DocumentHeader

CareConnect-Encounter-1

CareConnect-Encounter-1

Encounter
Definition

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.

Control 0..*
Type Encounter
Aliases Visit
Comments
Encounter.extension(transport)
Definition

Details of the transport used by the subject for the encounter.

Control 0..1
Type Extension
Comments
Encounter.identifier
Definition

Identifier(s) by which this encounter is known.

Control 0..*
Type Identifier
Comments
Encounter.identifier.use
Definition

The purpose of this identifier.

Control 0..1
Binding

Identifies the purpose for this identifier, if known .

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/identifier-use

Type Code
Is Modifier True
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Encounter.identifier.type
Definition

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

Control 0..1
Binding

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

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/identifier-type

Type CodeableConcept
Requirements

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

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.

Encounter.identifier.type.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.identifier.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.identifier.type.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.identifier.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.identifier.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.identifier.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.identifier.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.identifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control 1..1
Type Uri
Requirements

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

Comments
Example http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Encounter.identifier.value
Definition

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

Control 1..1
Type String
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example 123456
Encounter.identifier.period
Definition

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

Control 0..1
Type Period
Comments
Encounter.identifier.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.identifier.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control 0..1
Comments

The reference may be just a text description of the assigner.

Encounter.identifier.assigner.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.identifier.assigner.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.status
Definition

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

Control 1..1
Binding

Current state of the encounter

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/encounter-state

Type Code
Is Modifier True
Comments
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.

Control 0..*
Type BackboneElement
Comments

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

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Encounter.statusHistory.status
Definition

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

Control 1..1
Binding

Current state of the encounter

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/encounter-state

Type Code
Comments
Encounter.statusHistory.period
Definition

The time that the episode was in the specified status.

Control 1..1
Type Period
Comments
Encounter.statusHistory.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.statusHistory.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.class
Definition

inpatient | outpatient | ambulatory | emergency +.

Control 0..1
Binding

Classification of the encounter

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/encounter-class

Type Code
Comments
Encounter.type
Definition

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

Control 0..*
Binding

The type of encounter

For example codes, see http://hl7.org/fhir/ValueSet/encounter-type

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments

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

Encounter.type.coding(SNOMED CT)
Definition

A reference to a code defined by a terminology system.

Control 0..1
Binding

The type of encounter

The codes SHOULD be taken from http://hl7.org.uk/CareConnect-EncounterType-1.valueset.xml

; other codes may be used where these codes are not suitable
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 1..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Value http://snomed.info/sct
Encounter.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 1..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 1..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.priority
Definition

Indicates the urgency of the encounter.

Control 0..1
Binding

Urgency of the encounter.

The codes SHOULD be taken from http://hl7.org/fhir/ValueSet/encounter-priority

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Encounter.priority.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.priority.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.priority.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.priority.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.priority.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.priority.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.priority.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.patient
Definition

The patient present at the encounter.

Control 1..1
Aliases patient
Comments

While the encounter is always about the patient, the patient may not actually be known in all contexts of use.

Encounter.patient.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.patient.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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).

Control 0..*
Type EpisodeOfCare
Comments
Encounter.episodeOfCare.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.episodeOfCare.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.incomingReferral
Definition

The referral request this encounter satisfies (incoming referral).

Control 0..*
Type ReferralRequest
Comments
Encounter.incomingReferral.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.incomingReferral.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.participant
Definition

The list of people responsible for providing the service.

Control 0..*
Type BackboneElement
Comments
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Encounter.participant.type
Definition

Role of participant in encounter.

Control 0..*
Binding

Role of participant in encounter

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/encounter-participant-type

Type CodeableConcept
Comments

The participant type indicates how an individual partitipates 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.

Encounter.participant.type.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.participant.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.participant.type.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.participant.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.participant.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.participant.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.participant.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.participant.period
Definition

The period of time that the specified participant was present during the encounter. These can overlap or be sub-sets of the overall encounters period.

Control 0..1
Type Period
Comments
Encounter.participant.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.participant.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.participant.individual
Definition

Persons involved in the encounter other than the patient.

Control 0..1
Type Choice of:
Comments
Encounter.appointment
Definition

The appointment that scheduled this encounter.

Control 0..1
Type Appointment
Comments
Encounter.appointment.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.appointment.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.period
Definition

The start and end time of the encounter.

Control 0..1
Type Period
Comments

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

Encounter.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.length
Definition

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

Control 0..1
Type Quantity
Comments

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

Encounter.length.value
Definition

The value of the measured amount. The value includes an implicit precision in the presentation of the value.

Control 0..1
Type Decimal
Requirements

Precision is handled implicitly in almost all cases of measurement.

Comments

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Encounter.length.comparator
Definition

How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

Control 0..1
Binding

How the Quantity should be understood and represented.

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/quantity-comparator

Type Code
Is Modifier True
Requirements

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

Comments

This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value.

Encounter.length.unit
Definition

A human-readable form of the unit.

Control 0..1
Type String
Requirements

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

Comments
Encounter.length.system
Definition

The identification of the system that provides the coded form of the unit.

Control 0..1 ?
Type Uri
Requirements

Need to know the system that defines the coded form of the unit.

Comments
Encounter.length.code
Definition

A computer processable form of the unit in some unit representation system.

Control 0..1
Type Code
Requirements

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

Comments

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

Encounter.reason
Definition

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

Control 0..*
Binding

Reason why the encounter takes place.

For example codes, see http://hl7.org/fhir/ValueSet/encounter-reason

; other codes may be used where these codes are not suitable
Type CodeableConcept
Aliases Indication, Admission diagnosis
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).

Encounter.reason.coding(SNOMED CT)
Definition

A reference to a code defined by a terminology system.

Control 0..1
Binding

Reason why the encounter takes place.

The codes SHALL be taken from http://snomed.info/sct

Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.reason.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 1..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Value http://snomed.info/sct
Encounter.reason.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 1..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.reason.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 1..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.reason.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.reason.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.indication
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.

Control 0..*
Type Choice of:
Aliases Admission diagnosis
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).

Encounter.hospitalization
Definition

Details about the admission to a healthcare service.

Control 0..1
Type BackboneElement
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.

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Encounter.hospitalization.preAdmissionIdentifier
Definition

Pre-admission identifier.

Control 0..1
Type Identifier
Comments
Encounter.hospitalization.preAdmissionIdentifier.use
Definition

The purpose of this identifier.

Control 0..1
Binding

Identifies the purpose for this identifier, if known .

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/identifier-use

Type Code
Is Modifier True
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Encounter.hospitalization.preAdmissionIdentifier.type
Definition

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

Control 0..1
Binding

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

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/identifier-type

Type CodeableConcept
Requirements

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

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.

Encounter.hospitalization.preAdmissionIdentifier.type.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.preAdmissionIdentifier.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.preAdmissionIdentifier.type.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.preAdmissionIdentifier.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.preAdmissionIdentifier.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.preAdmissionIdentifier.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.preAdmissionIdentifier.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.preAdmissionIdentifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control 1..1
Type Uri
Requirements

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

Comments
Example http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Encounter.hospitalization.preAdmissionIdentifier.value
Definition

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

Control 1..1
Type String
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example 123456
Encounter.hospitalization.preAdmissionIdentifier.period
Definition

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

Control 0..1
Type Period
Comments
Encounter.hospitalization.preAdmissionIdentifier.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.hospitalization.preAdmissionIdentifier.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.hospitalization.preAdmissionIdentifier.assigner
Definition

Organization that issued/manages the identifier.

Control 0..1
Comments

The reference may be just a text description of the assigner.

Encounter.hospitalization.preAdmissionIdentifier.assigner.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.hospitalization.preAdmissionIdentifier.assigner.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.hospitalization.origin
Definition

The location from which the patient came before admission.

Control 0..1
Comments
Encounter.hospitalization.origin.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.hospitalization.origin.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.hospitalization.admitSource
Definition

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

Control 0..1
Binding

From where the patient was admitted.

The codes SHOULD be taken from http://hl7.org/fhir/ValueSet/encounter-admit-source

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Encounter.hospitalization.admitSource.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.admitSource.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.admitSource.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.admitSource.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.admitSource.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.admitSource.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.admitSource.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.admittingDiagnosis
Definition

The admitting diagnosis field is used to record the diagnosis codes as reported by admitting practitioner. This could be different or in addition to the conditions reported as reason-condition(s) for the encounter.

Control 0..*
Type Condition
Comments
Encounter.hospitalization.admittingDiagnosis.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.hospitalization.admittingDiagnosis.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.hospitalization.reAdmission
Definition

Whether this hospitalization is a readmission and why if known.

Control 0..1
Binding None Specified
Type CodeableConcept
Comments
Encounter.hospitalization.reAdmission.coding(SNOMED CT)
Definition

A reference to a code defined by a terminology system.

Control 0..1
Binding

The reason for re-admission of this hospitalization encounter.

The codes SHALL be taken from http://snomed.info/sct

Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.reAdmission.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 1..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Value http://snomed.info/sct
Encounter.hospitalization.reAdmission.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 1..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.reAdmission.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 1..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.reAdmission.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.reAdmission.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.dietPreference
Definition

Diet preferences reported by the patient.

Control 0..*
Binding

Diet preference

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/encounter-diet

Type CodeableConcept
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.

Comments

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

Encounter.hospitalization.dietPreference.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.dietPreference.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.dietPreference.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.dietPreference.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.dietPreference.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.dietPreference.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.dietPreference.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.specialCourtesy
Definition

Special courtesies (VIP, board member).

Control 0..*
Binding

Special courtesies

The codes SHOULD be taken from http://hl7.org/fhir/ValueSet/encounter-special-courtesy

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Encounter.hospitalization.specialCourtesy.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.specialCourtesy.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.specialCourtesy.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.specialCourtesy.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.specialCourtesy.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.specialCourtesy.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.specialCourtesy.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.specialArrangement
Definition

Wheelchair, translator, stretcher, etc.

Control 0..*
Binding

Special arrangements

The codes SHOULD be taken from http://hl7.org/fhir/ValueSet/encounter-special-arrangements

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Encounter.hospitalization.specialArrangement.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.specialArrangement.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.specialArrangement.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.specialArrangement.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.specialArrangement.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.specialArrangement.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.specialArrangement.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.destination
Definition

Location to which the patient is discharged.

Control 0..1
Comments
Encounter.hospitalization.destination.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.hospitalization.destination.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.hospitalization.dischargeDisposition
Definition

Category or kind of location after discharge.

Control 0..1
Binding

Discharge Disposition

The codes SHOULD be taken from http://hl7.org/fhir/ValueSet/encounter-discharge-disposition

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Encounter.hospitalization.dischargeDisposition.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Encounter.hospitalization.dischargeDisposition.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Encounter.hospitalization.dischargeDisposition.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Control 0..1
Type String
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Encounter.hospitalization.dischargeDisposition.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Encounter.hospitalization.dischargeDisposition.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Encounter.hospitalization.dischargeDisposition.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Encounter.hospitalization.dischargeDisposition.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control 0..1
Type String
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Encounter.hospitalization.dischargeDiagnosis
Definition

The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete.

Control 0..*
Type Condition
Comments
Encounter.hospitalization.dischargeDiagnosis.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.hospitalization.dischargeDiagnosis.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.location
Definition

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

Control 0..*
Type BackboneElement
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".

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
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.

Encounter.location.location
Definition

The location where the encounter takes place.

Control 1..1
Comments
Encounter.location.location.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.location.location.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.location.status
Definition

The status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.

Control 0..1
Binding

The status of the location.

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/encounter-location-status

Type Code
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.

Encounter.location.period
Definition

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

Control 0..1
Type Period
Comments
Encounter.location.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Encounter.location.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Encounter.serviceProvider
Definition

An organization that is in charge of maintaining the information of this Encounter (e.g. who maintains the report or the master service catalog item, etc.). This MAY be the same as the organization on the Patient record, however it could be different. This MAY not be not the Service Delivery Location's Organization.

Control 0..1
Comments
Encounter.serviceProvider.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.serviceProvider.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Encounter.partOf
Definition

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

Control 0..1
Comments
Encounter.partOf.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Encounter.partOf.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.