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Operation-capabilitystatement-implements.xml

8.11 Resource Encounter - Content

FHIR Infrastructure Patient Administration icon Work Group Maturity Level : N/A 2   Trial Use Standards Status : Informative Security Category : Patient Compartments : Not linked to any defined compartments Encounter , Patient , Practitioner , RelatedPerson

Raw XML

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.

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8.11.1 Scope and Usage

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 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 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 admission component is intended to store the extended information relating to an 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.reason) such as a follow-up encounter to resolve complications from an earlier procedure.

8.11.1.1 Status Management

During the life-cycle of an encounter it will pass through many statuses and subject statuses. Typically these are in order or the organization/department's workflow(s) e.g. planned, in-progress, completed/cancelled. In general terms the Encounter and Appointment both align with the Clinical Workflow Process Life Cycle pattern.
The status property tracks the (current) overall status of the encounter, whereas the subjectStatus property more closely tracks the patient explicitly. For example in a hospital emergency department the subjectStatus would reflect the patient's status e.g. arrived (when the patient first presents to the ED), triaged (when the patient is assessed by a triage nurse), etc.
This status information is often used for other things, and often an analysis of the status history is required for things like billing. This could be done by scanning through all the resource history versions of the encounter, checking the period of each, and then doing some form of post processing. However, this information is not always completed in real-time (or even in the same system) and needs to be updated over time - as a result the resource history is not adequate to satisfy these needs, and subsequently the new EncounterHistory + resource provides this information

Note to Implementers: In FHIR R4 and earlier this was done using the statusHistory and classHistory backbone elements, however with longer duration encounters (where a patient encounter might be considered active for years) this would become increasingly inefficient, and EncounterHistory remediates this issue.

There is no direct indication purely by the status or subjectStatus 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).
Subject statuses of "arrived", "triaged" or "receiving-care" could be considered the start of the admission, and also see have the presence of the 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". Refer to the appointment page for some sample possible workflows.
Also note that the binding for subjectStatus is "example" so that local use-cases could also include their own states to capture things like a "waiting" status if they decide to capture this in their specific workflow.

Subjects that have left without being seen would have a subjectStatus of departed, or possibly an implementer-specific code, while the Encounter.status could be completed or cancelled, depending on whether the patient had received some care before leaving, or other local business rules that could impact billing.

The "on-leave" subject 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.
During this time the encounter status itself might be marked as "on-hold". Local systems may have multiple different types of leave/hold and these can use appropriate combinations fo the status/subjectStatus fields to represent this.
The location is also likely to be filled in with a location status of "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.

8.11.2 Boundaries and Relationships

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.

8.11.3 References to this Resource

8.11.4 Resource Content

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 | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
Binding: Encounter Status ( Required )
... class Σ 0..* CodeableConcept Classification of patient encounter context - e.g. Inpatient, outpatient
Binding: Encounter class icon ( Preferred )

... priority 0..1 CodeableConcept Indicates the urgency of the encounter
Binding: ActPriority icon ( Example )
... type Σ 0..* CodeableConcept Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
Binding: Encounter Type ( Example )

... serviceType Σ 0..* CodeableReference ( HealthcareService ) Specific type of service
Binding: Service Type ( Example )

... subject Σ 0..1 Reference ( Patient | Group ) The patient or group related to this encounter
... subjectStatus 0..1 CodeableConcept The current status of the subject in relation to the Encounter
Binding: Encounter Subject Status ( 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 ( CareTeam ) The group(s) that 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 C 0..* CodeableConcept Role of participant in encounter
Binding: Participant Type ( Extensible )

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

... virtualService 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
... plannedEndDate 0..1 dateTime 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)
... reason Σ 0..* BackboneElement The list of medical reasons that are expected to be addressed during the episode of care

.... use Σ 0..* CodeableConcept What the reason value should be used for/as
Binding: Encounter Reason Use ( Example )

.... value Σ 0..* CodeableReference ( Condition | DiagnosticReport | Observation | ImmunizationRecommendation | Procedure ) Reason the encounter takes place (core or reference)
Binding: Encounter Reason Codes ( Preferred )

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

.... condition Σ 0..* CodeableReference ( Condition ) The diagnosis relevant to the encounter
Binding: Condition/Problem/Diagnosis Codes ( Example )

.... use 0..* CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Binding: Encounter Diagnosis Use ( Preferred )

... account 0..* Reference ( Account ) The set of accounts that may be used for billing for this Encounter

... dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Binding: Diet ( Example )

... specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc
Binding: Special Arrangements ( Preferred )

... specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
Binding: Special Courtesy ( Preferred )

... 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)
Binding: Admit Source ( Preferred )
.... reAdmission 0..1 CodeableConcept Indicates that the patient is being re-admitted
Binding: hl7VS-re-admissionIndicator icon ( Example )
.... 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
Binding: Discharge Disposition ( 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
Binding: Encounter Location Status ( Required )
.... form 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
Binding: Location Form ( Example )
.... period 0..1 Period Time period during which the patient was present at the location

doco Documentation for this format icon

Jump past Narrative See the Extensions for this resource

UML Diagram ( Legend )

Encounter ( DomainResource ) Identifier(s) by which this encounter is known identifier : Identifier [0..*] The current state of the encounter (not the state of the patient within the encounter - that is subjectState) (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 : CodeableConcept [0..*] « null (Strength=Preferred) 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 : CodeableReference [0..*] « HealthcareService ; null (Strength=Example) ServiceType ?? » The patient or group related to this encounter. In some use-cases the patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam subject : Reference [0..1] « 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 departed, has been triaged or is currently in a waiting status subjectStatus : CodeableConcept [0..1] « 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 colonoscopy example on the Encounter examples tab 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 actualPeriod : Period [0..1] The planned start date/time (or admission date) of the encounter plannedStartDate : dateTime [0..1] The planned end date/time (or discharge date) of the encounter plannedEndDate : dateTime [0..1] 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 length : Duration [0..1] The set of accounts that may be used for billing for this Encounter account : Reference [0..*] « Account » Diet preferences reported by the patient dietPreference : CodeableConcept [0..*] « null (Strength=Example) Diet ?? » Any special requests that have been made for this encounter, such as the provision of specific equipment or other things specialArrangement : CodeableConcept [0..*] « null (Strength=Preferred) SpecialArrangements ? » Special courtesies that may be provided to the patient during the encounter (VIP, board member, professional courtesy) specialCourtesy : CodeableConcept [0..*] « null (Strength=Preferred) SpecialCourtesy ? » Participant Role of participant in encounter type : CodeableConcept [0..*] « null (Strength=Extensible) ParticipantType + » « This element has or is affected by some invariants C » 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] Person involved in the 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 actor : Reference [0..1] « Patient | Group | RelatedPerson | Practitioner | PractitionerRole | Device | HealthcareService » « This element has or is affected by some invariants C » Reason What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening) use : CodeableConcept [0..*] « null (Strength=Example) EncounterReasonUse ?? » Reason the encounter takes place, expressed as a code or a reference to another resource. For admissions, this can be used for a coded admission diagnosis value : CodeableReference [0..*] « Condition | DiagnosticReport | Observation | ImmunizationRecommendation | Procedure ; null (Strength=Preferred) EncounterReasonCodes ? » Diagnosis The coded diagnosis or a reference to a Condition (with other resources referenced in the evidence.detail), the use property will indicate the purpose of this specific diagnosis condition : CodeableReference [0..*] « Condition ; null (Strength=Example) ConditionProblemDiagnosisCodes ?? » Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) use : CodeableConcept [0..*] « null (Strength=Preferred) EncounterDiagnosisUse ? » 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 ? » Indicates that this encounter is directly related to a prior admission, often because the conditions addressed in the prior admission were not fully addressed reAdmission : CodeableConcept [0..1] « null (Strength=Example) Hl7VSReAdmissionIndicator ?? » 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 form : CodeableConcept [0..1] « null (Strength=Example) LocationForm ?? » Time period during which the patient was present at the location period : Period [0..1] The list of people responsible for providing the service participant [0..*] The list of medical reasons that are expected to be addressed during the episode of care reason [0..*] The list of diagnosis relevant to this encounter diagnosis [0..*] Details about the stay during which a healthcare service is provided. This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge admission [0..1] List of locations where the patient has been during this encounter location [0..*]

Operation Definition XML Template

<?xml version="1.0" encoding="UTF-8"?> 
<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 | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->
 <class><!-- 0..* CodeableConcept Classification of patient encounter context - e.g. Inpatient, outpatient icon --></class>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter icon --></priority>
 <type><!-- 0..* CodeableConcept Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...) --></type>
 <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><!-- 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><!-- I 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter that the participant participated --></period>
  <actor><!-- I 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>
 <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 -->
 <
  
  
    
    
      
      
      
      
      
        This operation asks the server to check that it implements all the resources, interactions,
           search parameters, and operations that the client provides in its capability statement.
           The client provides its capability statement inline, or by referring the server to the
           canonical URL of its capability statement

When missing it is the time in between the start and end values." class="dict">length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length>
 <reason>  <!-- 0..* The list of medical reasons that are expected to be addressed during the episode of care -->
  <use><!-- 0..* CodeableConcept What the reason value should be used for/as --></use>
  <value><!-- 0..* CodeableReference(Condition|DiagnosticReport|
    ImmunizationRecommendation|Observation|Procedure) Reason the encounter takes place (core or reference) --></value>

 </reason>
 <diagnosis>  <!-- 0..* The list of diagnosis relevant to this encounter -->
  <condition><!-- 0..* CodeableReference(Condition) The diagnosis relevant to the encounter --></condition>
  <use><!-- 0..* CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) --></use>
 </diagnosis>
 <account><!-- 0..* Reference(Account) The set of accounts that may be used for billing for this Encounter --></account>
 <dietPreference><!-- 0..* CodeableConcept Diet preferences reported by the patient --></dietPreference>
 <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc --></specialArrangement>
 <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
 <      
      
      
      
      
        
          
            
          
          
            
          
          
            
          
          
            
          
          
            
          
          
            
          
        
        
          
          
          
          
            
          
          
          
            
              A canonical reference to the server capability statement - use this if the implements
                 is not invoked on an instance (or on the /metadata end-point)

This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge." class="dict">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 Indicates that the patient is being re-admitted icon --></reAdmission>
  <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 -->
  <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>
</Encounter>

JSON Template 


{doco
  "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 | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
  "class" : [{ CodeableConcept }], // Classification of patient encounter context - e.g. Inpatient, outpatient icon
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter icon
  "type" : [{ CodeableConcept }], // Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
  "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 }], // I 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) } // I 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
  "            
          
        
        
          
          
          
          
            
          
          
          
            
              A canonical reference to the client capability statement - use this if the implements
                 is not invoked on an instance (or on the /metadata end-point)

When missing it is the time in between the start and end values." class="dict">length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
  "reason" : [{ // The list of medical reasons that are expected to be addressed during the episode of care
    "use" : [{ CodeableConcept }], // What the reason value should be used for/as
    "value" : [{ CodeableReference(Condition|DiagnosticReport|
    ImmunizationRecommendation|Observation|Procedure) }] // Reason the encounter takes place (core or reference)

  }],
  "diagnosis" : [{ // The list of diagnosis relevant to this encounter
    "condition" : [{ CodeableReference(Condition) }], // The diagnosis relevant to the encounter
    "use" : [{ CodeableConcept }] // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
  }],
  "account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
  "dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
  "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc
  "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
  "            
          
        
        
          
          
          
          
            
          
          
          
            
              

This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge." class="dict">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 }, // Indicates that the patient is being re-admitted icon
    "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


            
          
        
        
          
          
          
          
            
          
          
          
            
              


            
          
        
      
      
        The operation does not perform a full conformance check; in particular it does not check
           that the profiles align. It merely checks that the behaviors the client wishes to use
           are provided    Technically, this operation is implemented as follows:

[ 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:identifier  ( [ Identifier ] ... ) ; # 0..* Identifier(s) by which this encounter is known
  fhir:status [ code ] ; # 1..1 planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
  fhir:class  ( [ CodeableConcept ] ... ) ; # 0..* Classification of patient encounter context - e.g. Inpatient, outpatient
  fhir:priority [ CodeableConcept ] ; # 0..1 Indicates the urgency of the encounter
  fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
  fhir:serviceType  ( [ CodeableReference(HealthcareService) ] ... ) ; # 0..* Specific type of service
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 The patient or group related to this encounter
  fhir:subjectStatus [ CodeableConcept ] ; # 0..1 The current status of the subject in relation to the Encounter
  fhir:episodeOfCare  ( [ Reference(EpisodeOfCare) ] ... ) ; # 0..* Episode(s) of care that this encounter should be recorded against
  fhir:basedOn  ( [ Reference(CarePlan|DeviceRequest|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* The request that initiated this encounter
  fhir:careTeam  ( [ Reference(CareTeam) ] ... ) ; # 0..* The group(s) that are allocated to participate in this encounter
  fhir:partOf [ Reference(Encounter) ] ; # 0..1 Another Encounter this encounter is part of
  fhir:serviceProvider [ Reference(Organization) ] ; # 0..1 The organization (facility) responsible for this encounter
  fhir:participant ( [ # 0..* List of participants involved in the encounter
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* I Role of participant in encounter
    fhir:period [ Period ] ; # 0..1 Period of time during the encounter that the participant participated
    fhir:actor [ Reference(Device|Group|HealthcareService|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ] ; # 0..1 I The individual, device, or service participating in the encounter

  ] ... ) ;
  fhir:appointment  ( [ Reference(Appointment) ] ... ) ; # 0..* The appointment that scheduled this encounter
  fhir:virtualService  ( [ VirtualServiceDetail ] ... ) ; # 0..* Connection details of a virtual service (e.g. conference call)
  fhir:actualPeriod [ Period ] ; # 0..1 The actual start and end time of the encounter
  fhir:plannedStartDate [ dateTime ] ; # 0..1 The planned start date/time (or admission date) of the encounter
  fhir:plannedEndDate [ dateTime ] ; # 0..1 The planned end date/time (or discharge date) of the encounter
  fhir:          The server's capability statement must have an entry for each resource in the client's
             capability statement

When missing it is the time in between the start and end values." class="dict">length [ Duration ] ; # 0..1 Actual quantity of time the encounter lasted (less time absent)
  fhir:reason ( [ # 0..* The list of medical reasons that are expected to be addressed during the episode of care
    fhir:use  ( [ CodeableConcept ] ... ) ; # 0..* What the reason value should be used for/as
    fhir:value  ( [ CodeableReference(Condition|DiagnosticReport|ImmunizationRecommendation|Observation|Procedure) ] ... ) ; # 0..* Reason the encounter takes place (core or reference)
  ] ... ) ;
  fhir:diagnosis ( [ # 0..* The list of diagnosis relevant to this encounter
    fhir:condition  ( [ CodeableReference(Condition) ] ... ) ; # 0..* The diagnosis relevant to the encounter
    fhir:use  ( [ CodeableConcept ] ... ) ; # 0..* Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
  ] ... ) ;
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* The set of accounts that may be used for billing for this Encounter
  fhir:dietPreference  ( [ CodeableConcept ] ... ) ; # 0..* Diet preferences reported by the patient
  fhir:specialArrangement  ( [ CodeableConcept ] ... ) ; # 0..* Wheelchair, translator, stretcher, etc
  fhir:specialCourtesy  ( [ CodeableConcept ] ... ) ; # 0..* Special courtesies (VIP, board member)
  fhir:          The server's resource support must have matching flags for updateCreate, conditionalCreate,
             conditionalRead, conditionalUpdate, conditionalDelete, searchInclude, searchRevInclude

This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge." class="dict">admission [ # 0..1 Details about the admission to a healthcare service
    fhir:preAdmissionIdentifier [ Identifier ] ; # 0..1 Pre-admission identifier
    fhir:origin [ Reference(Location|Organization) ] ; # 0..1 The location/organization from which the patient came before admission
    fhir:admitSource [ CodeableConcept ] ; # 0..1 From where patient was admitted (physician referral, transfer)
    fhir:reAdmission [ CodeableConcept ] ; # 0..1 Indicates that the patient is being re-admitted
    fhir:destination [ Reference(Location|Organization) ] ; # 0..1 Location/organization to which the patient is discharged
    fhir:dischargeDisposition [ CodeableConcept ] ; # 0..1 Category or kind of location after discharge
  ] ;
  fhir:location ( [ # 0..* List of locations where the patient has been
    fhir:location [ Reference(Location) ] ; # 1..1 Location the encounter takes place
    fhir:status [ code ] ; # 0..1 planned | active | reserved | completed
    fhir:form [ CodeableConcept ] ; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
    fhir:period [ Period ] ; # 0..1 Time period during which the patient was present at the location
  ] ... ) ;
]

Changes since R4

Encounter
Encounter.class
  • 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)
Encounter.serviceType
  • Max Cardinality changed from 1 to *
  • Type changed from CodeableConcept to CodeableReference
Encounter.subjectStatus
  • Added Element
Encounter.basedOn
  • 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.reason.use
  • Added Element
Encounter.reason.value
  • Added Element
Encounter.diagnosis.condition
  • Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
  • Type changed from Reference(Condition | Procedure) to CodeableReference
Encounter.diagnosis.use
  • Max Cardinality changed from 1 to *
Encounter.dietPreference
  • Added Element
Encounter.specialArrangement
  • Added Element
Encounter.specialCourtesy
  • 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.destination
  • Added Element
Encounter.admission.dischargeDisposition
  • Added Element
Encounter.location.form
  • Added Element
Encounter.statusHistory
  • deleted
Encounter.classHistory
  • deleted
Encounter.participant.individual
  • deleted
Encounter.period
  • deleted
Encounter.reasonCode
  • deleted
Encounter.reasonReference
  • deleted
Encounter.diagnosis.rank
  • deleted
Encounter.hospitalization
  • deleted
Encounter.location.physicalType
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

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 | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
Binding: Encounter Status ( Required )
... class Σ 0..* CodeableConcept Classification of patient encounter context - e.g. Inpatient, outpatient
Binding: Encounter class icon ( Preferred )

... priority 0..1 CodeableConcept Indicates the urgency of the encounter
Binding: ActPriority icon ( Example )
... type Σ 0..* CodeableConcept Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
Binding: Encounter Type ( Example )

... serviceType Σ 0..* CodeableReference ( HealthcareService ) Specific type of service
Binding: Service Type ( Example )

... subject Σ 0..1 Reference ( Patient | Group ) The patient or group related to this encounter
... subjectStatus 0..1 CodeableConcept The current status of the subject in relation to the Encounter
Binding: Encounter Subject Status ( 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 ( CareTeam ) The group(s) that 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 C 0..* CodeableConcept Role of participant in encounter
Binding: Participant Type ( Extensible )

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

... virtualService 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
... plannedEndDate 0..1 dateTime 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)
... reason Σ 0..* BackboneElement The list of medical reasons that are expected to be addressed during the episode of care

.... use Σ 0..* CodeableConcept What the reason value should be used for/as
Binding: Encounter Reason Use ( Example )

.... value Σ 0..* CodeableReference ( Condition | DiagnosticReport | Observation | ImmunizationRecommendation | Procedure ) Reason the encounter takes place (core or reference)
Binding: Encounter Reason Codes ( Preferred )

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

.... condition Σ 0..* CodeableReference ( Condition ) The diagnosis relevant to the encounter
Binding: Condition/Problem/Diagnosis Codes ( Example )

.... use 0..* CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Binding: Encounter Diagnosis Use ( Preferred )

... account 0..* Reference ( Account ) The set of accounts that may be used for billing for this Encounter

... dietPreference 0..* CodeableConcept Diet preferences reported by the patient
Binding: Diet ( Example )

... specialArrangement 0..* CodeableConcept Wheelchair, translator, stretcher, etc
Binding: Special Arrangements ( Preferred )

... specialCourtesy 0..* CodeableConcept Special courtesies (VIP, board member)
Binding: Special Courtesy ( Preferred )

... 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)
Binding: Admit Source ( Preferred )
.... reAdmission 0..1 CodeableConcept Indicates that the patient is being re-admitted
Binding: hl7VS-re-admissionIndicator icon ( Example )
.... 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
Binding: Discharge Disposition ( 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
Binding: Encounter Location Status ( Required )
.... form 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
Binding: Location Form ( Example )
.... period 0..1 Period Time period during which the patient was present at the location

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Encounter ( DomainResource ) Identifier(s) by which this encounter is known identifier : Identifier [0..*] The current state of the encounter (not the state of the patient within the encounter - that is subjectState) (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 : CodeableConcept [0..*] « null (Strength=Preferred) 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 : CodeableReference [0..*] « HealthcareService ; null (Strength=Example) ServiceType ?? » The patient or group related to this encounter. In some use-cases the patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam subject : Reference [0..1] « 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 departed, has been triaged or is currently in a waiting status subjectStatus : CodeableConcept [0..1] « 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 colonoscopy example on the Encounter examples tab 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 actualPeriod : Period [0..1] The planned start date/time (or admission date) of the encounter plannedStartDate : dateTime [0..1] The planned end date/time (or discharge date) of the encounter plannedEndDate : dateTime [0..1] 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 length : Duration [0..1] The set of accounts that may be used for billing for this Encounter account : Reference [0..*] « Account » Diet preferences reported by the patient dietPreference : CodeableConcept [0..*] « null (Strength=Example) Diet ?? » Any special requests that have been made for this encounter, such as the provision of specific equipment or other things specialArrangement : CodeableConcept [0..*] « null (Strength=Preferred) SpecialArrangements ? » Special courtesies that may be provided to the patient during the encounter (VIP, board member, professional courtesy) specialCourtesy : CodeableConcept [0..*] « null (Strength=Preferred) SpecialCourtesy ? » Participant Role of participant in encounter type : CodeableConcept [0..*] « null (Strength=Extensible) ParticipantType + » « This element has or is affected by some invariants C » 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] Person involved in the 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 actor : Reference [0..1] « Patient | Group | RelatedPerson | Practitioner | PractitionerRole | Device | HealthcareService » « This element has or is affected by some invariants C » Reason What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening) use : CodeableConcept [0..*] « null (Strength=Example) EncounterReasonUse ?? » Reason the encounter takes place, expressed as a code or a reference to another resource. For admissions, this can be used for a coded admission diagnosis value : CodeableReference [0..*] « Condition | DiagnosticReport | Observation | ImmunizationRecommendation | Procedure ; null (Strength=Preferred) EncounterReasonCodes ? » Diagnosis The coded diagnosis or a reference to a Condition (with other resources referenced in the evidence.detail), the use property will indicate the purpose of this specific diagnosis condition : CodeableReference [0..*] « Condition ; null (Strength=Example) ConditionProblemDiagnosisCodes ?? » Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) use : CodeableConcept [0..*] « null (Strength=Preferred) EncounterDiagnosisUse ? » 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 ? » Indicates that this encounter is directly related to a prior admission, often because the conditions addressed in the prior admission were not fully addressed reAdmission : CodeableConcept [0..1] « null (Strength=Example) Hl7VSReAdmissionIndicator ?? » 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 form : CodeableConcept [0..1] « null (Strength=Example) LocationForm ?? » Time period during which the patient was present at the location period : Period [0..1] The list of people responsible for providing the service participant [0..*] The list of medical reasons that are expected to be addressed during the episode of care reason [0..*] The list of diagnosis relevant to this encounter diagnosis [0..*] Details about the stay during which a healthcare service is provided. This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge 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 | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown -->
 <class><!-- 0..* CodeableConcept Classification of patient encounter context - e.g. Inpatient, outpatient icon --></class>
 <priority><!-- 0..1 CodeableConcept Indicates the urgency of the encounter icon --></priority>
 <type><!-- 0..* CodeableConcept Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...) --></type>
 <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><!-- 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><!-- I 0..* CodeableConcept Role of participant in encounter --></type>
  <period><!-- 0..1 Period Period of time during the encounter that the participant participated --></period>
  <actor><!-- I 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>
 <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 -->
 <          The server's capability statement must have a matching interaction for each interaction
             in the client capability statement (whether or not it is on a resource)

When missing it is the time in between the start and end values." class="dict">length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length>
 <reason>  <!-- 0..* The list of medical reasons that are expected to be addressed during the episode of care -->
  <use><!-- 0..* CodeableConcept What the reason value should be used for/as --></use>
  <value><!-- 0..* CodeableReference(Condition|DiagnosticReport|
    ImmunizationRecommendation|Observation|Procedure) Reason the encounter takes place (core or reference) --></value>

 </reason>
 <diagnosis>  <!-- 0..* The list of diagnosis relevant to this encounter -->
  <condition><!-- 0..* CodeableReference(Condition) The diagnosis relevant to the encounter --></condition>
  <use><!-- 0..* CodeableConcept Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) --></use>
 </diagnosis>
 <account><!-- 0..* Reference(Account) The set of accounts that may be used for billing for this Encounter --></account>
 <dietPreference><!-- 0..* CodeableConcept Diet preferences reported by the patient --></dietPreference>
 <specialArrangement><!-- 0..* CodeableConcept Wheelchair, translator, stretcher, etc --></specialArrangement>
 <specialCourtesy><!-- 0..* CodeableConcept Special courtesies (VIP, board member) --></specialCourtesy>
 <          The server's capability statement must have a search parameter with matching name and
             definition for any search parameters in the client capability statement

This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge." class="dict">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 Indicates that the patient is being re-admitted icon --></reAdmission>
  <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 -->
  <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>
</Encounter>

JSON Template 


{doco
  "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 | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
  "class" : [{ CodeableConcept }], // Classification of patient encounter context - e.g. Inpatient, outpatient icon
  "priority" : { CodeableConcept }, // Indicates the urgency of the encounter icon
  "type" : [{ CodeableConcept }], // Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
  "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 }], // I 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) } // I 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
  "          The server must have an operation definition with a matching reference for any operations
             in the client capability statement

When missing it is the time in between the start and end values." class="dict">length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
  "reason" : [{ // The list of medical reasons that are expected to be addressed during the episode of care
    "use" : [{ CodeableConcept }], // What the reason value should be used for/as
    "value" : [{ CodeableReference(Condition|DiagnosticReport|
    ImmunizationRecommendation|Observation|Procedure) }] // Reason the encounter takes place (core or reference)

  }],
  "diagnosis" : [{ // The list of diagnosis relevant to this encounter
    "condition" : [{ CodeableReference(Condition) }], // The diagnosis relevant to the encounter
    "use" : [{ CodeableConcept }] // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
  }],
  "account" : [{ Reference(Account) }], // The set of accounts that may be used for billing for this Encounter
  "dietPreference" : [{ CodeableConcept }], // Diet preferences reported by the patient
  "specialArrangement" : [{ CodeableConcept }], // Wheelchair, translator, stretcher, etc
  "specialCourtesy" : [{ CodeableConcept }], // Special courtesies (VIP, board member)
  "        

This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge." class="dict">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 }, // Indicates that the patient is being re-admitted icon
    "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


        If the capability statements match by these rules, then the return value is a 200 OK with
           an operation outcome that contains no issues with severity &gt;= error. If the capability
           statement doesn't match, the return value is a 4xx error, with an OperationOutcome with
           at least one issue with severity &gt;= error


      
    
  
  
    
  
  
    
  
  
  
  
  
  
  
  
  
    
      
      
    
    
      
      
    
  
  This operation asks the server to check that it implements all the resources, interactions,
   search parameters, and operations that the client provides in its capability statement.
   The client provides its capability statement inline, or by referring the server to the
   canonical URL of its capability statement
  
  The operation does not perform a full conformance check; in particular it does not check
   that the profiles align. It merely checks that the behaviors the client wishes to use
   are provided    Technically, this operation is implemented as follows:   

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


* The server's capability statement must have an entry for each resource in the client's
   capability statement    
* The server's resource support must have matching flags for updateCreate, conditionalCreate,
   conditionalRead, conditionalUpdate, conditionalDelete, searchInclude, searchRevInclude
     
* The server's capability statement must have a matching interaction for each interaction
   in the client capability statement (whether or not it is on a resource)   
* The server's capability statement must have a search parameter with matching name and
   definition for any search parameters in the client capability statement   
* The server must have an operation definition with a matching reference for any operations
   in the client capability statement   

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Identifier(s) by which this encounter is known
  fhir:status [ code ] ; # 1..1 planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
  fhir:class  ( [ CodeableConcept ] ... ) ; # 0..* Classification of patient encounter context - e.g. Inpatient, outpatient
  fhir:priority [ CodeableConcept ] ; # 0..1 Indicates the urgency of the encounter
  fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* Specific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
  fhir:serviceType  ( [ CodeableReference(HealthcareService) ] ... ) ; # 0..* Specific type of service
  fhir:subject [ Reference(Group|Patient) ] ; # 0..1 The patient or group related to this encounter
  fhir:subjectStatus [ CodeableConcept ] ; # 0..1 The current status of the subject in relation to the Encounter
  fhir:episodeOfCare  ( [ Reference(EpisodeOfCare) ] ... ) ; # 0..* Episode(s) of care that this encounter should be recorded against
  fhir:basedOn  ( [ Reference(CarePlan|DeviceRequest|MedicationRequest|ServiceRequest) ] ... ) ; # 0..* The request that initiated this encounter
  fhir:careTeam  ( [ Reference(CareTeam) ] ... ) ; # 0..* The group(s) that are allocated to participate in this encounter
  fhir:partOf [ Reference(Encounter) ] ; # 0..1 Another Encounter this encounter is part of
  fhir:serviceProvider [ Reference(Organization) ] ; # 0..1 The organization (facility) responsible for this encounter
  fhir:participant ( [ # 0..* List of participants involved in the encounter
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* I Role of participant in encounter
    fhir:period [ Period ] ; # 0..1 Period of time during the encounter that the participant participated
    fhir:actor [ Reference(Device|Group|HealthcareService|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ] ; # 0..1 I The individual, device, or service participating in the encounter

  ] ... ) ;
  fhir:appointment  ( [ Reference(Appointment) ] ... ) ; # 0..* The appointment that scheduled this encounter
  fhir:virtualService  ( [ VirtualServiceDetail ] ... ) ; # 0..* Connection details of a virtual service (e.g. conference call)
  fhir:actualPeriod [ Period ] ; # 0..1 The actual start and end time of the encounter
  fhir:plannedStartDate [ dateTime ] ; # 0..1 The planned start date/time (or admission date) of the encounter
  fhir:plannedEndDate [ dateTime ] ; # 0..1 The planned end date/time (or discharge date) of the encounter
  fhir:If the capability statements match by these rules, then the return value is a 200 OK with
   an operation outcome that contains no issues with severity &gt;= error. If the capability
   statement doesn't match, the return value is a 4xx error, with an OperationOutcome with
   at least one issue with severity &gt;= error
  
  
  
  
  
    
    
    
    
    A canonical reference to the server capability statement - use this if the implements
     is not invoked on an instance (or on the /metadata end-point)
    
  
  
    
    
    
    
    A canonical reference to the client capability statement - use this if the implements
     is not invoked on an instance (or on the /metadata end-point)
    
  
  
    
    
    
    
    
    
  
  
    
    
    
    
    
    
  

When missing it is the time in between the start and end values." class="dict">length [ Duration ] ; # 0..1 Actual quantity of time the encounter lasted (less time absent)
  fhir:reason ( [ # 0..* The list of medical reasons that are expected to be addressed during the episode of care
    fhir:use  ( [ CodeableConcept ] ... ) ; # 0..* What the reason value should be used for/as
    fhir:value  ( [ CodeableReference(Condition|DiagnosticReport|ImmunizationRecommendation|Observation|Procedure) ] ... ) ; # 0..* Reason the encounter takes place (core or reference)
  ] ... ) ;
  fhir:diagnosis ( [ # 0..* The list of diagnosis relevant to this encounter
    fhir:condition  ( [ CodeableReference(Condition) ] ... ) ; # 0..* The diagnosis relevant to the encounter
    fhir:use  ( [ CodeableConcept ] ... ) ; # 0..* Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
  ] ... ) ;
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* The set of accounts that may be used for billing for this Encounter
  fhir:dietPreference  ( [ CodeableConcept ] ... ) ; # 0..* Diet preferences reported by the patient
  fhir:specialArrangement  ( [ CodeableConcept ] ... ) ; # 0..* Wheelchair, translator, stretcher, etc
  fhir:specialCourtesy  ( [ CodeableConcept ] ... ) ; # 0..* Special courtesies (VIP, board member)
  fhir:admission [ # 0..1 Details about the admission to a healthcare service
    fhir:preAdmissionIdentifier [ Identifier ] ; # 0..1 Pre-admission identifier
    fhir:origin [ Reference(Location|Organization) ] ; # 0..1 The location/organization from which the patient came before admission
    fhir:admitSource [ CodeableConcept ] ; # 0..1 From where patient was admitted (physician referral, transfer)
    fhir:reAdmission [ CodeableConcept ] ; # 0..1 Indicates that the patient is being re-admitted
    fhir:destination [ Reference(Location|Organization) ] ; # 0..1 Location/organization to which the patient is discharged
    fhir:dischargeDisposition [ CodeableConcept ] ; # 0..1 Category or kind of location after discharge
  ] ;
  fhir:location ( [ # 0..* List of locations where the patient has been
    fhir:location [ Reference(Location) ] ; # 1..1 Location the encounter takes place
    fhir:status [ code ] ; # 0..1 planned | active | reserved | completed
    fhir:form [ CodeableConcept ] ; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
    fhir:period [ Period ] ; # 0..1 Time period during which the patient was present at the location
  ] ... ) ;
]

Changes since Release 4 </ OperationDefinition

Encounter >
Encounter.class
  • 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)
Encounter.serviceType
  • Max Cardinality changed from 1 to *
  • Type changed from CodeableConcept to CodeableReference
Encounter.subjectStatus
  • Added Element
Encounter.basedOn
  • 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.reason.use
  • Added Element
Encounter.reason.value
  • Added Element
Encounter.diagnosis.condition
  • Min Cardinality changed from 1 to 0
  • Max Cardinality changed from 1 to *
  • Type changed from Reference(Condition | Procedure) to CodeableReference
Encounter.diagnosis.use
  • Max Cardinality changed from 1 to *
Encounter.dietPreference
  • Added Element
Encounter.specialArrangement
  • Added Element
Encounter.specialCourtesy
  • 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.destination
  • Added Element
Encounter.admission.dischargeDisposition
  • Added Element
Encounter.location.form
  • Added Element
Encounter.statusHistory
  • deleted
Encounter.classHistory
  • deleted
Encounter.participant.individual
  • deleted
Encounter.period
  • deleted
Encounter.reasonCode
  • deleted
Encounter.reasonReference
  • deleted
Encounter.diagnosis.rank
  • deleted
Encounter.hospitalization
  • deleted
Encounter.location.physicalType
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

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). )

 

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

8.11.4.1 Terminology Bindings

Path ValueSet Type Documentation
Encounter.status EncounterStatus Required

Usage note: every effort has been made Current state of the encounter.

Encounter.class EncounterClass icon Preferred

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

Encounter.priority ActPriority icon Example

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.

Encounter.type EncounterType Example

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.

Encounter.serviceType ServiceType Example

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

Encounter.subjectStatus EncounterSubjectStatus Example

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

Encounter.participant.type ParticipantType Extensible

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

Encounter.reason.use EncounterReasonUse Example

What a specific Encounter/EpisodeOfCare reason.value is to be used for.

Encounter.reason.value EncounterReasonCodes Preferred

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

Encounter.diagnosis.condition ConditionProblemDiagnosisCodes Example

Example value set for Condition/Problem/Diagnosis codes.

Encounter.diagnosis.use EncounterDiagnosisUse Preferred

What a specific Encounter/EpisodeOfCare diagnosis.condition is to be used for.

Encounter.dietPreference Diet Example

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

Encounter.specialArrangement SpecialArrangements Preferred

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.

Encounter.specialCourtesy SpecialCourtesy Preferred

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

Encounter.admission.admitSource AdmitSource Preferred

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

Encounter.admission.reAdmission Hl7VSReAdmissionIndicator icon (a valid code from re-admissionIndicator icon ) Example

Value Set of codes which are correct and useful, but 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.

Encounter.admission.dischargeDisposition DischargeDisposition Example

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

Encounter.location.status EncounterLocationStatus Required

The status of the location.

Encounter.location.form LocationForm (a valid code from Location type icon ) Example

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

"http://hl7.org/fhir/extensions/0.1.0/

8.11.4.2 Constraints

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()

8.11.5 Notes

  • 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.

8.11.6 Example usage

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 not 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 normative 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 specification. 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.

8.11.7 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to 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 actualPeriod the Encounter lasted Encounter.actualPeriod 27 Resources
date-start date The actual start date of the Encounter Encounter.actualPeriod.start
diagnosis-code token The diagnosis or procedure relevant to the encounter (coded) Encounter.diagnosis.condition.concept
diagnosis-reference reference The diagnosis or procedure relevant to the encounter (resource reference) Encounter.diagnosis.condition.reference
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 65 Resources
length quantity Length of encounter in days Encounter.length
location reference Location the encounter takes place Encounter.location.location
( Location )
location-period composite Time period during which the patient was present at the location On Encounter.location:
  location: location.reference
  period: 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.actor
( Practitioner , Group , Device , Patient , HealthcareService , PractitionerRole , RelatedPerson )
participant-type token Role of participant in encounter Encounter.participant.type
patient reference The patient present at the encounter Encounter.subject.where(resolve() is Patient)
( Patient ) 		66 Resources
practitioner reference Persons involved in the encounter other than the patient Encounter.participant.actor.where(resolve() is Practitioner)
( Practitioner )
reason-code token Reference to a concept (coded) Encounter.reason.value.concept
reason-reference reference Reference to a resource (resource reference) Encounter.reason.value.reference
service-provider reference The organization (facility) responsible for this encounter Encounter.serviceProvider
( Organization )
special-arrangement token Wheelchair, translator, stretcher, etc. Encounter.specialArrangement
status token planned | in-progress | on-hold | 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 11 Resources