<del class="diff-old">
This
page
is
part
of
the
FHIR
Specification
(v0.0.82:
DSTU
1).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
R2
Content
Examples
Formal
Definitions
Mappings
Profiles
5.9
Resource
Encounter
-
Content
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.
5.9.1
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
Hospitalization
component
within
Encounter.
The
class
element
is
used
to
distinguish
between
these
settings,
which
will
guide
further
validation
and
application
of
business
rules.
There
is
also
substantial
variance
from
organization
to
organization
(and
between
jurisdictions
and
countries)
on
which
business
events
translate
to
the
start
of
a
new
Encounter,
or
what
level
of
aggregation
is
used
for
Encounter.
For
example,
each
single
visit
of
a
practitioner
during
a
hospitalization
may
lead
to
a
new
instance
of
Encounter,
but
depending
on
local
practice
and
the
systems
involved,
it
may
well
be
that
this
is
aggregated
to
a
single
instance
for
a
whole
hospitalization.
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,
planned
accommodation
or
planned
encounter
locations.
In
this
case
the
status
element
is
set
to
'planned'.
5.9.2
Boundaries
and
Relationships
Appointment
information
is
out
of
scope
for
Encounter,
the
Appointment
resource
(yet
to
be
defined)
needs
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.
5.9.3
Resource
Content
Encounter
(
Resource
)
Identifier(s)
by
which
this
encounter
is
known
identifier
:
Identifier
0..*
planned
|
in
progress
|
onleave
|
finished
|
cancelled
(this
element
modifies
the
meaning
of
other
elements)
status
:
code
1..1
&lt;&lt;
Current
state
of
the
encounter
EncounterState
&gt;&gt;
inpatient
|
outpatient
|
ambulatory
|
emergency
+
(this
element
modifies
the
meaning
of
other
elements)
class
:
code
1..1
&lt;&lt;
Classification
of
the
encounter
EncounterClass
&gt;&gt;
Specific
type
of
encounter
(e.g.
e-mail
consultation,
surgical
day-care,
skilled
nursing,
rehabilitation)
type
:
CodeableConcept
0..*
&lt;&lt;
The
type
of
encounter
EncounterType
&gt;&gt;
The
patient
present
at
the
encounter
subject
:
Resource
(
Patient
)
0..1
The
start
and
end
time
of
the
encounter
period
:
Period
0..1
Quantity
of
time
the
encounter
lasted.
This
excludes
the
time
during
leaves
of
absence
length
:
Duration
0..1
Reason
the
encounter
takes
place,
expressed
as
a
code.
For
admissions,
this
can
be
used
for
a
coded
admission
diagnosis
reason
:
CodeableConcept
0..1
&lt;&lt;
Reason
why
the
encounter
takes
place
EncounterReason
&gt;&gt;
Reason
the
encounter
takes
place,
as
specified
using
information
from
another
resource.
For
admissions,
this
is
the
admission
diagnosis
indication
:
Resource
(
Any
)
0..1
Indicates
the
urgency
of
the
encounter
priority
:
CodeableConcept
0..1
&lt;&lt;
Indicates
the
urgency
of
the
encounter
Priority
&gt;&gt;
Department
or
team
providing
care
serviceProvider
:
Resource
(
Organization
)
0..1
Another
Encounter
of
which
this
encounter
is
a
part
of
(administratively
or
in
time)
partOf
:
Resource
(
Encounter
)
0..1
Participant
Role
of
participant
in
encounter
type
:
CodeableConcept
0..*
&lt;&lt;
Role
of
participant
in
encounter
ParticipantType
&gt;&gt;
Persons
involved
in
the
encounter
other
than
the
patient
individual
:
Resource
(
Practitioner
|
RelatedPerson
)
0..1
Hospitalization
Pre-admission
identifier
preAdmissionIdentifier
:
Identifier
0..1
The
location
from
which
the
patient
came
before
admission
origin
:
Resource
(
Location
)
0..1
From
where
patient
was
admitted
(physician
referral,
transfer)
admitSource
:
CodeableConcept
0..1
&lt;&lt;
From
where
the
patient
was
admitted
AdmitSource
&gt;&gt;
Period
during
which
the
patient
was
admitted
period
:
Period
0..1
Dietary
restrictions
for
the
patient
diet
:
CodeableConcept
0..1
&lt;&lt;
Medical,
cultural
or
ethical
food
preferences
to
help
with
catering
requirements
PatientDiet
&gt;&gt;
Special
courtesies
(VIP,
board
member)
specialCourtesy
:
CodeableConcept
0..*
&lt;&lt;
Special
courtesies
Courtesies
&gt;&gt;
Wheelchair,
translator,
stretcher,
etc
specialArrangement
:
CodeableConcept
0..*
&lt;&lt;
Special
arrangements
Arrangements
&gt;&gt;
Location
to
which
the
patient
is
discharged
destination
:
Resource
(
Location
)
0..1
Category
or
kind
of
location
after
discharge
dischargeDisposition
:
CodeableConcept
0..1
&lt;&lt;
Discharge
Disposition
DischargeDisp
&gt;&gt;
The
final
diagnosis
given
a
patient
before
release
from
the
hospital
after
all
testing,
surgery,
and
workup
are
complete
dischargeDiagnosis
:
Resource
(
Any
)
0..1
Whether
this
hospitalization
is
a
readmission
reAdmission
:
boolean
0..1
Accomodation
The
bed
that
is
assigned
to
the
patient
bed
:
Resource
(
Location
)
0..1
Period
during
which
the
patient
was
assigned
the
bed
period
:
Period
0..1
Location
The
location
where
the
encounter
takes
place
location
:
Resource
(
Location
)
1..1
Time
period
during
which
the
patient
was
present
at
the
location
period
:
Period
1..1
The
main
practitioner
responsible
for
providing
the
service
participant
0..*
Where
the
patient
stays
during
this
encounter
accomodation
0..*
Details
about
an
admission
to
a
clinic
hospitalization
0..1
List
of
locations
at
which
the
patient
has
been
location
0..*
This
resource
is
referenced
by
CarePlan
,
Composition
,
Condition
,
DiagnosticOrder
,
MedicationAdministration
,
MedicationPrescription
,
Procedure
and
Questionnaire

&lt;
 &lt;!-- from  --&gt;
 &lt;&lt;/identifier&gt;
 &lt;
 &lt;
 &lt;&lt;/type&gt;
 &lt;&lt;/subject&gt;
 &lt;
  &lt;&lt;/type&gt;
  &lt;
      Persons involved in the encounter other than the patient&lt;/individual&gt;
 &lt;/participant&gt;
 &lt;&lt;/period&gt;
 &lt;&lt;/length&gt;
 &lt;&lt;/reason&gt;
 &lt;&lt;/indication&gt;
 &lt;&lt;/priority&gt;
 &lt;
  &lt;&lt;/preAdmissionIdentifier&gt;
  &lt;
      The location from which the patient came before admission&lt;/origin&gt;
  &lt;&lt;/admitSource&gt;
  &lt;&lt;/period&gt;
  &lt;
   &lt;&lt;/bed&gt;
   &lt;&lt;/period&gt;
  &lt;/accomodation&gt;
  &lt;&lt;/diet&gt;
  &lt;&lt;/specialCourtesy&gt;
  &lt;&lt;/specialArrangement&gt;
  &lt;&lt;/destination&gt;
  &lt;&lt;/dischargeDisposition&gt;
  &lt;
      The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete&lt;/dischargeDiagnosis&gt;
  &lt;
 &lt;/hospitalization&gt;
 &lt;
  &lt;&lt;/location&gt;
  &lt;&lt;/period&gt;
 &lt;/location&gt;
 &lt;&lt;/serviceProvider&gt;
 &lt;&lt;/partOf&gt;
&lt;/Encounter&gt;
Alternate
definitions:
Schema
/
Schematron
,
Resource
Profile
5.9.3.1
Terminology
Bindings
Path
Definition
Type
Reference
Encounter.status
Current
state
of
the
encounter
Fixed
http://hl7.org/fhir/encounter-state
Encounter.class
Classification
of
the
encounter
Fixed
http://hl7.org/fhir/encounter-class
Encounter.type
The
type
of
encounter
Example
http://hl7.org/fhir/vs/encounter-type
Encounter.participant.type
Role
of
participant
in
encounter
Incomplete
http://hl7.org/fhir/vs/encounter-participant-type
Encounter.reason
Reason
why
the
encounter
takes
place
Example
http://hl7.org/fhir/vs/encounter-reason
Encounter.priority
Indicates
the
urgency
of
the
encounter
Example
http://hl7.org/fhir/vs/encounter-priority
Encounter.hospitalization.admitSource
From
where
the
patient
was
admitted
Incomplete
http://hl7.org/fhir/vs/encounter-admit-source
Encounter.hospitalization.diet
Medical,
cultural
or
ethical
food
preferences
to
help
with
catering
requirements
Incomplete
http://hl7.org/fhir/vs/encounter-diet
Encounter.hospitalization.specialCourtesy
Special
courtesies
Incomplete
http://hl7.org/fhir/vs/encounter-special-courtesy
Encounter.hospitalization.specialArrangement
Special
arrangements
Incomplete
http://hl7.org/fhir/vs/encounter-special-arrangements
Encounter.hospitalization.dischargeDisposition
Discharge
Disposition
Incomplete
http://hl7.org/fhir/vs/encounter-discharge-disposition
5.9.4
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.
The
Location
indicates
where
the
patient
has
been
during
the
encounter
(he
might
visit
multiple
locations,
e.g.
to
an
MRI
room
for
examinations,
while
Accommodation
keeps
information
about
the
bed
in
which
a
patient
stays
during
a
hospitalization.
In
future
versions
of
FHIR,
some
kind
of
charge
posting
vehicle
(e.g.
Account)
will
be
added.
5.9.5
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
given
for
the
duration
of
the
whole
stay.
The
admitting
doctor
and
the
responsible
doctor
during
the
stay
are
specified
using
the
Participant
component.
During
the
encounter,
the
patient
moves
from
the
admitting
department
to
the
Intensive
Care
unit
and
back
-
Three
more
detailed
additional
Encounters
can
be
created,
one
for
each
location
in
which
the
patient
stayed.
Each
of
these
Encounters
has
a
single
location
(twice
the
admitting
department
and
once
the
Intensive
Care
unit)
and
one
or
more
participants
at
that
location.
These
Encounters
may
use
the
partOf
relationship
to
indicate
these
movements
occurred
during
the
longer
overarching
Encounter.
During
the
last
part
of
the
stay,
the
patient
is
visited
by
the
members
of
the
multi-disciplinary
team
that
treated
him
for
final
evaluation
-
If
relevant,
for
each
of
these
short
visits,
an
Encounter
may
be
created
with
a
single
participant.
Since
these
took
place
during
the
last
part
of
the
stay,
the
partOf
element
can
be
used
to
associate
these
short
visits
with
either
the
third
patient
movement
or
the
bigger
overall
encounter.
Exactly
how
the
Encounter
is
used
depends
on
information
available
in
the
source
system,
the
relevance
of
exchange
of
each
level
of
Encounter
and
demands
specific
to
the
communicating
partners.
The
expectation
is
that
for
each
domain
of
exchange,
Profiles
are
used
to
limit
the
flexibility
of
Encounter
to
meet
the
demands
of
the
usecase.
5.9.6
Search
Parameters
Search
parameters
for
this
resource.
The
standard
parameters
also
apply.
See
Searching
for
more
information
about
searching
in
REST,
messaging,
and
services.
Name
Type
Description
Paths
_id
token
The
logical
resource
id
associated
with
the
resource
(must
be
supported
by
all
servers)
_language
token
The
language
of
the
resource
date
date
A
date
within
the
period
the
Encounter
lasted
Encounter.period
identifier
token
Identifier(s)
by
which
this
encounter
is
known
Encounter.identifier
indication
reference
Reason
the
encounter
takes
place
(resource)
Encounter.indication
(Any)
length
number
Length
of
encounter
in
days
Encounter.length
location
reference
Location
the
encounter
takes
place
Encounter.location.location
(
Location
)
location-period
date
Time
period
during
which
the
patient
was
present
at
the
location
Encounter.location.period
status
token
planned
|
in
progress
|
onleave
|
finished
|
cancelled
Encounter.status
subject
reference
The
patient
present
at
the
encounter
Encounter.subject
(
Patient
)
&copy;
HL7.org
2011+.
FHIR
DSTU
(v0.0.82.2943)
generated
on
Tue,
Sep
30,
2014
18:09+1000.
Links:
What's
a
DSTU?
|
Version
History
|
|
Propose
a
change
var
disqus_shortname
=
'fhirdstu';(function()
{var
dsq
=
document.createElement('script');
dsq.type
=
'text/javascript';
dsq.async
=
true;dsq.src
=
'//'
+
disqus_shortname
+
'.disqus.com/embed.js';(document.getElementsByTagName('head')[0]
||
document.getElementsByTagName('body')[0]).appendChild(dsq);
})();
Please
enable
JavaScript
to
view
the
comments
powered
by
Disqus.
comments
powered
by
Disqus
var
_gaq
=
_gaq
||
[];
_gaq.push(['_setAccount',
'UA-676355-1']);
_gaq.push(['_setDomainName',
'.hl7.org']);
_gaq.push(['_trackPageview']);
(function()
{
var
ga
=
document.createElement('script');
ga.type
=
'text/javascript';
ga.async
=
true;
ga.src
=
('https:'
==
document.location.protocol
?
'https://ssl'
:
'http://www')
+
'.google-analytics.com/ga.js';
var
s
=
document.getElementsByTagName('script')[0];
s.parentNode.insertBefore(ga,
s);
})();
</del>