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This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-ballot: R5 Ballot - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

8.11 Resource Encounter - Content

Patient Administration icon Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Encounter , Patient , Practitioner , RelatedPerson

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. Encounter is primarily used to record information about the actual activities that occurred, where Appointment is used to record planned activities.

A patient encounter is further characterized by the setting in which it takes place. Amongst them are ambulatory, emergency, home health, inpatient and virtual encounters. An Encounter encompasses the lifecycle from pre-admission, the actual encounter (for ambulatory encounters), and admission, stay and discharge (for inpatient encounters). During the encounter the patient may move from practitioner to practitioner and location to location.

Because of the broad scope of Encounter, not all elements will be relevant in all settings. For this reason, admission/discharge related information is kept in a separate Hospitalization admission component within Encounter. The class element is used to distinguish between these settings, which will guide further validation and application of business rules.

There is also substantial variance from organization to organization (and between jurisdictions and countries) on which business events translate to the start of a new Encounter, or what level of aggregation is used for Encounter. For example, each single visit of a practitioner during a hospitalization may lead to a new instance of Encounter, but depending on local practice and the systems involved, it may well be that this is aggregated to a single instance for a whole hospitalization. admission. Even more aggregation may occur where jurisdictions introduce groups of Encounters for financial or other reasons. Encounters can be aggregated or grouped under other Encounters using the partOf element. See below for examples.

Encounter instances may exist before the actual encounter takes place to convey pre-admission information, including using Encounters elements to reflect the planned start date or planned encounter locations. In this case the status element is set to 'planned'.

The Hospitalization admission component is intended to store the extended information relating to a hospitalization admission event. It is always expected to be the same period as the encounter itself. Where the period is different, another encounter instance should be used to capture this information as a partOf this encounter instance.

The Procedure and encounter have references to each other, and these should be to different procedures; one for the procedure that was performed during the encounter (stored in Procedure.encounter), and another for cases where an encounter is a result of another procedure (stored in Encounter.indication) Encounter.reason) such as a follow-up encounter to resolve complications from an earlier procedure.

During the life-cycle of an encounter it will pass through many statuses. Typically these are in order or the organization's workflow: planned, in-progress, finished/cancelled.
This status information is often used for other things, and often an analysis of the status history is required. This could be done by scanning through all the versions of the encounter, checking the period of each, and then doing some form of post processing. To ease the burden of this (or where a system doesn't support resource histories) a status history component is included.

There is no direct indication purely by the status field as to whether an encounter is considered "admitted".
The context of the encounter and business practices/policies/workflows/types can influence this definition. (e.g., acute care facility, aged care center, outpatient clinic, emergency department, community-based clinic).
Statuses of "arrived", "triaged" or "in progress" could be considered the start of the admission, and also have the presence of the hospitalization admission sub-component entered.
The "discharged" status can be used when the patient care is complete but the encounter itself is not yet completed, such as while collating required information for billing or other purposes, or could be skipped and go direct to "completed".

The "on leave" status might or might not be a part of the admission, for example if the patient was permitted to go home for a weekend or some other form of external event.
The location is also likely to be filled in with a location status of "present". "active".
For other examples such as an outpatient visit (day procedure - colonoscopy), the patient could also be considered to be admitted, hence the encounter doesn't have a fixed definition of admitted. At a minimum, we do believe that a patient IS admitted when the status is in-progress.

The Encounter resource is not to be used to store appointment information, the Appointment resource is intended to be used for that. Note that in many systems outpatient encounters (which are in scope for Encounter) and Appointment are used concurrently. In FHIR, Appointment is used for establishing a date for the encounter, while Encounter is applicable to information about the actual Encounter, i.e., the patient showing up.
As such, an encounter in the "planned" status is not identical to the appointment that scheduled it, but it is the encounter prior to its actual occurrence, with the expectation that encounter will be updated as it progresses to completion. Patient arrival at a location does not necessarily mean the start of the encounter (e.g. a patient arrives an hour earlier than he is actually seen by a practitioner).

An appointment is normally used for the planning stage of an appointment, searching, locating an available time, then making the appointment. Once this process is completed and the appointment is about to start, then the appointment will be marked as fulfilled, and linked to the newly created encounter.
This new encounter may start in an "arrived" status when they are admitted at a location of the facility, and then will move to the ward where another part-of encounter may begin.

Communication resources are used for a simultaneous interaction between a practitioner and a patient where there is no direct contact. Examples include a phone message, or transmission of some correspondence documentation.
There is no duration recorded for a communication resource, but it could contain sent and received times.

Standard Extension: Associated Encounter
This extension should be used to reference an encounter where there is no property that already defines this association on the resource.

This resource is referenced by

Structure

Name Flags Card. Type Description & Constraints doco
. . Encounter TU DomainResource An interaction during which services are provided to the patient

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifier(s) by which this encounter is known

. . . status ?! Σ 1..1 code planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown
EncounterStatus ( Required )
. . . statusHistory 0..* BackboneElement List of past encounter statuses

. . . . status 1..1 code planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown
EncounterStatus ( Required )
. . . . period 1..1 Period The time that the episode was in the specified status
. . . class Σ 1..1 0..* Coding CodeableConcept Classification of patient encounter
ActEncounterCode EncounterClass icon ( Extensible Preferred )

. . . classHistory 0..* BackboneElement List of past encounter classes

. . . . class 1..1 Coding inpatient | outpatient | ambulatory | emergency +
ActEncounterCode EncounterClass icon ( Extensible Preferred )
. . . . period 1..1 Period The time that the episode was in the specified class
. . . type priority Σ 0..* 0..1 CodeableConcept Specific type Indicates the urgency of the encounter
EncounterType ActPriority icon ( Example )
. . . serviceType type Σ 0..1 0..* CodeableConcept Specific type of service encounter
ServiceType EncounterType ( Example )

. . priority . serviceType Σ 0..1 0..* CodeableConcept CodeableReference ( HealthcareService ) Indicates the urgency Specific type of the encounter service
ActPriority ServiceType ( Example )

. . . subject Σ 0..1 Reference ( Patient | Group ) The patient or group present at the related to this encounter
. . . subjectStatus 0..1 CodeableConcept The current status of the subject in relation to the Encounter
EncounterSubjectStatus ( Example )
... episodeOfCare Σ 0..* Reference ( EpisodeOfCare ) Episode(s) of care that this encounter should be recorded against

. . . basedOn 0..* Reference ( CarePlan | DeviceRequest | MedicationRequest | ServiceRequest ) The request that initiated this encounter

... careTeam 0..* Reference ( ServiceRequest CareTeam ) The ServiceRequest group(s) that initiated are allocated to participate in this encounter

. . . partOf 0..1 Reference ( Encounter ) Another Encounter this encounter is part of
... serviceProvider 0..1 Reference ( Organization ) The organization (facility) responsible for this encounter
. . . participant Σ C 0..* BackboneElement List of participants involved in the encounter
+ Rule: A type must be provided when no explicit actor is specified
+ Rule: A type cannot be provided for a patient or group participant

. . . . type Σ 0..* CodeableConcept Role of participant in encounter
ParticipantType ( Extensible )

. . . . period 0..1 Period Period of time during the encounter that the participant participated
. . . . individual actor Σ 0..1 Reference ( Patient | Group | RelatedPerson | Practitioner | PractitionerRole | RelatedPerson Device | HealthcareService ) Persons involved The individual, device, or service participating in the encounter other than the patient
. . . appointment Σ 0..* Reference ( Appointment ) The appointment that scheduled this encounter

. . . period virtualService 0..1 0..* VirtualServiceDetail Connection details of a virtual service (e.g. conference call)

... actualPeriod 0..1 Period The actual start and end time of the encounter
. . . plannedStartDate 0..1 dateTime The planned start date/time (or admission date) of the encounter
. . length . plannedEndDate 0..1 Duration dateTime Quantity The planned end date/time (or discharge date) of time the encounter lasted (less time absent)
. . . reasonCode length Σ 0..* 0..1 CodeableConcept Duration Coded reason Actual quantity of time the encounter takes place Encounter Reason Codes ( Preferred ) lasted (less time absent)
. . . reasonReference reason Σ 0..* Reference CodeableReference ( Condition | Procedure DiagnosticReport | ImmunizationRecommendation | Observation | ImmunizationRecommendation Procedure ) Reason the encounter takes place (reference) (core or reference)
Encounter Reason Codes ( Preferred )

. . . diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this encounter

. . . . condition Σ 1..1 Reference ( Condition | Procedure ) The diagnosis or procedure relevant to the encounter
. . . . use 0..1 CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
DiagnosisRole ( Preferred )
. . . . rank 0..1 positiveInt Ranking of the diagnosis (for each role type)
. . . account 0..* Reference ( Account ) The set of accounts that may be used for billing for this Encounter

. . . hospitalization admission 0..1 BackboneElement Details about the admission to a healthcare service
. . . . preAdmissionIdentifier 0..1 Identifier Pre-admission identifier
. . . . origin 0..1 Reference ( Location | Organization ) The location/organization from which the patient came before admission
. . . . admitSource 0..1 CodeableConcept From where patient was admitted (physician referral, transfer)
AdmitSource ( Preferred )
. . . . reAdmission 0..1 CodeableConcept The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
hl7VS-re-admissionIndicator icon ( Example )
. . . . dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Diet ( Example )

. . . . specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
SpecialCourtesy ( Preferred )

. . . . specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc.
SpecialArrangements ( Preferred )

. . . . destination 0..1 Reference ( Location | Organization ) Location/organization to which the patient is discharged
. . . . dischargeDisposition 0..1 CodeableConcept Category or kind of location after discharge
DischargeDisposition ( Example )
. . . location 0..* BackboneElement List of locations where the patient has been

. . . . location 1..1 Reference ( Location ) Location the encounter takes place
. . . . status 0..1 code planned | active | reserved | completed
EncounterLocationStatus ( Required )
. . . . physicalType form 0..1 CodeableConcept The physical type of the location (usually the level in the location hierachy hierarchy - bed room ward bed, room, ward, virtual etc.)
LocationType Location Form ( Example )
. . . . period 0..1 Period Time period during which the patient was present at the location serviceProvider 0..1 Reference ( Organization ) The organization (facility) responsible for this encounter partOf 0..1
Reference ( Encounter ) Another Encounter this encounter is part of

doco Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

Encounter ( DomainResource ) Identifier(s) by which this encounter is known identifier : Identifier [0..*] planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) EncounterStatus ! » Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations class : Coding CodeableConcept [1..1] [0..*] « null (Strength=Extensible) (Strength=Preferred) ActEncounterCode EncounterClass + ? » Indicates the urgency of the encounter priority : CodeableConcept [0..1] « null (Strength=Example) ActPriority ?? » Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation) type : CodeableConcept [0..*] « null (Strength=Example) EncounterType ?? » Broad categorization of the service that is to be provided (e.g. cardiology) serviceType : CodeableConcept CodeableReference [0..1] [0..*] « HealthcareService ; null (Strength=Example) ServiceType ?? » Indicates the urgency of The patient or group related to this encounter. In some use-cases the encounter patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam priority subject : CodeableConcept Reference [0..1] « null (Strength=Example) ActPriority Patient | Group ?? » The subjectStatus value can be used to track the patient's status within the encounter. It details whether the patient has arrived or group present at the encounter departed, has been triaged or is currently in a waiting status subject subjectStatus : Reference CodeableConcept [0..1] « Patient | Group null (Strength=Example) EncounterSubjectStatus ?? » Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years) episodeOfCare : Reference [0..*] « EpisodeOfCare » The request this encounter satisfies (e.g. incoming referral or procedure request) basedOn : Reference [0..*] « CarePlan | DeviceRequest | MedicationRequest | ServiceRequest » The group(s) of individuals, organizations that are allocated to participate in this encounter. The participants backbone will record the actuals of when these individuals participated during the encounter careTeam : Reference [0..*] « CareTeam » Another Encounter of which this encounter is a part of (administratively or in time) partOf : Reference [0..1] « Encounter » The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy serviceProvider : Reference [0..1] « Organization » The appointment that scheduled this encounter appointment : Reference [0..*] « Appointment » Connection details of a virtual service (e.g. conference call) virtualService : VirtualServiceDetail [0..*] The actual start and end time of the encounter period actualPeriod : Period [0..1] Quantity The planned start date/time (or admission date) of time the encounter lasted. This excludes the time during leaves of absence length plannedStartDate : Duration dateTime [0..1] Reason The planned end date/time (or discharge date) of the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis reasonCode plannedEndDate : CodeableConcept dateTime [0..*] « [0..1] null (Strength=Preferred) Actual quantity of time the encounter lasted. This excludes the time during leaves of absence. When missing it is the time in between the start and end values EncounterReasonCodes length ? » : Duration [0..1] Reason the encounter takes place, expressed as a code. code or a reference to another resource. For admissions, this can be used for a coded admission diagnosis reasonReference reason : Reference CodeableReference [0..*] « Condition | Procedure DiagnosticReport | ImmunizationRecommendation | Observation | Procedure ; null (Strength=Preferred) ImmunizationRecommendation EncounterReasonCodes ? » The set of accounts that may be used for billing for this Encounter account : Reference [0..*] « Account » The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy serviceProvider : Reference [0..1] « Organization » Another Encounter of which this encounter is a part of (administratively or in time) partOf : Reference [0..1] « Encounter » StatusHistory planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown status : code [1..1] « null (Strength=Required) EncounterStatus ! » The time that the episode was in the specified status period : Period [1..1] ClassHistory inpatient | outpatient | ambulatory | emergency + class : Coding [1..1] « null (Strength=Extensible) (Strength=Preferred) ActEncounterCode EncounterClass + ? » The time that the episode was in the specified class period : Period [1..1] Participant Role of participant in encounter type : CodeableConcept [0..*] « null (Strength=Extensible) ParticipantType + » The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period period : Period [0..1] Persons Person involved in the encounter other than encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times individual actor : Reference [0..1] « Practitioner Patient | PractitionerRole Group | RelatedPerson | Practitioner | RelatedPerson PractitionerRole | Device | HealthcareService » Diagnosis Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure condition : Reference [1..1] « Condition | Procedure » Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) use : CodeableConcept [0..1] « null (Strength=Preferred) DiagnosisRole ? » Ranking of the diagnosis (for each role type) rank : positiveInt [0..1] Hospitalization Admission Pre-admission identifier preAdmissionIdentifier : Identifier [0..1] The location/organization from which the patient came before admission origin : Reference [0..1] « Location | Organization » From where patient was admitted (physician referral, transfer) admitSource : CodeableConcept [0..1] « null (Strength=Preferred) AdmitSource ? » Whether this hospitalization admission is a readmission and why if known reAdmission : CodeableConcept [0..1] « null (Strength=Example) Hl7VSReAdmissionIndicator ?? » Diet preferences reported by the patient dietPreference : CodeableConcept [0..*] « null (Strength=Example) Diet ?? » Special courtesies (VIP, board member) specialCourtesy : CodeableConcept [0..*] « null (Strength=Preferred) SpecialCourtesy ? » Any special requests that have been made for this hospitalization admission encounter, such as the provision of specific equipment or other things specialArrangement : CodeableConcept [0..*] « null (Strength=Preferred) SpecialArrangements ? » Location/organization to which the patient is discharged destination : Reference [0..1] « Location | Organization » Category or kind of location after discharge dischargeDisposition : CodeableConcept [0..1] « null (Strength=Example) DischargeDisposition ?? » Location The location where the encounter takes place location : Reference [1..1] « Location » The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time status : code [0..1] « null (Strength=Required) EncounterLocationStatus ! » This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query physicalType form : CodeableConcept [0..1] « null (Strength=Example) LocationType LocationForm ?? » Time period during which the patient was present at the location period : Period [0..1] The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them statusHistory [0..*] The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient classHistory [0..*] The list of people responsible for providing the service participant [0..*] The list of diagnosis relevant to this encounter diagnosis [0..*] Details about the admission to a healthcare service hospitalization admission [0..1] List of locations where the patient has been during this encounter location [0..*]

XML Template

<

<Encounter xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) by which this encounter is known --></identifier>
 <

 <status value="[code]"/><!-- 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->

 <statusHistory>  <!-- 0..* List of past encounter statuses -->
  <

  <status value="[code]"/><!-- 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->

  <period><!-- 1..1 Period The time that the episode was in the specified status --></period>
 </statusHistory>
 <</class>

 <class><!-- 0..* CodeableConcept Classification of patient encounter icon --></class>

 <classHistory>  <!-- 0..* List of past encounter classes -->
  <</class>

  <class><!-- 1..1 Coding inpatient | outpatient | ambulatory | emergency + icon --></class>

  <period><!-- 1..1 Period The time that the episode was in the specified class --></period>
 </classHistory>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter icon --></priority>

 <type><!-- 0..* CodeableConcept Specific type of encounter --></type>
 <</serviceType>
 <</priority>
 <</subject>

 <serviceType><!-- 0..* CodeableReference(HealthcareService) Specific type of service --></serviceType>
 <subject><!-- 0..1 Reference(Group|Patient) The patient or group related to this encounter --></subject>
 <subjectStatus><!-- 0..1 CodeableConcept The current status of the subject in relation to the Encounter --></subjectStatus>

 <episodeOfCare><!-- 0..* Reference(EpisodeOfCare) Episode(s) of care that this encounter should be recorded against --></episodeOfCare>
 <</basedOn>

 <basedOn><!-- 0..* Reference(CarePlan|DeviceRequest|MedicationRequest|
   ServiceRequest) The request that initiated this encounter --></basedOn>

 <careTeam><!-- 0..* Reference(CareTeam) The group(s) that are allocated to participate in this encounter --></careTeam>
 <partOf><!-- 0..1 Reference(Encounter) Another Encounter this encounter is part of --></partOf>
 <serviceProvider><!-- 0..1 Reference(Organization) The organization (facility) responsible for this encounter --></serviceProvider>

 <participant>  <!-- 0..* List of participants involved in the encounter -->
  <type><!-- 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter that the participant participated --></period>
  <</individual>

  <actor><!-- 0..1 Reference(Device|Group|HealthcareService|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The individual, device, or service participating in the encounter --></actor>
 </participant>
 <appointment><!-- 0..* Reference(Appointment) The appointment that scheduled this encounter --></appointment>
 <</period>
 <</length>
 <</reasonCode>
 <|
   </reasonReference>

 <virtualService><!-- 0..* VirtualServiceDetail Connection details of a virtual service (e.g. conference call) --></virtualService>
 <actualPeriod><!-- 0..1 Period The actual start and end time of the encounter --></actualPeriod>
 <plannedStartDate value="[dateTime]"/><!-- 0..1 The planned start date/time (or admission date) of the encounter -->
 <plannedEndDate value="[dateTime]"/><!-- 0..1 The planned end date/time (or discharge date) of the encounter -->
 <length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|
   ImmunizationRecommendation|Observation|Procedure) Reason the encounter takes place (core or reference) --></reason>
 <diagnosis>  <!-- 0..* The list of diagnosis relevant to this encounter -->
  <condition><!-- 1..1 Reference(Condition|Procedure) The diagnosis or procedure relevant to the encounter --></condition>
  <use><!-- 0..1 CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) --></use>
  <rank value="[positiveInt]"/><!-- 0..1 Ranking of the diagnosis (for each role type) -->
 </diagnosis>
 <account><!-- 0..* Reference(Account) The set of accounts that may be used for billing for this Encounter --></account>
 <
  <</preAdmissionIdentifier>
  <</origin>
  <</admitSource>
  <</reAdmission>
  <</dietPreference>
  <</specialCourtesy>
  <</specialArrangement>
  <</destination>
  <</dischargeDisposition>
 </hospitalization>

 <admission>  <!-- 0..1 Details about the admission to a healthcare service -->
  <preAdmissionIdentifier><!-- 0..1 Identifier Pre-admission identifier --></preAdmissionIdentifier>
  <origin><!-- 0..1 Reference(Location|Organization) The location/organization from which the patient came before admission --></origin>
  <admitSource><!-- 0..1 CodeableConcept From where patient was admitted (physician referral, transfer) --></admitSource>
  <reAdmission><!-- 0..1 CodeableConcept The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission icon --></reAdmission>
  <dietPreference><!-- 0..* CodeableConcept Diet preferences reported by the patient --></dietPreference>
  <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
  <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc. --></specialArrangement>
  <destination><!-- 0..1 Reference(Location|Organization) Location/organization to which the patient is discharged --></destination>
  <dischargeDisposition><!-- 0..1 CodeableConcept Category or kind of location after discharge --></dischargeDisposition>
 </admission>

 <location>  <!-- 0..* List of locations where the patient has been -->
  <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location>
  <status value="[code]"/><!-- 0..1 planned | active | reserved | completed -->
  <</physicalType>

  <form><!-- 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) --></form>

  <period><!-- 0..1 Period Time period during which the patient was present at the location --></period>
 </location>
 <</serviceProvider>
 <</partOf>

</Encounter>

JSON Template

{doco
  "resourceType" : "",

  "resourceType" : "Encounter",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) by which this encounter is known
  "

  "status" : "<code>", // R!  planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

  "statusHistory" : [{ // List of past encounter statuses
    "

    "status" : "<code>", // R!  planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

    "period" : { Period } // R!  The time that the episode was in the specified status
  }],
  "

  "class" : [{ CodeableConcept }], // Classification of patient encounter icon

  "classHistory" : [{ // List of past encounter classes
    "

    "class" : { Coding }, // R!  inpatient | outpatient | ambulatory | emergency + icon

    "period" : { Period } // R!  The time that the episode was in the specified class
  }],
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter icon

  "type" : [{ CodeableConcept }], // Specific type of encounter
  "
  "
  "

  "serviceType" : [{ CodeableReference(HealthcareService) }], // Specific type of service
  "subject" : { Reference(Group|Patient) }, // The patient or group related to this encounter
  "subjectStatus" : { CodeableConcept }, // The current status of the subject in relation to the Encounter

  "episodeOfCare" : [{ Reference(EpisodeOfCare) }], // Episode(s) of care that this encounter should be recorded against
  "

  "basedOn" : [{ Reference(CarePlan|DeviceRequest|MedicationRequest|
   ServiceRequest) }], // The request that initiated this encounter

  "careTeam" : [{ Reference(CareTeam) }], // The group(s) that are allocated to participate in this encounter
  "partOf" : { Reference(Encounter) }, // Another Encounter this encounter is part of
  "serviceProvider" : { Reference(Organization) }, // The organization (facility) responsible for this encounter

  "participant" : [{ // List of participants involved in the encounter
    "type" : [{ CodeableConcept }], // Role of participant in encounter
    "period" : { Period }, // Period of time during the encounter that the participant participated
    "

    "actor" : { Reference(Device|Group|HealthcareService|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // The individual, device, or service participating in the encounter
  }],
  "appointment" : [{ Reference(Appointment) }], // The appointment that scheduled this encounter
  "
  "
  "
  "|
   

  "virtualService" : [{ VirtualServiceDetail }], // Connection details of a virtual service (e.g. conference call)
  "actualPeriod" : { Period }, // The actual start and end time of the encounter
  "plannedStartDate" : "<dateTime>", // The planned start date/time (or admission date) of the encounter
  "plannedEndDate" : "<dateTime>", // The planned end date/time (or discharge date) of the encounter
  "length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|
   ImmunizationRecommendation|Observation|Procedure) }], // Reason the encounter takes place (core or reference)
  "diagnosis" : [{ // The list of diagnosis relevant to this encounter
    "condition" : { Reference(Condition|Procedure) }, // R!  The diagnosis or procedure relevant to the encounter
    "use" : { CodeableConcept }, // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
    "rank" : "<positiveInt>" // Ranking of the diagnosis (for each role type)
  }],
  "account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
  "
    "
    "
    "
    "
    "
    "
    "
    "
    "

  "admission" : { // Details about the admission to a healthcare service
    "preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
    "origin" : { Reference(Location|Organization) }, // The location/organization from which the patient came before admission
    "admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
    "reAdmission" : { CodeableConcept }, // The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission icon
    "dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
    "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
    "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc.
    "destination" : { Reference(Location|Organization) }, // Location/organization to which the patient is discharged
    "dischargeDisposition" : { CodeableConcept } // Category or kind of location after discharge

  },
  "location" : [{ // List of locations where the patient has been
    "location" : { Reference(Location) }, // R!  Location the encounter takes place
    "status" : "<code>", // planned | active | reserved | completed
    "

    "form" : { CodeableConcept }, // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)

    "period" : { Period } // Time period during which the patient was present at the location
  }],
  "
  "

  }]

}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:Encounter;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Encounter.identifier [ Identifier ], ... ; # 0..* Identifier(s) by which this encounter is known
  fhir:

  fhir:Encounter.status [ code ]; # 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

  fhir:Encounter.statusHistory [ # 0..* List of past encounter statuses
    fhir:

    fhir:Encounter.statusHistory.status [ code ]; # 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

    fhir:Encounter.statusHistory.period [ Period ]; # 1..1 The time that the episode was in the specified status
  ], ...;
  fhir:

  fhir:Encounter.class [ CodeableConcept ], ... ; # 0..* Classification of patient encounter

  fhir:Encounter.classHistory [ # 0..* List of past encounter classes
    fhir:Encounter.classHistory.class [ Coding ]; # 1..1 inpatient | outpatient | ambulatory | emergency +
    fhir:Encounter.classHistory.period [ Period ]; # 1..1 The time that the episode was in the specified class
  ], ...;
  fhir:
  fhir:

  fhir:Encounter.priority [ CodeableConcept ]; # 0..1 Indicates the urgency of the encounter
  fhir:

  fhir:Encounter.type [ CodeableConcept ], ... ; # 0..* Specific type of encounter
  fhir:Encounter.serviceType [ CodeableReference(HealthcareService) ], ... ; # 0..* Specific type of service
  fhir:Encounter.subject [ Reference(Group|Patient) ]; # 0..1 The patient or group related to this encounter
  fhir:Encounter.subjectStatus [ CodeableConcept ]; # 0..1 The current status of the subject in relation to the Encounter

  fhir:Encounter.episodeOfCare [ Reference(EpisodeOfCare) ], ... ; # 0..* Episode(s) of care that this encounter should be recorded against
  fhir:

  fhir:Encounter.basedOn [ Reference(CarePlan|DeviceRequest|MedicationRequest|ServiceRequest) ], ... ; # 0..* The request that initiated this encounter
  fhir:Encounter.careTeam [ Reference(CareTeam) ], ... ; # 0..* The group(s) that are allocated to participate in this encounter
  fhir:Encounter.partOf [ Reference(Encounter) ]; # 0..1 Another Encounter this encounter is part of
  fhir:Encounter.serviceProvider [ Reference(Organization) ]; # 0..1 The organization (facility) responsible for this encounter

  fhir:Encounter.participant [ # 0..* List of participants involved in the encounter
    fhir:Encounter.participant.type [ CodeableConcept ], ... ; # 0..* Role of participant in encounter
    fhir:Encounter.participant.period [ Period ]; # 0..1 Period of time during the encounter that the participant participated
    fhir:

    fhir:Encounter.participant.actor [ Reference(Device|Group|HealthcareService|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ]; # 0..1 The individual, device, or service participating in the encounter
  ], ...;
  fhir:Encounter.appointment [ Reference(Appointment) ], ... ; # 0..* The appointment that scheduled this encounter
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:Encounter.virtualService [ VirtualServiceDetail ], ... ; # 0..* Connection details of a virtual service (e.g. conference call)
  fhir:Encounter.actualPeriod [ Period ]; # 0..1 The actual start and end time of the encounter
  fhir:Encounter.plannedStartDate [ dateTime ]; # 0..1 The planned start date/time (or admission date) of the encounter
  fhir:Encounter.plannedEndDate [ dateTime ]; # 0..1 The planned end date/time (or discharge date) of the encounter
  fhir:Encounter.length [ Duration ]; # 0..1 Actual quantity of time the encounter lasted (less time absent)
  fhir:Encounter.reason [ CodeableReference(Condition|DiagnosticReport|ImmunizationRecommendation|Observation|Procedure) ], ... ; # 0..* Reason the encounter takes place (core or reference)

  fhir:Encounter.diagnosis [ # 0..* The list of diagnosis relevant to this encounter
    fhir:Encounter.diagnosis.condition [ Reference(Condition|Procedure) ]; # 1..1 The diagnosis or procedure relevant to the encounter
    fhir:Encounter.diagnosis.use [ CodeableConcept ]; # 0..1 Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
    fhir:Encounter.diagnosis.rank [ positiveInt ]; # 0..1 Ranking of the diagnosis (for each role type)
  ], ...;
  fhir:Encounter.account [ Reference(Account) ], ... ; # 0..* The set of accounts that may be used for billing for this Encounter
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:Encounter.admission [ # 0..1 Details about the admission to a healthcare service
    fhir:Encounter.admission.preAdmissionIdentifier [ Identifier ]; # 0..1 Pre-admission identifier
    fhir:Encounter.admission.origin [ Reference(Location|Organization) ]; # 0..1 The location/organization from which the patient came before admission
    fhir:Encounter.admission.admitSource [ CodeableConcept ]; # 0..1 From where patient was admitted (physician referral, transfer)
    fhir:Encounter.admission.reAdmission [ CodeableConcept ]; # 0..1 The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
    fhir:Encounter.admission.dietPreference [ CodeableConcept ], ... ; # 0..* Diet preferences reported by the patient
    fhir:Encounter.admission.specialCourtesy [ CodeableConcept ], ... ; # 0..* Special courtesies (VIP, board member)
    fhir:Encounter.admission.specialArrangement [ CodeableConcept ], ... ; # 0..* Wheelchair, translator, stretcher, etc.
    fhir:Encounter.admission.destination [ Reference(Location|Organization) ]; # 0..1 Location/organization to which the patient is discharged
    fhir:Encounter.admission.dischargeDisposition [ CodeableConcept ]; # 0..1 Category or kind of location after discharge

  ];
  fhir:Encounter.location [ # 0..* List of locations where the patient has been
    fhir:Encounter.location.location [ Reference(Location) ]; # 1..1 Location the encounter takes place
    fhir:Encounter.location.status [ code ]; # 0..1 planned | active | reserved | completed
    fhir:

    fhir:Encounter.location.form [ CodeableConcept ]; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)

    fhir:Encounter.location.period [ Period ]; # 0..1 Time period during which the patient was present at the location
  ], ...;
  fhir:
  fhir:

]

Changes since R4

Encounter
Encounter.class
  • No Changes Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
  • Type changed from Coding to CodeableConcept
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
Encounter.classHistory.class
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
Encounter.serviceType
  • Max Cardinality changed from 1 to *
  • Type changed from CodeableConcept to CodeableReference
  • Type changed from CodeableConcept to CodeableReference
Encounter.subjectStatus
  • Added Element
Encounter.basedOn
  • Type Reference: Added Target Types CarePlan, DeviceRequest, MedicationRequest
  • Type Reference: Added Target Types CarePlan, DeviceRequest, MedicationRequest
Encounter.careTeam
  • Added Element
Encounter.participant.actor
  • Added Element
Encounter.virtualService
  • Added Element
Encounter.actualPeriod
  • Added Element
Encounter.plannedStartDate
  • Added Element
Encounter.plannedEndDate
  • Added Element
Encounter.reason
  • Added Element
Encounter.admission
  • Added Element
Encounter.admission.preAdmissionIdentifier
  • Added Element
Encounter.admission.origin
  • Added Element
Encounter.admission.admitSource
  • Added Element
Encounter.admission.reAdmission
  • Added Element
Encounter.admission.dietPreference
  • Added Element
Encounter.admission.specialCourtesy
  • Added Element
Encounter.admission.specialArrangement
  • Added Element
Encounter.admission.destination
  • Added Element
Encounter.admission.dischargeDisposition
  • Added Element
Encounter.location.form
  • Added Element
Encounter.participant.individual
  • deleted
Encounter.period
  • deleted
Encounter.reasonCode
  • deleted
Encounter.reasonReference
  • deleted
Encounter.hospitalization
  • deleted
Encounter.location.physicalType
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 10 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . Encounter TU DomainResource An interaction during which services are provided to the patient

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier Identifier(s) by which this encounter is known

. . . status ?! Σ 1..1 code planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown
EncounterStatus ( Required )
. . . statusHistory 0..* BackboneElement List of past encounter statuses

. . . . status 1..1 code planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown
EncounterStatus ( Required )
. . . . period 1..1 Period The time that the episode was in the specified status
. . . class Σ 1..1 0..* Coding CodeableConcept Classification of patient encounter
ActEncounterCode EncounterClass icon ( Extensible Preferred )

. . . classHistory 0..* BackboneElement List of past encounter classes

. . . . class 1..1 Coding inpatient | outpatient | ambulatory | emergency +
ActEncounterCode EncounterClass icon ( Extensible Preferred )
. . . . period 1..1 Period The time that the episode was in the specified class
. . . type priority Σ 0..* 0..1 CodeableConcept Specific type Indicates the urgency of the encounter
EncounterType ActPriority icon ( Example )
. . . serviceType type Σ 0..1 0..* CodeableConcept Specific type of service encounter
ServiceType EncounterType ( Example )

. . priority . serviceType Σ 0..1 0..* CodeableConcept CodeableReference ( HealthcareService ) Indicates the urgency Specific type of the encounter service
ActPriority ServiceType ( Example )

. . . subject Σ 0..1 Reference ( Patient | Group ) The patient or group present at the related to this encounter
. . . subjectStatus 0..1 CodeableConcept The current status of the subject in relation to the Encounter
EncounterSubjectStatus ( Example )
... episodeOfCare Σ 0..* Reference ( EpisodeOfCare ) Episode(s) of care that this encounter should be recorded against

. . . basedOn 0..* Reference ( CarePlan | DeviceRequest | MedicationRequest | ServiceRequest ) The request that initiated this encounter

... careTeam 0..* Reference ( ServiceRequest CareTeam ) The ServiceRequest group(s) that initiated are allocated to participate in this encounter

. . . partOf 0..1 Reference ( Encounter ) Another Encounter this encounter is part of
... serviceProvider 0..1 Reference ( Organization ) The organization (facility) responsible for this encounter
. . . participant Σ C 0..* BackboneElement List of participants involved in the encounter
+ Rule: A type must be provided when no explicit actor is specified
+ Rule: A type cannot be provided for a patient or group participant

. . . . type Σ 0..* CodeableConcept Role of participant in encounter
ParticipantType ( Extensible )

. . . . period 0..1 Period Period of time during the encounter that the participant participated
. . . . individual actor Σ 0..1 Reference ( Patient | Group | RelatedPerson | Practitioner | PractitionerRole | RelatedPerson Device | HealthcareService ) Persons involved The individual, device, or service participating in the encounter other than the patient
. . . appointment Σ 0..* Reference ( Appointment ) The appointment that scheduled this encounter

. . . period virtualService 0..1 0..* VirtualServiceDetail Connection details of a virtual service (e.g. conference call)

... actualPeriod 0..1 Period The actual start and end time of the encounter
. . . plannedStartDate 0..1 dateTime The planned start date/time (or admission date) of the encounter
. . length . plannedEndDate 0..1 Duration dateTime Quantity The planned end date/time (or discharge date) of time the encounter lasted (less time absent)
. . . reasonCode length Σ 0..* 0..1 CodeableConcept Duration Coded reason Actual quantity of time the encounter takes place Encounter Reason Codes ( Preferred ) lasted (less time absent)
. . . reasonReference reason Σ 0..* Reference CodeableReference ( Condition | Procedure DiagnosticReport | ImmunizationRecommendation | Observation | ImmunizationRecommendation Procedure ) Reason the encounter takes place (reference) (core or reference)
Encounter Reason Codes ( Preferred )

. . . diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this encounter

. . . . condition Σ 1..1 Reference ( Condition | Procedure ) The diagnosis or procedure relevant to the encounter
. . . . use 0..1 CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
DiagnosisRole ( Preferred )
. . . . rank 0..1 positiveInt Ranking of the diagnosis (for each role type)
. . . account 0..* Reference ( Account ) The set of accounts that may be used for billing for this Encounter

. . . hospitalization admission 0..1 BackboneElement Details about the admission to a healthcare service
. . . . preAdmissionIdentifier 0..1 Identifier Pre-admission identifier
. . . . origin 0..1 Reference ( Location | Organization ) The location/organization from which the patient came before admission
. . . . admitSource 0..1 CodeableConcept From where patient was admitted (physician referral, transfer)
AdmitSource ( Preferred )
. . . . reAdmission 0..1 CodeableConcept The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
hl7VS-re-admissionIndicator icon ( Example )
. . . . dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Diet ( Example )

. . . . specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
SpecialCourtesy ( Preferred )

. . . . specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc.
SpecialArrangements ( Preferred )

. . . . destination 0..1 Reference ( Location | Organization ) Location/organization to which the patient is discharged
. . . . dischargeDisposition 0..1 CodeableConcept Category or kind of location after discharge
DischargeDisposition ( Example )
. . . location 0..* BackboneElement List of locations where the patient has been

. . . . location 1..1 Reference ( Location ) Location the encounter takes place
. . . . status 0..1 code planned | active | reserved | completed
EncounterLocationStatus ( Required )
. . . . physicalType form 0..1 CodeableConcept The physical type of the location (usually the level in the location hierachy hierarchy - bed room ward bed, room, ward, virtual etc.)
LocationType Location Form ( Example )
. . . . period 0..1 Period Time period during which the patient was present at the location serviceProvider 0..1 Reference ( Organization ) The organization (facility) responsible for this encounter partOf 0..1 Reference ( Encounter )
Another Encounter this encounter is part of

doco Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

Encounter ( DomainResource ) Identifier(s) by which this encounter is known identifier : Identifier [0..*] planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) EncounterStatus ! » Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations class : Coding CodeableConcept [1..1] [0..*] « null (Strength=Extensible) (Strength=Preferred) ActEncounterCode EncounterClass + ? » Indicates the urgency of the encounter priority : CodeableConcept [0..1] « null (Strength=Example) ActPriority ?? » Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation) type : CodeableConcept [0..*] « null (Strength=Example) EncounterType ?? » Broad categorization of the service that is to be provided (e.g. cardiology) serviceType : CodeableConcept CodeableReference [0..1] [0..*] « HealthcareService ; null (Strength=Example) ServiceType ?? » Indicates the urgency of The patient or group related to this encounter. In some use-cases the encounter patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam priority subject : CodeableConcept Reference [0..1] « null (Strength=Example) ActPriority Patient | Group ?? » The subjectStatus value can be used to track the patient's status within the encounter. It details whether the patient has arrived or group present at the encounter departed, has been triaged or is currently in a waiting status subject subjectStatus : Reference CodeableConcept [0..1] « Patient | Group null (Strength=Example) EncounterSubjectStatus ?? » Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years) episodeOfCare : Reference [0..*] « EpisodeOfCare » The request this encounter satisfies (e.g. incoming referral or procedure request) basedOn : Reference [0..*] « CarePlan | DeviceRequest | MedicationRequest | ServiceRequest » The group(s) of individuals, organizations that are allocated to participate in this encounter. The participants backbone will record the actuals of when these individuals participated during the encounter careTeam : Reference [0..*] « CareTeam » Another Encounter of which this encounter is a part of (administratively or in time) partOf : Reference [0..1] « Encounter » The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy serviceProvider : Reference [0..1] « Organization » The appointment that scheduled this encounter appointment : Reference [0..*] « Appointment » Connection details of a virtual service (e.g. conference call) virtualService : VirtualServiceDetail [0..*] The actual start and end time of the encounter period actualPeriod : Period [0..1] Quantity The planned start date/time (or admission date) of time the encounter lasted. This excludes the time during leaves of absence length plannedStartDate : Duration dateTime [0..1] Reason The planned end date/time (or discharge date) of the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis reasonCode plannedEndDate : CodeableConcept dateTime [0..*] « [0..1] null (Strength=Preferred) Actual quantity of time the encounter lasted. This excludes the time during leaves of absence. When missing it is the time in between the start and end values EncounterReasonCodes length ? » : Duration [0..1] Reason the encounter takes place, expressed as a code. code or a reference to another resource. For admissions, this can be used for a coded admission diagnosis reasonReference reason : Reference CodeableReference [0..*] « Condition | Procedure DiagnosticReport | ImmunizationRecommendation | Observation | Procedure ; null (Strength=Preferred) ImmunizationRecommendation EncounterReasonCodes ? » The set of accounts that may be used for billing for this Encounter account : Reference [0..*] « Account » The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy serviceProvider : Reference [0..1] « Organization » Another Encounter of which this encounter is a part of (administratively or in time) partOf : Reference [0..1] « Encounter » StatusHistory planned | arrived | triaged | in-progress | onleave onhold | finished discharged | completed | cancelled + | discontinued | entered-in-error | unknown status : code [1..1] « null (Strength=Required) EncounterStatus ! » The time that the episode was in the specified status period : Period [1..1] ClassHistory inpatient | outpatient | ambulatory | emergency + class : Coding [1..1] « null (Strength=Extensible) (Strength=Preferred) ActEncounterCode EncounterClass + ? » The time that the episode was in the specified class period : Period [1..1] Participant Role of participant in encounter type : CodeableConcept [0..*] « null (Strength=Extensible) ParticipantType + » The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period period : Period [0..1] Persons Person involved in the encounter other than encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times individual actor : Reference [0..1] « Practitioner Patient | PractitionerRole Group | RelatedPerson | Practitioner | RelatedPerson PractitionerRole | Device | HealthcareService » Diagnosis Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure condition : Reference [1..1] « Condition | Procedure » Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) use : CodeableConcept [0..1] « null (Strength=Preferred) DiagnosisRole ? » Ranking of the diagnosis (for each role type) rank : positiveInt [0..1] Hospitalization Admission Pre-admission identifier preAdmissionIdentifier : Identifier [0..1] The location/organization from which the patient came before admission origin : Reference [0..1] « Location | Organization » From where patient was admitted (physician referral, transfer) admitSource : CodeableConcept [0..1] « null (Strength=Preferred) AdmitSource ? » Whether this hospitalization admission is a readmission and why if known reAdmission : CodeableConcept [0..1] « null (Strength=Example) Hl7VSReAdmissionIndicator ?? » Diet preferences reported by the patient dietPreference : CodeableConcept [0..*] « null (Strength=Example) Diet ?? » Special courtesies (VIP, board member) specialCourtesy : CodeableConcept [0..*] « null (Strength=Preferred) SpecialCourtesy ? » Any special requests that have been made for this hospitalization admission encounter, such as the provision of specific equipment or other things specialArrangement : CodeableConcept [0..*] « null (Strength=Preferred) SpecialArrangements ? » Location/organization to which the patient is discharged destination : Reference [0..1] « Location | Organization » Category or kind of location after discharge dischargeDisposition : CodeableConcept [0..1] « null (Strength=Example) DischargeDisposition ?? » Location The location where the encounter takes place location : Reference [1..1] « Location » The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time status : code [0..1] « null (Strength=Required) EncounterLocationStatus ! » This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query physicalType form : CodeableConcept [0..1] « null (Strength=Example) LocationType LocationForm ?? » Time period during which the patient was present at the location period : Period [0..1] The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them statusHistory [0..*] The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient classHistory [0..*] The list of people responsible for providing the service participant [0..*] The list of diagnosis relevant to this encounter diagnosis [0..*] Details about the admission to a healthcare service hospitalization admission [0..1] List of locations where the patient has been during this encounter location [0..*]

XML Template

<

<Encounter xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifier(s) by which this encounter is known --></identifier>
 <

 <status value="[code]"/><!-- 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->

 <statusHistory>  <!-- 0..* List of past encounter statuses -->
  <

  <status value="[code]"/><!-- 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->

  <period><!-- 1..1 Period The time that the episode was in the specified status --></period>
 </statusHistory>
 <</class>

 <class><!-- 0..* CodeableConcept Classification of patient encounter icon --></class>

 <classHistory>  <!-- 0..* List of past encounter classes -->
  <</class>

  <class><!-- 1..1 Coding inpatient | outpatient | ambulatory | emergency + icon --></class>

  <period><!-- 1..1 Period The time that the episode was in the specified class --></period>
 </classHistory>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter icon --></priority>

 <type><!-- 0..* CodeableConcept Specific type of encounter --></type>
 <</serviceType>
 <</priority>
 <</subject>

 <serviceType><!-- 0..* CodeableReference(HealthcareService) Specific type of service --></serviceType>
 <subject><!-- 0..1 Reference(Group|Patient) The patient or group related to this encounter --></subject>
 <subjectStatus><!-- 0..1 CodeableConcept The current status of the subject in relation to the Encounter --></subjectStatus>

 <episodeOfCare><!-- 0..* Reference(EpisodeOfCare) Episode(s) of care that this encounter should be recorded against --></episodeOfCare>
 <</basedOn>

 <basedOn><!-- 0..* Reference(CarePlan|DeviceRequest|MedicationRequest|
   ServiceRequest) The request that initiated this encounter --></basedOn>

 <careTeam><!-- 0..* Reference(CareTeam) The group(s) that are allocated to participate in this encounter --></careTeam>
 <partOf><!-- 0..1 Reference(Encounter) Another Encounter this encounter is part of --></partOf>
 <serviceProvider><!-- 0..1 Reference(Organization) The organization (facility) responsible for this encounter --></serviceProvider>

 <participant>  <!-- 0..* List of participants involved in the encounter -->
  <type><!-- 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter that the participant participated --></period>
  <</individual>

  <actor><!-- 0..1 Reference(Device|Group|HealthcareService|Patient|Practitioner|
    PractitionerRole|RelatedPerson) The individual, device, or service participating in the encounter --></actor>
 </participant>
 <appointment><!-- 0..* Reference(Appointment) The appointment that scheduled this encounter --></appointment>
 <</period>
 <</length>
 <</reasonCode>
 <|
   </reasonReference>

 <virtualService><!-- 0..* VirtualServiceDetail Connection details of a virtual service (e.g. conference call) --></virtualService>
 <actualPeriod><!-- 0..1 Period The actual start and end time of the encounter --></actualPeriod>
 <plannedStartDate value="[dateTime]"/><!-- 0..1 The planned start date/time (or admission date) of the encounter -->
 <plannedEndDate value="[dateTime]"/><!-- 0..1 The planned end date/time (or discharge date) of the encounter -->
 <length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|
   ImmunizationRecommendation|Observation|Procedure) Reason the encounter takes place (core or reference) --></reason>
 <diagnosis>  <!-- 0..* The list of diagnosis relevant to this encounter -->
  <condition><!-- 1..1 Reference(Condition|Procedure) The diagnosis or procedure relevant to the encounter --></condition>
  <use><!-- 0..1 CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) --></use>
  <rank value="[positiveInt]"/><!-- 0..1 Ranking of the diagnosis (for each role type) -->
 </diagnosis>
 <account><!-- 0..* Reference(Account) The set of accounts that may be used for billing for this Encounter --></account>
 <
  <</preAdmissionIdentifier>
  <</origin>
  <</admitSource>
  <</reAdmission>
  <</dietPreference>
  <</specialCourtesy>
  <</specialArrangement>
  <</destination>
  <</dischargeDisposition>
 </hospitalization>

 <admission>  <!-- 0..1 Details about the admission to a healthcare service -->
  <preAdmissionIdentifier><!-- 0..1 Identifier Pre-admission identifier --></preAdmissionIdentifier>
  <origin><!-- 0..1 Reference(Location|Organization) The location/organization from which the patient came before admission --></origin>
  <admitSource><!-- 0..1 CodeableConcept From where patient was admitted (physician referral, transfer) --></admitSource>
  <reAdmission><!-- 0..1 CodeableConcept The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission icon --></reAdmission>
  <dietPreference><!-- 0..* CodeableConcept Diet preferences reported by the patient --></dietPreference>
  <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
  <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc. --></specialArrangement>
  <destination><!-- 0..1 Reference(Location|Organization) Location/organization to which the patient is discharged --></destination>
  <dischargeDisposition><!-- 0..1 CodeableConcept Category or kind of location after discharge --></dischargeDisposition>
 </admission>

 <location>  <!-- 0..* List of locations where the patient has been -->
  <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location>
  <status value="[code]"/><!-- 0..1 planned | active | reserved | completed -->
  <</physicalType>

  <form><!-- 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) --></form>

  <period><!-- 0..1 Period Time period during which the patient was present at the location --></period>
 </location>
 <</serviceProvider>
 <</partOf>

</Encounter>

JSON Template

{doco
  "resourceType" : "",

  "resourceType" : "Encounter",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifier(s) by which this encounter is known
  "

  "status" : "<code>", // R!  planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

  "statusHistory" : [{ // List of past encounter statuses
    "

    "status" : "<code>", // R!  planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

    "period" : { Period } // R!  The time that the episode was in the specified status
  }],
  "

  "class" : [{ CodeableConcept }], // Classification of patient encounter icon

  "classHistory" : [{ // List of past encounter classes
    "

    "class" : { Coding }, // R!  inpatient | outpatient | ambulatory | emergency + icon

    "period" : { Period } // R!  The time that the episode was in the specified class
  }],
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter icon

  "type" : [{ CodeableConcept }], // Specific type of encounter
  "
  "
  "

  "serviceType" : [{ CodeableReference(HealthcareService) }], // Specific type of service
  "subject" : { Reference(Group|Patient) }, // The patient or group related to this encounter
  "subjectStatus" : { CodeableConcept }, // The current status of the subject in relation to the Encounter

  "episodeOfCare" : [{ Reference(EpisodeOfCare) }], // Episode(s) of care that this encounter should be recorded against
  "

  "basedOn" : [{ Reference(CarePlan|DeviceRequest|MedicationRequest|
   ServiceRequest) }], // The request that initiated this encounter

  "careTeam" : [{ Reference(CareTeam) }], // The group(s) that are allocated to participate in this encounter
  "partOf" : { Reference(Encounter) }, // Another Encounter this encounter is part of
  "serviceProvider" : { Reference(Organization) }, // The organization (facility) responsible for this encounter

  "participant" : [{ // List of participants involved in the encounter
    "type" : [{ CodeableConcept }], // Role of participant in encounter
    "period" : { Period }, // Period of time during the encounter that the participant participated
    "

    "actor" : { Reference(Device|Group|HealthcareService|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // The individual, device, or service participating in the encounter
  }],
  "appointment" : [{ Reference(Appointment) }], // The appointment that scheduled this encounter
  "
  "
  "
  "|
   

  "virtualService" : [{ VirtualServiceDetail }], // Connection details of a virtual service (e.g. conference call)
  "actualPeriod" : { Period }, // The actual start and end time of the encounter
  "plannedStartDate" : "<dateTime>", // The planned start date/time (or admission date) of the encounter
  "plannedEndDate" : "<dateTime>", // The planned end date/time (or discharge date) of the encounter
  "length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|
   ImmunizationRecommendation|Observation|Procedure) }], // Reason the encounter takes place (core or reference)
  "diagnosis" : [{ // The list of diagnosis relevant to this encounter
    "condition" : { Reference(Condition|Procedure) }, // R!  The diagnosis or procedure relevant to the encounter
    "use" : { CodeableConcept }, // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
    "rank" : "<positiveInt>" // Ranking of the diagnosis (for each role type)
  }],
  "account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
  "
    "
    "
    "
    "
    "
    "
    "
    "
    "

  "admission" : { // Details about the admission to a healthcare service
    "preAdmissionIdentifier" : { Identifier }, // Pre-admission identifier
    "origin" : { Reference(Location|Organization) }, // The location/organization from which the patient came before admission
    "admitSource" : { CodeableConcept }, // From where patient was admitted (physician referral, transfer)
    "reAdmission" : { CodeableConcept }, // The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission icon
    "dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
    "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
    "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc.
    "destination" : { Reference(Location|Organization) }, // Location/organization to which the patient is discharged
    "dischargeDisposition" : { CodeableConcept } // Category or kind of location after discharge

  },
  "location" : [{ // List of locations where the patient has been
    "location" : { Reference(Location) }, // R!  Location the encounter takes place
    "status" : "<code>", // planned | active | reserved | completed
    "

    "form" : { CodeableConcept }, // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)

    "period" : { Period } // Time period during which the patient was present at the location
  }],
  "
  "

  }]

}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:Encounter;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Encounter.identifier [ Identifier ], ... ; # 0..* Identifier(s) by which this encounter is known
  fhir:

  fhir:Encounter.status [ code ]; # 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

  fhir:Encounter.statusHistory [ # 0..* List of past encounter statuses
    fhir:

    fhir:Encounter.statusHistory.status [ code ]; # 1..1 planned | in-progress | onhold | discharged | completed | cancelled | discontinued | entered-in-error | unknown

    fhir:Encounter.statusHistory.period [ Period ]; # 1..1 The time that the episode was in the specified status
  ], ...;
  fhir:

  fhir:Encounter.class [ CodeableConcept ], ... ; # 0..* Classification of patient encounter

  fhir:Encounter.classHistory [ # 0..* List of past encounter classes
    fhir:Encounter.classHistory.class [ Coding ]; # 1..1 inpatient | outpatient | ambulatory | emergency +
    fhir:Encounter.classHistory.period [ Period ]; # 1..1 The time that the episode was in the specified class
  ], ...;
  fhir:
  fhir:

  fhir:Encounter.priority [ CodeableConcept ]; # 0..1 Indicates the urgency of the encounter
  fhir:

  fhir:Encounter.type [ CodeableConcept ], ... ; # 0..* Specific type of encounter
  fhir:Encounter.serviceType [ CodeableReference(HealthcareService) ], ... ; # 0..* Specific type of service
  fhir:Encounter.subject [ Reference(Group|Patient) ]; # 0..1 The patient or group related to this encounter
  fhir:Encounter.subjectStatus [ CodeableConcept ]; # 0..1 The current status of the subject in relation to the Encounter

  fhir:Encounter.episodeOfCare [ Reference(EpisodeOfCare) ], ... ; # 0..* Episode(s) of care that this encounter should be recorded against
  fhir:

  fhir:Encounter.basedOn [ Reference(CarePlan|DeviceRequest|MedicationRequest|ServiceRequest) ], ... ; # 0..* The request that initiated this encounter
  fhir:Encounter.careTeam [ Reference(CareTeam) ], ... ; # 0..* The group(s) that are allocated to participate in this encounter
  fhir:Encounter.partOf [ Reference(Encounter) ]; # 0..1 Another Encounter this encounter is part of
  fhir:Encounter.serviceProvider [ Reference(Organization) ]; # 0..1 The organization (facility) responsible for this encounter

  fhir:Encounter.participant [ # 0..* List of participants involved in the encounter
    fhir:Encounter.participant.type [ CodeableConcept ], ... ; # 0..* Role of participant in encounter
    fhir:Encounter.participant.period [ Period ]; # 0..1 Period of time during the encounter that the participant participated
    fhir:

    fhir:Encounter.participant.actor [ Reference(Device|Group|HealthcareService|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ]; # 0..1 The individual, device, or service participating in the encounter
  ], ...;
  fhir:Encounter.appointment [ Reference(Appointment) ], ... ; # 0..* The appointment that scheduled this encounter
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:Encounter.virtualService [ VirtualServiceDetail ], ... ; # 0..* Connection details of a virtual service (e.g. conference call)
  fhir:Encounter.actualPeriod [ Period ]; # 0..1 The actual start and end time of the encounter
  fhir:Encounter.plannedStartDate [ dateTime ]; # 0..1 The planned start date/time (or admission date) of the encounter
  fhir:Encounter.plannedEndDate [ dateTime ]; # 0..1 The planned end date/time (or discharge date) of the encounter
  fhir:Encounter.length [ Duration ]; # 0..1 Actual quantity of time the encounter lasted (less time absent)
  fhir:Encounter.reason [ CodeableReference(Condition|DiagnosticReport|ImmunizationRecommendation|Observation|Procedure) ], ... ; # 0..* Reason the encounter takes place (core or reference)

  fhir:Encounter.diagnosis [ # 0..* The list of diagnosis relevant to this encounter
    fhir:Encounter.diagnosis.condition [ Reference(Condition|Procedure) ]; # 1..1 The diagnosis or procedure relevant to the encounter
    fhir:Encounter.diagnosis.use [ CodeableConcept ]; # 0..1 Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
    fhir:Encounter.diagnosis.rank [ positiveInt ]; # 0..1 Ranking of the diagnosis (for each role type)
  ], ...;
  fhir:Encounter.account [ Reference(Account) ], ... ; # 0..* The set of accounts that may be used for billing for this Encounter
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:Encounter.admission [ # 0..1 Details about the admission to a healthcare service
    fhir:Encounter.admission.preAdmissionIdentifier [ Identifier ]; # 0..1 Pre-admission identifier
    fhir:Encounter.admission.origin [ Reference(Location|Organization) ]; # 0..1 The location/organization from which the patient came before admission
    fhir:Encounter.admission.admitSource [ CodeableConcept ]; # 0..1 From where patient was admitted (physician referral, transfer)
    fhir:Encounter.admission.reAdmission [ CodeableConcept ]; # 0..1 The type of re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
    fhir:Encounter.admission.dietPreference [ CodeableConcept ], ... ; # 0..* Diet preferences reported by the patient
    fhir:Encounter.admission.specialCourtesy [ CodeableConcept ], ... ; # 0..* Special courtesies (VIP, board member)
    fhir:Encounter.admission.specialArrangement [ CodeableConcept ], ... ; # 0..* Wheelchair, translator, stretcher, etc.
    fhir:Encounter.admission.destination [ Reference(Location|Organization) ]; # 0..1 Location/organization to which the patient is discharged
    fhir:Encounter.admission.dischargeDisposition [ CodeableConcept ]; # 0..1 Category or kind of location after discharge

  ];
  fhir:Encounter.location [ # 0..* List of locations where the patient has been
    fhir:Encounter.location.location [ Reference(Location) ]; # 1..1 Location the encounter takes place
    fhir:Encounter.location.status [ code ]; # 0..1 planned | active | reserved | completed
    fhir:

    fhir:Encounter.location.form [ CodeableConcept ]; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)

    fhir:Encounter.location.period [ Period ]; # 0..1 Time period during which the patient was present at the location
  ], ...;
  fhir:
  fhir:

]

Changes since Release 4

Encounter
Encounter.class
  • No Changes Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
  • Type changed from Coding to CodeableConcept
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
Encounter.classHistory.class
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
  • Remove Binding http://terminology.hl7.org/ValueSet/v3-ActEncounterCode (extensible)
Encounter.serviceType
  • Max Cardinality changed from 1 to *
  • Type changed from CodeableConcept to CodeableReference
  • Type changed from CodeableConcept to CodeableReference
Encounter.subjectStatus
  • Added Element
Encounter.basedOn
  • Type Reference: Added Target Types CarePlan, DeviceRequest, MedicationRequest
  • Type Reference: Added Target Types CarePlan, DeviceRequest, MedicationRequest
Encounter.careTeam
  • Added Element
Encounter.participant.actor
  • Added Element
Encounter.virtualService
  • Added Element
Encounter.actualPeriod
  • Added Element
Encounter.plannedStartDate
  • Added Element
Encounter.plannedEndDate
  • Added Element
Encounter.reason
  • Added Element
Encounter.admission
  • Added Element
Encounter.admission.preAdmissionIdentifier
  • Added Element
Encounter.admission.origin
  • Added Element
Encounter.admission.admitSource
  • Added Element
Encounter.admission.reAdmission
  • Added Element
Encounter.admission.dietPreference
  • Added Element
Encounter.admission.specialCourtesy
  • Added Element
Encounter.admission.specialArrangement
  • Added Element
Encounter.admission.destination
  • Added Element
Encounter.admission.dischargeDisposition
  • Added Element
Encounter.location.form
  • Added Element
Encounter.participant.individual
  • deleted
Encounter.period
  • deleted
Encounter.reasonCode
  • deleted
Encounter.reasonReference
  • deleted
Encounter.hospitalization
  • deleted
Encounter.location.physicalType
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 10 tests that all execute ok. All tests pass round-trip testing and 3 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

Encounter.priority Encounter.location.physicalType
Path Definition Type Reference
Encounter.status

Current state of the encounter.

Required EncounterStatus
Encounter.statusHistory.status

Current state of the encounter.

Required EncounterStatus
Encounter.class Extensible Preferred ActEncounterCode http://terminology.hl7.org/ValueSet/EncounterClass icon
Encounter.classHistory.class Extensible Preferred ActEncounterCode http://terminology.hl7.org/ValueSet/EncounterClass icon
Encounter.priority

A code or set of codes (e.g., for routine, emergency,) specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.

Discussion: This attribute is used in orders to indicate the ordered priority, and in event documentation it indicates the actual priority used to perform the act. In definition mood it indicates the available priorities.

Example ActPriority icon
Encounter.type

This example value set defines a set of codes that can be used to indicate the type of encounter: a specific code indicating type of service provided.

Example EncounterType
Encounter.serviceType

This value set defines an example set of codes of service-types.

Example ServiceType
Encounter.subjectStatus

This example value set defines a set of codes that can be used to indicate the status of the subject within the encounter

Example ActPriority EncounterSubjectStatus
Encounter.participant.type

This value set defines a set of codes that can be used to indicate how an individual participates in an encounter.

Extensible ParticipantType
Encounter.reasonCode Encounter.reason

This examples value set defines the set of codes that can be used to indicate reasons for an encounter.

Preferred EncounterReasonCodes
Encounter.diagnosis.use

This value set defines a set of codes that can be used to express the role of a diagnosis on the Encounter or EpisodeOfCare record.

Preferred DiagnosisRole
Encounter.hospitalization.admitSource Encounter.admission.admitSource

This value set defines a set of codes that can be used to indicate from where the patient came in.

Preferred AdmitSource
Encounter.hospitalization.reAdmission Encounter.admission.reAdmission

Value Set of codes which are used to specify that a patient is being re-admitted to a healthcare facility from which they were discharged, and indicates the circumstances around such re-admission.

Example Hl7VSReAdmissionIndicator icon
Encounter.hospitalization.dietPreference Encounter.admission.dietPreference

This value set defines a set of codes that can be used to indicate dietary preferences or restrictions a patient may have.

Example Diet
Encounter.hospitalization.specialCourtesy Encounter.admission.specialCourtesy

This value set defines a set of codes that can be used to indicate special courtesies provided to the patient.

Preferred SpecialCourtesy
Encounter.hospitalization.specialArrangement Encounter.admission.specialArrangement

This value set defines a set of codes that can be used to indicate the kinds of special arrangements in place for a patients visit.

Preferred SpecialArrangements
Encounter.hospitalization.dischargeDisposition Encounter.admission.dischargeDisposition

This value set defines a set of codes that can be used to where the patient left the hospital.

Example DischargeDisposition
Encounter.location.status

The status of the location.

Required EncounterLocationStatus
Encounter.location.form

This example value set defines a set of codes that can be used to indicate the physical form of the Location.

Example LocationType LocationForm

UniqueKey Level Location Description Expression
img  enc-1 Rule Encounter.participant A type must be provided when no explicit actor is specified actor.exists() or type.exists()
img  enc-2 Rule Encounter.participant A type cannot be provided for a patient or group participant actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not()

  • The class element describes the setting (in/outpatient etc.) in which the Encounter took place. Since this is important for interpreting the context of the encounter, choosing the appropriate business rules to enforce and for the management of the process, this element is required.
  • In future versions of FHIR, some kind of charge posting vehicle (e.g. Account) will be added.

As stated, Encounter allows a flexible nesting of Encounters using the partOf element. For example:

  • A patient is admitted for two weeks - This could be modeled using a single Encounter instance, in which the start and length are given for the duration of the whole stay. The admitting doctor and the responsible doctor during the stay are specified using the Participant component.
  • During the encounter, the patient moves from the admitting department to the Intensive Care unit and back - Three more detailed additional Encounters can be created, one for each location in which the patient stayed. Each of these Encounters has a single location (twice the admitting department and once the Intensive Care unit) and one or more participants at that location. These Encounters may use the partOf relationship to indicate these movements occurred during the longer overarching Encounter.
  • During the last part of the stay, the patient is visited by the members of the multi-disciplinary team that treated him for final evaluation - If relevant, for each of these short visits, an Encounter may be created with a single participant. Since these took place during the last part of the stay, the partOf element can be used to associate these short visits with either the third patient movement or the bigger overall encounter.

Exactly how the Encounter is used depends on information available in the source system, the relevance of exchange of each level of Encounter and demands specific to the communicating partners. The expectation is that for each domain of exchange, profiles are used to limit the flexibility of Encounter to meet the demands of the use case.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
account reference The set of accounts that may be used for billing for this Encounter Encounter.account
( Account )
appointment reference The appointment that scheduled this encounter Encounter.appointment
( Appointment )
based-on reference The ServiceRequest that initiated this encounter Encounter.basedOn
( CarePlan , MedicationRequest , DeviceRequest , ServiceRequest )
careteam reference Careteam allocated to participate in the encounter Encounter.careTeam
( CareTeam )
class token Classification of patient encounter Encounter.class
date date A date within the period actualPeriod the Encounter lasted Encounter.period Encounter.actualPeriod
date-start date The actual start date of the Encounter Encounter.actualPeriod.start
diagnosis reference The diagnosis or procedure relevant to the encounter Encounter.diagnosis.condition
( Condition , Procedure )
end-date date The actual end date of the Encounter Encounter.actualPeriod.end
episode-of-care reference Episode(s) of care that this encounter should be recorded against Encounter.episodeOfCare
( EpisodeOfCare )
identifier token Identifier(s) by which this encounter is known Encounter.identifier
length quantity Length of encounter in days Encounter.length
location reference Location the encounter takes place Encounter.location.location
( Location )
location-period date Time period during which the patient was present at the location Encounter.location.period
part-of reference Another Encounter this encounter is part of Encounter.partOf
( Encounter )
participant reference Persons involved in the encounter other than the patient Encounter.participant.individual Encounter.participant.actor
( Practitioner , Group , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
participant-type token Role of participant in encounter Encounter.participant.type
patient reference The patient or group present at the encounter Encounter.subject.where(resolve() is Patient)
( Patient )
practitioner reference Persons involved in the encounter other than the patient Encounter.participant.individual.where(resolve() Encounter.participant.actor.where(resolve() is Practitioner)
( Practitioner )
reason-code D token Coded reason the encounter takes place Reference to a concept (by class) Encounter.reasonCode Encounter.reason.concept
reason-reference D reference Reason the encounter takes place (reference) Reference to a resource (by instance) Encounter.reasonReference ( Condition , Observation , Procedure , ImmunizationRecommendation ) Encounter.reason.reference
service-provider reference The organization (facility) responsible for this encounter Encounter.serviceProvider
( Organization )
special-arrangement token Wheelchair, translator, stretcher, etc. Encounter.hospitalization.specialArrangement Encounter.admission.specialArrangement
status N token planned | arrived | triaged | in-progress | onleave onhold | finished completed | cancelled + | entered-in-error | unknown Encounter.status
subject reference The patient or group present at the encounter Encounter.subject
( Group , Patient )
subject-status token The current status of the subject in relation to the Encounter Encounter.subjectStatus
type token Specific type of encounter Encounter.type