CH Core (R4)
4.0.1 - trial-use Switzerland flag

This page is part of the CH Core (R4) (v4.0.1: STU 4) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: CHCoreEncounter - Detailed Descriptions

Active as of 2023-12-28

Definitions for the ch-core-encounter resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

This is basic constraint on Encounter for use in CH Core resources.

ShortCH Core Encounter
2. Encounter.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
SlicingThis element introduces a set of slices on Encounter.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
4. Encounter.identifier:VisitNumber
Slice NameVisitNumber
ShortVisit number (Fallnummer)
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;VN&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
6. Encounter.identifier:VisitNumber.system
Control1..?
8. Encounter.identifier:VisitNumber.value
Control1..?
10. Encounter.class
Definition

See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIR mapping

ShortAMB | IMP : See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIR
12. Encounter.priority
ShortBFS Medizinische Statistik - Eintrittsart / Mode d’admission / Genere di ricovero
BindingUnless not suitable, these codes SHALL be taken from BFS Medizinische Statistik - 18 1.2.V03 - Eintrittsart / Mode d’admission / Genere di ricovero
14. Encounter.subject
Control1..?
TypeReference(CH Core Patient)
16. Encounter.participant
18. Encounter.participant.type
BindingUnless not suitable, these codes SHALL be taken from ChCoreEncounterParticipationType
20. Encounter.participant.individual
TypeReference(CH Core Practitioner)
22. Encounter.hospitalization
24. Encounter.hospitalization.extension
SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
26. Encounter.hospitalization.extension:BfsAdmitRole
Slice NameBfsAdmitRole
ShortBFS Medizinische Statistik - Einweisende Instanz
Control0..1
TypeExtension(BFS Extension Medical Statistic: Admit Role for Encounter) (Extension Type: Coding)
28. Encounter.hospitalization.extension:accident
Slice Nameaccident
ShortFlag if hospitalization was due to an accident
Control0..1
TypeExtension(If an encounter is caused by an accident) (Complex Extension)
30. Encounter.hospitalization.extension:readmission
Slice Namereadmission
ShortFlag to indicate if it is a suspected readmission
Control0..1
TypeExtension(Encounter, Suspected Readmission) (Extension Type: boolean)
32. Encounter.hospitalization.extension:BfsDischargeDecision
Slice NameBfsDischargeDecision
ShortBFS Medizinische Statistik - Entscheid für Austritt
Control0..1
TypeExtension(BFS Extension Medical Statistic: Discharge Décision for Encounter) (Extension Type: Coding)
34. Encounter.hospitalization.extension:BfsDischargeDestination
Slice NameBfsDischargeDestination
ShortBFS Medizinische Statistik - Aufenthalt nach Austritt
Control0..1
TypeExtension(BFS Extension Medical Statistic: Discharge Destination for Encounter) (Extension Type: Coding)
36. Encounter.hospitalization.origin
TypeReference(CH Core Location, CH Core Organization)
38. Encounter.hospitalization.admitSource
ShortBFS Medizinische Statistik - Aufenthaltsort vor dem Eintritt / Séjour avant l’admission / Luogo di soggiorno prima dell’ammissione
BindingUnless not suitable, these codes SHALL be taken from BFS Medizinische Statistik - 17 1.2.V02 - Aufenthaltsort vor dem Eintritt / Séjour avant l’admission / Luogo di soggiorno prima dell’ammissione
40. Encounter.hospitalization.destination
TypeReference(CH Core Location, CH Core Organization)
42. Encounter.hospitalization.dischargeDisposition
ShortBFS Medizinische Statistik - Behandlung nach Austritt
BindingThe codes SHOULD be taken from BFS Medizinische Statistik - 29 1.5.V04 - Behandlung nach Austritt / Prise en charge après la sortie / Trattamento dopo l’uscita

BFS Medizinische Statistik - Behandlung nach Austritt

44. Encounter.location
46. Encounter.location.location
TypeReference(CH Core Location)
48. Encounter.serviceProvider
TypeReference(CH Core Organization)
50. Encounter.partOf
TypeReference(CH Core Encounter)

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

This is basic constraint on Encounter for use in CH Core resources.


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.

ShortCH Core EncounterAn interaction during which services are provided to the patient
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVisit
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Encounter.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Encounter.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Encounter.identifier
Definition

Identifier(s) by which this encounter is known.

ShortIdentifier(s) by which this encounter is known
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Encounter.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
8. Encounter.identifier:VisitNumber
Slice NameVisitNumber
Definition

Identifier(s) by which this encounter is known.

ShortVisit number (Fallnummer)Identifier(s) by which this encounter is known
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;VN&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Encounter.identifier:VisitNumber.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

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

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Encounter.identifier:VisitNumber.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Encounter.identifier:VisitNumber.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Encounter.status
Definition

planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

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

Control1..1
BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1

Current state of the encounter.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Encounter.class
Definition

See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIR mapping


Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

ShortAMB | IMP : See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIRClassification of patient encounter
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode

Classification of the encounter.

TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Encounter.priority
Definition

Indicates the urgency of the encounter.

ShortBFS Medizinische Statistik - Eintrittsart / Mode d’admission / Genere di ricoveroIndicates the urgency of the encounter
Control0..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see BFS Medizinische Statistik - 18 1.2.V03 - Eintrittsart / Mode d’admission / Genere di ricoverohttp://terminology.hl7.org/ValueSet/v3-ActPriority
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Encounter.subject
Definition

The patient or group present at the encounter.

ShortThe patient or group present at the encounter
Comments

While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Control10..1
TypeReference(CH Core Patient, Patient, Group)
Is Modifierfalse
Summarytrue
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Encounter.serviceProvider
Definition

The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

ShortThe organization (facility) responsible for this encounter
Control0..1
TypeReference(CH Core Organization, Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Encounter.partOf
Definition

Another Encounter of which this encounter is a part of (administratively or in time).

ShortAnother Encounter this encounter is part of
Comments

This is also used for associating a child's encounter back to the mother's encounter.

Refer to the Notes section in the Patient resource for further details.

Control0..1
TypeReference(CH Core Encounter, Encounter)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

This is basic constraint on Encounter for use in CH Core resources.

ShortCH Core Encounter
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVisit
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Encounter.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. Encounter.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Encounter.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Encounter.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Encounter.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Encounter.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. Encounter.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Encounter.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Encounter.identifier
Definition

Identifier(s) by which this encounter is known.

ShortIdentifier(s) by which this encounter is known
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Encounter.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
20. Encounter.identifier:VisitNumber
Slice NameVisitNumber
Definition

Identifier(s) by which this encounter is known.

ShortVisit number (Fallnummer)
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Pattern Value&lt;valueIdentifier&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;type&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;VN&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;/coding&gt;<br/>&nbsp;&nbsp;&lt;/type&gt;<br/>&lt;/valueIdentifier&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Encounter.identifier:VisitNumber.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
24. Encounter.identifier:VisitNumber.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Encounter.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
26. Encounter.identifier:VisitNumber.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

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

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Encounter.identifier:VisitNumber.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Encounter.identifier:VisitNumber.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Encounter.identifier:VisitNumber.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Encounter.identifier:VisitNumber.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Encounter.identifier:VisitNumber.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Encounter.status
Definition

planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

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

Control1..1
BindingThe codes SHALL be taken from EncounterStatus

Current state of the encounter.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Encounter.statusHistory
Definition

The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

ShortList of past encounter statuses
Comments

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

Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Encounter.statusHistory.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
44. Encounter.statusHistory.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
46. Encounter.statusHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. Encounter.statusHistory.status
Definition

planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Control1..1
BindingThe codes SHALL be taken from EncounterStatus

Current state of the encounter.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Encounter.statusHistory.period
Definition

The time that the episode was in the specified status.

ShortThe time that the episode was in the specified status
Control1..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Encounter.class
Definition

See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIR mapping

ShortAMB | IMP : See mapping from BFS Medizinische Statistik BFS Encounter Class to FHIR
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode

Classification of the encounter.

TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Encounter.classHistory
Definition

The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

ShortList of past encounter classes
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Encounter.classHistory.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
58. Encounter.classHistory.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
60. Encounter.classHistory.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
62. Encounter.classHistory.class
Definition

inpatient | outpatient | ambulatory | emergency +.

Shortinpatient | outpatient | ambulatory | emergency +
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode

Classification of the encounter.

TypeCoding
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Encounter.classHistory.period
Definition

The time that the episode was in the specified class.

ShortThe time that the episode was in the specified class
Control1..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Encounter.type
Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

ShortSpecific type of encounter
Comments

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

Control0..*
BindingFor example codes, see EncounterType

The type of encounter.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Encounter.serviceType
Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

ShortSpecific type of service
Control0..1
BindingFor example codes, see ServiceType

Broad categorization of the service that is to be provided.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Encounter.priority
Definition

Indicates the urgency of the encounter.

ShortBFS Medizinische Statistik - Eintrittsart / Mode d’admission / Genere di ricovero
Control0..1
BindingUnless not suitable, these codes SHALL be taken from BFS Medizinische Statistik - 18 1.2.V03 - Eintrittsart / Mode d’admission / Genere di ricovero
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Encounter.subject
Definition

The patient or group present at the encounter.

ShortThe patient or group present at the encounter
Comments

While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Control1..1
TypeReference(CH Core Patient)
Is Modifierfalse
Summarytrue
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Encounter.episodeOfCare
Definition

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).

ShortEpisode(s) of care that this encounter should be recorded against
Control0..*
TypeReference(EpisodeOfCare)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Encounter.basedOn
Definition

The request this encounter satisfies (e.g. incoming referral or procedure request).

ShortThe ServiceRequest that initiated this encounter
Control0..*
TypeReference(ServiceRequest)
Is Modifierfalse
Summaryfalse
Alternate NamesincomingReferral
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Encounter.participant
Definition

The list of people responsible for providing the service.

ShortList of participants involved in the encounter
Control0..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Encounter.participant.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
82. Encounter.participant.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
84. Encounter.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. Encounter.participant.type
Definition

Role of participant in encounter.

ShortRole of participant in encounter
Comments

The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from ChCoreEncounterParticipationType
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Encounter.participant.period
Definition

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.

ShortPeriod of time during the encounter that the participant participated
Control0..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Encounter.participant.individual
Definition

Persons involved in the encounter other than the patient.

ShortPersons involved in the encounter other than the patient
Control0..1
TypeReference(CH Core Practitioner)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Encounter.appointment
Definition

The appointment that scheduled this encounter.

ShortThe appointment that scheduled this encounter
Control0..*
TypeReference(Appointment)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Encounter.period
Definition

The start and end time of the encounter.

ShortThe start and end time of the encounter
Comments

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

Control0..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Encounter.length
Definition

Quantity of time the encounter lasted. This excludes the time during leaves of absence.

ShortQuantity of time the encounter lasted (less time absent)
Comments

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

Control0..1
TypeDuration
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Encounter.reasonCode
Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

ShortCoded reason the encounter takes place
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Control0..*
BindingThe codes SHOULD be taken from EncounterReasonCodes

Reason why the encounter takes place.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Alternate NamesIndication, Admission diagnosis
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Encounter.reasonReference
Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

ShortReason the encounter takes place (reference)
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Control0..*
TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
Is Modifierfalse
Summarytrue
Alternate NamesIndication, Admission diagnosis
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Encounter.diagnosis
Definition

The list of diagnosis relevant to this encounter.

ShortThe list of diagnosis relevant to this encounter
Control0..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Encounter.diagnosis.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
106. Encounter.diagnosis.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. Encounter.diagnosis.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
110. Encounter.diagnosis.condition
Definition

Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

ShortThe diagnosis or procedure relevant to the encounter
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Control1..1
TypeReference(Condition, Procedure)
Is Modifierfalse
Summarytrue
Alternate NamesAdmission diagnosis, discharge diagnosis, indication
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Encounter.diagnosis.use
Definition

Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Control0..1
BindingThe codes SHOULD be taken from DiagnosisRole

The type of diagnosis this condition represents.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Encounter.diagnosis.rank
Definition

Ranking of the diagnosis (for each role type).

ShortRanking of the diagnosis (for each role type)
Control0..1
TypepositiveInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Encounter.account
Definition

The set of accounts that may be used for billing for this Encounter.

ShortThe set of accounts that may be used for billing for this Encounter
Comments

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

Control0..*
TypeReference(Account)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Encounter.hospitalization
Definition

Details about the admission to a healthcare service.

ShortDetails about the admission to a healthcare service
Comments

An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

Control0..1
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Encounter.hospitalization.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
122. Encounter.hospitalization.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
124. Encounter.hospitalization.extension:BfsAdmitRole
Slice NameBfsAdmitRole
Definition

Optional Extension Element - found in all resources.

ShortBFS Medizinische Statistik - Einweisende Instanz
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(BFS Extension Medical Statistic: Admit Role for Encounter) (Extension Type: Coding)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. Encounter.hospitalization.extension:accident
Slice Nameaccident
Definition

Extension to define an encounter is caused by an accident and at which time the accident happened

ShortFlag if hospitalization was due to an accident
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(If an encounter is caused by an accident) (Complex Extension)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
128. Encounter.hospitalization.extension:readmission
Slice Namereadmission
Definition

Optional Extension Element - found in all resources.

ShortFlag to indicate if it is a suspected readmission
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Encounter, Suspected Readmission) (Extension Type: boolean)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
130. Encounter.hospitalization.extension:BfsDischargeDecision
Slice NameBfsDischargeDecision
Definition

Optional Extension Element - found in all resources.

ShortBFS Medizinische Statistik - Entscheid für Austritt
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(BFS Extension Medical Statistic: Discharge Décision for Encounter) (Extension Type: Coding)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
132. Encounter.hospitalization.extension:BfsDischargeDestination
Slice NameBfsDischargeDestination
Definition

Optional Extension Element - found in all resources.

ShortBFS Medizinische Statistik - Aufenthalt nach Austritt
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(BFS Extension Medical Statistic: Discharge Destination for Encounter) (Extension Type: Coding)
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
134. Encounter.hospitalization.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
136. Encounter.hospitalization.preAdmissionIdentifier
Definition

Pre-admission identifier.

ShortPre-admission identifier
Control0..1
TypeIdentifier
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Encounter.hospitalization.origin
Definition

The location/organization from which the patient came before admission.

ShortThe location/organization from which the patient came before admission
Control0..1
TypeReference(CH Core Location, CH Core Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Encounter.hospitalization.admitSource
Definition

From where patient was admitted (physician referral, transfer).

ShortBFS Medizinische Statistik - Aufenthaltsort vor dem Eintritt / Séjour avant l’admission / Luogo di soggiorno prima dell’ammissione
Control0..1
BindingUnless not suitable, these codes SHALL be taken from BFS Medizinische Statistik - 17 1.2.V02 - Aufenthaltsort vor dem Eintritt / Séjour avant l’admission / Luogo di soggiorno prima dell’ammissione
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Encounter.hospitalization.reAdmission
Definition

Whether this hospitalization is a readmission and why if known.

ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
Control0..1
BindingFor example codes, see hl7VS-re-admissionIndicator

The reason for re-admission of this hospitalization encounter.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Encounter.hospitalization.dietPreference
Definition

Diet preferences reported by the patient.

ShortDiet preferences reported by the patient
Comments

For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Control0..*
BindingFor example codes, see Diet

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

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Encounter.hospitalization.specialCourtesy
Definition

Special courtesies (VIP, board member).

ShortSpecial courtesies (VIP, board member)
Control0..*
BindingThe codes SHOULD be taken from SpecialCourtesy

Special courtesies.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Encounter.hospitalization.specialArrangement
Definition

Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

ShortWheelchair, translator, stretcher, etc.
Control0..*
BindingThe codes SHOULD be taken from SpecialArrangements

Special arrangements.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Encounter.hospitalization.destination
Definition

Location/organization to which the patient is discharged.

ShortLocation/organization to which the patient is discharged
Control0..1
TypeReference(CH Core Location, CH Core Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. Encounter.hospitalization.dischargeDisposition
Definition

Category or kind of location after discharge.

ShortBFS Medizinische Statistik - Behandlung nach Austritt
Control0..1
BindingThe codes SHOULD be taken from BFS Medizinische Statistik - 29 1.5.V04 - Behandlung nach Austritt / Prise en charge après la sortie / Trattamento dopo l’uscita

BFS Medizinische Statistik - Behandlung nach Austritt

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Encounter.location
Definition

List of locations where the patient has been during this encounter.

ShortList of locations where the patient has been
Comments

Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. Encounter.location.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
158. Encounter.location.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
160. Encounter.location.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
162. Encounter.location.location
Definition

The location where the encounter takes place.

ShortLocation the encounter takes place
Control1..1
TypeReference(CH Core Location)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Encounter.location.status
Definition

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.

Shortplanned | active | reserved | completed
Comments

When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

Control0..1
BindingThe codes SHALL be taken from EncounterLocationStatus

The status of the location.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Encounter.location.physicalType
Definition

This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Comments

This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

Control0..1
BindingFor example codes, see LocationType

Physical form of the location.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Encounter.location.period
Definition

Time period during which the patient was present at the location.

ShortTime period during which the patient was present at the location
Control0..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Encounter.serviceProvider
Definition

The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

ShortThe organization (facility) responsible for this encounter
Control0..1
TypeReference(CH Core Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Encounter.partOf
Definition

Another Encounter of which this encounter is a part of (administratively or in time).

ShortAnother Encounter this encounter is part of
Comments

This is also used for associating a child's encounter back to the mother's encounter.

Refer to the Notes section in the Patient resource for further details.

Control0..1
TypeReference(CH Core Encounter)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))