList of locations where the patient has been during this encounter.
Cardinality0...*
TypeBackboneElement
Must SupportTrue
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".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .participation[typeCode=LOC]
Encounter.location.id
DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Mappings
  • rim: n/a
Encounter.location.extension
DefinitionMay 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.
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.

Invariants
  • 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
Encounter.location.modifierExtension
DefinitionMay 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).
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, 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
  • 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
Encounter.location.location
DefinitionThe location where the encounter takes place.
Cardinality1...1
TypeReference(Location)
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.location
  • w5: FiveWs.where[x]
  • v2: PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
  • rim: .role
  • fhir-patient-finder-mapping: admission location
  • fhir-patient-finder-mapping: admission period location
  • fhir-patient-finder-mapping: appointment location
Encounter.location.status
DefinitionThe 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.
Cardinality0...1
Typecode
Binding

The status of the location.

EncounterLocationStatus (required)
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .role.statusCode
Encounter.location.physicalType
DefinitionThis will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.
Cardinality0...1
TypeCodeableConcept
Binding

Physical form of the location.

LocationType (example)
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Encounter.location.period
DefinitionTime period during which the patient was present at the location.
Cardinality0...1
TypePeriod
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: .time
Encounter.serviceProvider
DefinitionThe 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.
Cardinality0...1
TypeReference(Organization)
Must SupportTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.performer.actor
  • v2: PL.6 & PL.1
  • rim: .particiaption[typeCode=PFM].role
  • fhir-patient-finder-mapping: (Organization) admission service provider
  • fhir-patient-finder-mapping: (Organization) admission period service provider
  • fhir-patient-finder-mapping: (Organization) appointment service provider
Encounter.partOf
DefinitionAnother Encounter of which this encounter is a part of (administratively or in time).
Cardinality0...1
TypeReference(Encounter)
Must SupportTrue
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.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • workflow: Event.partOf
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]
  • fhir-patient-finder-mapping: (Encounter) reference to the admission that the admission period is part of

Attribute list

Attribute Description Example
identifier.value The id that identifies the Encounter in the source system
status Encounter status 'completed'
class.code Used to determine an Encounter is an admission 'IMP'
class.display Description of the class, not mandatory 'inpatient encounter'
type.coding.code Encounter type code 'ShSt'
type.coding.display Encounter type descritpion 'Short stay'
subject Reference to the Patient that has the Encounter 'Patient/patient-1'
episodeOfCare Reference to the Episode of Care overarching the Encounter 'EpisodeOfCare/eoc-1'
participant.individual Reference to the care practitioner of the encounter 'Practioner/practitioner-1'
period.start Admission or appointment start date/time '2021-01-01T12:00:00Z'
period.end Admission or appointment end date/time '2021-01-02T12:00:00Z'
length The duration in minutes 1080
reasonCode.coding.code Classification code for the admission reason '843004'
reasonCode.coding.display Admission reason 'Poliomyelomalacia'
location Reference to the location of the Encounter 'Location/location-1'
serviceProvider Reference to the department facilitating the Encounter 'Organization/department-1'
partOf In the case of an Admission Period, this is a reference to the Encounter that represents the Admission it is part of