Administration
This
page
is
part
of
the
FHIR
Specification
(v5.0.0:
R5
-
STU
v6.0.0-ballot2:
Release
6
Ballot
(2nd
Draft)
(see
Ballot
Notes
).
This
is
the
The
current
published
version
in
it's
permanent
home
(it
will
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be
available
at
this
URL).
is
5.0.0
.
For
a
full
list
of
available
versions,
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the
Directory
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published
versions
|
Patient
Administration
Work
Group
|
Maturity Level : 0 | Trial Use | Security Category : Patient | Compartments : Encounter , Patient |
A record of significant events/milestones key data throughout the history of an Encounter, often tracked for specific purposes such as billing.
The EncounterHistory is used to be able to record an ongoing history of significant events/changes that occur during a patient encounter. This information is not always up to date/accurate while entering encounter information and is often back-dated as more detailed information becomes available, or corrections need to be made during the completion of the encounter while it is being processed in coding or billing.
Note to Implementers: In FHIR R4 and earlier this data was in the Encounter 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, so was re-factored into this resource.
The design notes for this change are on confluence
The Encounter resource stores the complete set of current/most recent data about an Encounter. The EncounterHistory contains a snapshot of some key aspects (properties) of the encounter to track changes to the encounter over time - specifically those that contribute to significant changes/events/milestones during the encounter - such as moving between departments or locations.
Note
that
this
historical
information
is
different
than
what
is
tracked
in
the
versions
of
the
Encounter
resource.
Past
movements
of
a
patient
are
often
updated
after
the
fact
to
correct
what
actually
happened.
FHIR
History
(_history)
doesn't
cater
for
this
need
as
the
information
isn't
always
accurate
and
can
be
corrected/back
populated
too.
Another
challenge
with
_history
is
that
it
also
includes
corrections
to
errors
in
data
entry
which
could
not
be
differentiated
from
actual
movements/changes.
No clinical resources are expected to ever refer to a specific EncounterHistory event, they are only attributed to the Encounter as a whole. If a resource is desiring to connect to a portion of an encounter (and wanting to use EncounterHistory) this is an indication that you should be using a child Encounter through the partOf property.
No references for this Resource.
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
EncounterHistory
|
TU | DomainResource |
A
record
of
significant
events/milestones
key
data
throughout
the
history
of
an
Encounter
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
encounter
|
0..1 | Reference ( Encounter ) |
The
Encounter
associated
with
this
set
of
historic
values
|
|
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 | 1..1 | CodeableConcept |
Classification
of
patient
encounter
Binding: ActEncounterCode
(
Extensible
)
|
|
type
|
Σ | 0..* | CodeableConcept |
Specific
type
of
encounter
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 ) |
|
|
actualPeriod
|
0..1 | Period |
The
actual
start
and
end
time
associated
with
this
set
of
values
associated
with
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)
|
|
location
|
0..* | BackboneElement |
Location
of
the
patient
at
this
point
in
the
encounter
|
|
location
|
1..1 | Reference ( Location ) |
Location
the
encounter
takes
place
|
|
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 ) |
|
|
Documentation
for
this
format
|
||||
See the Extensions for this resource
UML Diagram ( Legend )
XML Template
<EncounterHistory xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <encounter><!-- 0..1 Reference(Encounter) The Encounter associated with this set of historic values --></encounter> <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><class><!-- 1..1 CodeableConcept Classification of patient encounter<<a href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict"></length><length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length> <location> <!-- 0..* Location of the patient at this point in the encounter --> <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location> <form><!-- 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) --></form> </location> </EncounterHistory>
JSON Template
{
"resourceType" : "EncounterHistory",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"encounter" : { Reference(Encounter) }, // The Encounter associated with this set of historic values
"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 }, // R! Classification of patient encounter
"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
"actualPeriod" : { Period }, // The actual start and end time associated with this set of values associated with 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 href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict">length
"length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
"location" : [{ // Location of the patient at this point in the encounter
"location" : { Reference(Location) }, // R! Location the encounter takes place
"form" : { CodeableConcept } // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .fhir:<a href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict">lengthfhir:length [ Duration ] ; # 0..1 Actual quantity of time the encounter lasted (less time absent) fhir:location ( [ # 0..* Location of the patient at this point in the encounter fhir:location [ Reference(Location) ] ; # 1..1 Location the encounter takes place fhir:form [ CodeableConcept ] ; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) ] ... ) ; ]
Changes from both R4 and R4B
This resource did not exist in Release R4
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
|
EncounterHistory
|
TU | DomainResource |
A
record
of
significant
events/milestones
key
data
throughout
the
history
of
an
Encounter
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
|
encounter
|
0..1 | Reference ( Encounter ) |
The
Encounter
associated
with
this
set
of
historic
values
|
|
|
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 | 1..1 | CodeableConcept |
Classification
of
patient
encounter
Binding: ActEncounterCode
(
Extensible
)
|
|
type
|
Σ | 0..* | CodeableConcept |
Specific
type
of
encounter
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 ) |
|
|
actualPeriod
|
0..1 | Period |
The
actual
start
and
end
time
associated
with
this
set
of
values
associated
with
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)
|
|
|
location
|
0..* | BackboneElement |
Location
of
the
patient
at
this
point
in
the
encounter
|
|
|
location
|
1..1 | Reference ( Location ) |
Location
the
encounter
takes
place
|
|
|
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 ) |
|
|
Documentation
for
this
format
|
||||
See the Extensions for this resource
XML Template
<EncounterHistory xmlns="http://hl7.org/fhir"><</class><class><!-- 1..1 CodeableConcept Classification of patient encounter<<a href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict"></length><length><!-- 0..1 Duration Actual quantity of time the encounter lasted (less time absent) --></length> <location> <!-- 0..* Location of the patient at this point in the encounter --> <location><!-- 1..1 Reference(Location) Location the encounter takes place --></location> <form><!-- 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) --></form> </location> </EncounterHistory>
JSON Template
{
"resourceType" : "EncounterHistory",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"encounter" : { Reference(Encounter) }, // The Encounter associated with this set of historic values
"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 }, // R! Classification of patient encounter
"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
"actualPeriod" : { Period }, // The actual start and end time associated with this set of values associated with 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 href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict">length
"length" : { Duration }, // Actual quantity of time the encounter lasted (less time absent)
"location" : [{ // Location of the patient at this point in the encounter
"location" : { Reference(Location) }, // R! Location the encounter takes place
"form" : { CodeableConcept } // The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
}]
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .fhir:<a href="encounterhistory-definitions.html#EncounterHistory.length" title="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." class="dict">lengthfhir:length [ Duration ] ; # 0..1 Actual quantity of time the encounter lasted (less time absent) fhir:location ( [ # 0..* Location of the patient at this point in the encounter fhir:location [ Reference(Location) ] ; # 1..1 Location the encounter takes place fhir:form [ CodeableConcept ] ; # 0..1 The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.) ] ... ) ; ]
Changes from both R4 and R4B
This resource did not exist in Release R4
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .
Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis
| Path | ValueSet | Type | Documentation |
|---|---|---|---|
| EncounterHistory.status | EncounterStatus | Required |
Current state of the encounter. |
| EncounterHistory.class |
ActEncounterCode
|
Extensible |
Domain provides codes that qualify the ActEncounterClass (ENC) |
| EncounterHistory.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. |
| EncounterHistory.serviceType | ServiceType | Example |
This value set defines an example set of codes of service-types. |
| EncounterHistory.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 |
| EncounterHistory.location.form |
LocationForm
(a
valid
code
from
Location
type
)
|
Example |
This example value set defines a set of codes that can be used to indicate the physical form of the Location. |
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 |
| encounter | reference | The Encounter associated with this set of history values |
EncounterHistory.encounter
( Encounter ) |
29 Resources |
| identifier | token | Identifier(s) by which this encounter is known | EncounterHistory.identifier | |
| patient | reference | The patient present at the encounter |
EncounterHistory.subject.where(resolve()
is
Patient)
( Patient ) |
|
| status | token | Status of the Encounter history entry | EncounterHistory.status | |
| subject | reference | The patient or group present at the encounter |
EncounterHistory.subject
( Group , Patient ) |
FHIR
®©
HL7.org
2011+.
FHIR
R5
hl7.fhir.core#5.0.0
R6
hl7.fhir.core#6.0.0-ballot2
generated
on
Sun,
Mar
26,
2023
15:24+1100.
Mon,
Aug
12,
2024
16:58+0800.
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