CDA On FHIR England - Document Header

CareConnect-Encounter-1

This Encounter resource in most but not all cases covers an episode of care.

NameCard.TypeDescription & Constraints
..EncounterEncounterAn interaction during which services are provided to the patient

...transport0..1ExtensionEncounter transport
Extension http://fhir.nhs.net/StructureDefinition/extension-careconnect-encountertransport-1

...identifier0..*IdentifierIdentifier(s) by which this encounter is known

....use0..1Codeusual | official | temp | secondary (If known)
Binding Identifies the purpose for this identifier, if known . (http://hl7.org/fhir/ValueSet/identifier-use)
Binding Strength Required

....type0..1CodeableConceptDescription of identifier
Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. (http://hl7.org/fhir/ValueSet/identifier-type)
Binding Strength Extensible

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....system1..1UriThe namespace for the identifier
Example Value http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri

....value1..1StringThe value that is unique
Example Value 123456

....period0..1PeriodTime period when id is/was valid for use

.....start0..1DateTimeStarting time with inclusive boundary

.....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

....assigner0..1Reference (careconnect-organization-1)Organization that issued id (may be just text)

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

...status1..1Codeplanned | arrived | in-progress | onleave | finished | cancelled
Binding Current state of the encounter (http://hl7.org/fhir/ValueSet/encounter-state)
Binding Strength Required

...statusHistory0..*BackboneElementList of past encounter statuses

....status1..1Codeplanned | arrived | in-progress | onleave | finished | cancelled
Binding Current state of the encounter (http://hl7.org/fhir/ValueSet/encounter-state)
Binding Strength Required

....period1..1PeriodThe time that the episode was in the specified status

.....start0..1DateTimeStarting time with inclusive boundary

.....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

...class0..1Codeinpatient | outpatient | ambulatory | emergency +
Binding Classification of the encounter (http://hl7.org/fhir/ValueSet/encounter-class)
Binding Strength Required

...type0..*CodeableConceptSpecific type of encounter
Binding The type of encounter (http://hl7.org/fhir/ValueSet/encounter-type)
Binding Strength Example

....codingCode defined by a terminology system
Slice: Ordering: Ordered, Discriminator: system, Rules: Open at End

....coding (SNOMED CT)0..1CodingSNOMED CT representation of the type encounter
Binding The type of encounter (http://hl7.org.uk/CareConnect-EncounterType-1.valueset.xml)
Binding Strength Preferred

.....system1..1UriIdentity of the terminology system
Fixed Value http://snomed.info/sct

.....code1..1CodeSymbol in syntax defined by the system

.....display1..1StringRepresentation defined by the system

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...priority0..1CodeableConceptIndicates the urgency of the encounter
Binding Urgency of the encounter. (http://hl7.org/fhir/ValueSet/encounter-priority)
Binding Strength Preferred

....coding0..*CodingCode defined by a terminology system

.....system0..1UriIdentity of the terminology system

.....version0..1StringVersion of the system - if relevant

.....code0..1CodeSymbol in syntax defined by the system

.....display0..1StringRepresentation defined by the system

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...patient1..1Reference (careconnect-patient-1)The patient present at the encounter

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

...episodeOfCare0..*Reference (EpisodeOfCare)Episode(s) of care that this encounter should be recorded against

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

...incomingReferral0..*Reference (ReferralRequest)The ReferralRequest that initiated this encounter

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

...participant0..*BackboneElementList of participants involved in the encounter

....type0..*CodeableConceptRole of participant in encounter
Binding Role of participant in encounter (http://hl7.org/fhir/ValueSet/encounter-participant-type)
Binding Strength Extensible

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....period0..1PeriodPeriod of time during the encounter participant was present

.....start0..1DateTimeStarting time with inclusive boundary

.....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

....individual0..1careconnect-practitioner-1 | -related-person-1Persons involved in the encounter other than the patient

...appointment0..1Reference (Appointment)The appointment that scheduled this encounter

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

...period0..1PeriodThe start and end time of the encounter

....start0..1DateTimeStarting time with inclusive boundary

....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

...length0..1DurationQuantity of time the encounter lasted (less time absent)

....value0..1DecimalNumerical value (with implicit precision)

....comparator0..1Code< | <= | >= | > - how to understand the value
Binding How the Quantity should be understood and represented. (http://hl7.org/fhir/ValueSet/quantity-comparator)
Binding Strength Required

....unit0..1StringUnit representation

....system0..1UriSystem that defines coded unit form

....code0..1CodeCoded form of the unit

...reason0..*CodeableConceptReason the encounter takes place (code)
Binding Reason why the encounter takes place. (http://hl7.org/fhir/ValueSet/encounter-reason)
Binding Strength Example

....codingCode defined by a terminology system
Slice: Ordering: Ordered, Discriminator: system, Rules: Open at End

....coding (SNOMED CT)0..1CodingSNOMED CT representation of the reason why the encounter takes place
Binding Reason why the encounter takes place. (http://snomed.info/sct)
Binding Strength Required

.....system1..1UriIdentity of the terminology system
Fixed Value http://snomed.info/sct

.....code1..1CodeSymbol in syntax defined by the system

.....display1..1StringRepresentation defined by the system

.....userSelected0..1BooleanIf this coding was chosen directly by the user

....text0..1StringPlain text representation of the concept

...indication0..*Reference (Condition | Procedure)Reason the encounter takes place (resource). IMPORTANT NOTE: THIS CONDITION AND/OR PROCEDURE CURRENTLY LINKS TO THE DSTU FHIR SPECIFICATION CONDTION AND/OR PROCEDURE RESOURCE FOR INFORMATION ONLY. WHERE THIS REFERENCE IS USED IN A DOMAIN SPECIFICATION, THE SPECIFICATION SHOULD INCLUDE A SPECIFIC CONDITION AND/OR PROCEDURE PROFILE.

...hospitalization0..1BackboneElementDetails about the admission to a healthcare service

....preAdmissionIdentifier0..1IdentifierPre-admission identifier

.....use0..1Codeusual | official | temp | secondary (If known)
Binding Identifies the purpose for this identifier, if known . (http://hl7.org/fhir/ValueSet/identifier-use)
Binding Strength Required

.....type0..1CodeableConceptDescription of identifier
Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. (http://hl7.org/fhir/ValueSet/identifier-type)
Binding Strength Extensible

......coding0..*CodingCode defined by a terminology system

.......system0..1UriIdentity of the terminology system

.......version0..1StringVersion of the system - if relevant

.......code0..1CodeSymbol in syntax defined by the system

.......display0..1StringRepresentation defined by the system

.......userSelected0..1BooleanIf this coding was chosen directly by the user

......text0..1StringPlain text representation of the concept

.....system1..1UriThe namespace for the identifier
Example Value http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri

.....value1..1StringThe value that is unique
Example Value 123456

.....period0..1PeriodTime period when id is/was valid for use

......start0..1DateTimeStarting time with inclusive boundary

......end0..1DateTimeEnd time with inclusive boundary, if not ongoing

.....assigner0..1Reference (careconnect-organization-1)Organization that issued id (may be just text)

......reference0..1StringRelative, internal or absolute URL reference

......display0..1StringText alternative for the resource

....origin0..1Reference (cofe-location-1)The location from which the patient came before admission

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

....admitSource0..1CodeableConceptFrom where patient was admitted (physician referral, transfer)
Binding From where the patient was admitted. (http://hl7.org/fhir/ValueSet/encounter-admit-source)
Binding Strength Preferred

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....admittingDiagnosis0..*Reference (Condition)The admitting diagnosis as reported by admitting practitioner. IMPORTANT NOTE: THIS CONDITION CURRENTLY LINKS TO THE DSTU FHIR SPECIFICATION CONDITION RESOURCE FOR INFORMATION ONLY. WHERE THIS REFERENCE IS USED IN A DOMAIN SPECIFICATION, THE SPECIFICATION SHOULD INCLUDE A SPECIFIC CONDITION PROFILE.

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

....reAdmission0..1CodeableConceptThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
Binding The reason for re-admission of this hospitalization encounter. (http://example.com/valueset)
Binding Strength Example

.....codingCode defined by a terminology system
Slice: Ordering: Ordered, Discriminator: system, Rules: Open at End

.....coding (SNOMED CT)0..1CodingSNOMED CT representation of the reason for re-admission.
Binding The reason for re-admission of this hospitalization encounter. (http://snomed.info/sct)
Binding Strength Required

......system1..1UriIdentity of the terminology system
Fixed Value http://snomed.info/sct

......code1..1CodeSymbol in syntax defined by the system

......display1..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....dietPreference0..*CodeableConceptDiet preferences reported by the patient
Binding Diet preference (http://hl7.org/fhir/ValueSet/encounter-diet)
Binding Strength Extensible

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....specialCourtesy0..*CodeableConceptSpecial courtesies (VIP, board member)
Binding Special courtesies (http://hl7.org/fhir/ValueSet/encounter-special-courtesy)
Binding Strength Preferred

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....specialArrangement0..*CodeableConceptWheelchair, translator, stretcher, etc.
Binding Special arrangements (http://hl7.org/fhir/ValueSet/encounter-special-arrangements)
Binding Strength Preferred

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....destination0..1Reference (cofe-location-1)Location to which the patient is discharged

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

....dischargeDisposition0..1CodeableConceptCategory or kind of location after discharge
Binding Discharge Disposition (http://hl7.org/fhir/ValueSet/encounter-discharge-disposition)
Binding Strength Preferred

.....coding0..*CodingCode defined by a terminology system

......system0..1UriIdentity of the terminology system

......version0..1StringVersion of the system - if relevant

......code0..1CodeSymbol in syntax defined by the system

......display0..1StringRepresentation defined by the system

......userSelected0..1BooleanIf this coding was chosen directly by the user

.....text0..1StringPlain text representation of the concept

....dischargeDiagnosis0..*Reference (Condition)The final diagnosis given a patient before release from the hospital after all testing, surgery, and workup are complete. IMPORTANT NOTE: THIS CONDITION CURRENTLY LINKS TO THE DSTU FHIR SPECIFICATION CONDITION RESOURCE FOR INFORMATION ONLY. WHERE THIS REFERENCE IS USED IN A DOMAIN SPECIFICATION, THE SPECIFICATION SHOULD INCLUDE A SPECIFIC CONDITION PROFILE.

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

...location0..*BackboneElementList of locations where the patient has been

....location1..1Reference (cofe-location-1)Location the encounter takes place

.....reference0..1StringRelative, internal or absolute URL reference

.....display0..1StringText alternative for the resource

....status0..1Codeplanned | active | reserved | completed
Binding The status of the location. (http://hl7.org/fhir/ValueSet/encounter-location-status)
Binding Strength Required

....period0..1PeriodTime period during which the patient was present at the location

.....start0..1DateTimeStarting time with inclusive boundary

.....end0..1DateTimeEnd time with inclusive boundary, if not ongoing

...serviceProvider0..1Reference (careconnect-organization-1)The custodian organization of this Encounter record

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

...partOf0..1Reference (careconnect-encounter-1)Another Encounter this encounter is part of

....reference0..1StringRelative, internal or absolute URL reference

....display0..1StringText alternative for the resource

Name Type Description & Constraints
. . extension-careconnect-encountertransport-1 Extension An extension to the Encounter resource to include the Transport used by the subject for an encounter.
Path Name Binding Strength ValueSet
.Encounter.type.coding SNOMED CT Preferred http://hl7.org.uk/CareConnect-EncounterType-1.valueset.xml
.Encounter.priority priority Preferred http://hl7.org/fhir/ValueSet/encounter-priority
.Encounter.reason.coding SNOMED CT Required http://snomed.info/sct
.Encounter.hospitalization.dietPreference dietPreference Extensible http://hl7.org/fhir/ValueSet/encounter-diet

CareConnect-Encounter-1

Examples Description XML File
COFE-Encounter-1-Example-1 Emergency visit to department