Birth And Fetal Death (BFDR) - STU2-ballot
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Birth And Fetal Death (BFDR) - STU2-ballot, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions

Resource Profile: EncounterBirth - Detailed Descriptions

Active as of 2024-05-01

Definitions for the Encounter-birth resource profile.

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

0. Encounter
2. Encounter.extension
Control1..?
SlicingThis element introduces a set of slices on Encounter.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Encounter.extension:role
    Slice Namerole
    ShortDifferentiates Birth and Maternity Encounters.
    Control1..1
    TypeExtension(Role Vital Records) (Extension Type: CodeableConcept)
    6. Encounter.extension:role.value[x]
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "code" : "CHILD"
      }]
    }
    8. Encounter.subject
    TypeReference(Patient - Child Vital Records)
    10. Encounter.participant
    SlicingThis element introduces a set of slices on Encounter.participant. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ type
    • 12. Encounter.participant:attendant
      Slice Nameattendant
      Definition

      The attendant at birth is defined as the individual at the delivery who is responsible for the delivery. For example, if an intern or nurse-midwife delivers an infant under the supervision of an obstetrician who is present in the delivery room, the obstetrician is to be reported as the attendant. However, a person who is not physically present at the delivery should not be reported as the attendant. For example, if the obstetrician is not physically present, the intern or nurse-midwife MUST be reported as the attendant.

      ShortThe person responsible for delivering the child.
      Control0..*
      Must Supporttrue
      14. Encounter.participant:attendant.type
      Control1..?
      SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • pattern @ $this
      • 16. Encounter.participant:attendant.type:requiredType
        Slice NamerequiredType
        Definition

        Birth attendant [Extended Identifier]

        ShortBirth attendant [Extended Identifier]
        Control1..1
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "87286-1"
          }]
        }
        18. Encounter.participant:attendant.individual
        Control1..?
        TypeReference(Practitioner - Birth Attendant)
        20. Encounter.participant:certifier
        Slice Namecertifier
        Definition

        The individual who certifies to the fact that the birth occurred. May be, but need not be, the same as the attendant at birth.

        ShortThe individual who certifies to the fact that the birth occurred.
        Control0..*
        Must Supporttrue
        22. Encounter.participant:certifier.type
        Control1..?
        SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • pattern @ $this
        • 24. Encounter.participant:certifier.type:requiredType
          Slice NamerequiredType
          Definition

          Birth certifier [Extended Identifier]

          ShortBirth certifier [Extended Identifier]
          Control1..1
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "87287-9"
            }]
          }
          26. Encounter.participant:certifier.period
          28. Encounter.participant:certifier.period.start
          Definition

          Date certified.

          ShortDate certified
          Must Supporttrue
          30. Encounter.participant:certifier.individual
          Control1..?
          TypeReference(Practitioner - Birth Certifier)
          32. Encounter.hospitalization
          34. Encounter.hospitalization.destination
          Definition

          If infant transferred, facility transferred to

          ShortIf infant transferred, facility transferred to
          TypeReference(Birth and Fetal Death Location)
          36. Encounter.hospitalization.dischargeDisposition
          Definition

          If infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility): the patient was transferred to another healthcare facility.

          ShortIf infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility) from codesystem https://terminology.hl7.org/5.4.0/CodeSystem-discharge-disposition.html
          38. Encounter.location
          Definition

          Information about the location of birth

          ShortInformation about the location of birth
          40. Encounter.location.location
          ShortFacility where birth occurred
          TypeReference(Birth and Fetal Death Location)
          42. Encounter.location.physicalType
          Definition

          Place where birth occurred (type of place)

          ShortThe value set contains the list of values used to indicate the type of place where birth or delivery occurred.
          BindingThe codes SHOULD be taken from Birth Delivery Occurred
          (preferred to http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-birth-delivery-occurred)

          Birth or Delivery Occurred (NCHS)

          Must Supporttrue
          44. Encounter.partOf
          Definition

          Reference to the mother's maternity encounter

          ShortReference to the mother's maternity encounter
          TypeReference(Encounter - Maternity)
          Must Supporttrue

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

          0. 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.

          ShortAn interaction during which services are provided to the patient
          Comments

          -

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

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

          ShortA set of rules under which this content was created
          Comments

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

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

          An Extension


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

          ShortExtensionAdditional content defined by implementations
          Comments

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

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Encounter.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. Encounter.extension:role
            Slice Namerole
            Definition

            Used to indicate whether an instance relates to the father or the mother.

            ShortDifferentiates Birth and Maternity Encounters.
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Role Vital Records) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            8. Encounter.extension:role.extension
            Definition

            An Extension


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

            ShortExtensionAdditional content defined by implementations
            Comments

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

            Control0..0*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Encounter.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 10. Encounter.extension:role.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-role-vr
              12. Encounter.extension:role.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue set used to indicate father or mother.Value of extension
              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from For codes, see Role Vital Records
              (extensible to http://hl7.org/fhir/us/vr-common-library/ValueSet/ValueSet-role-vr)

              Vital Records Role

              TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Pattern Value{
                "coding" : [{
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                  "code" : "CHILD"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              14. Encounter.modifierExtension
              Definition

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

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

              ShortExtensions that cannot be ignored
              Comments

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

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

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

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

              Identifier(s) by which this encounter is known.

              ShortIdentifier(s) by which this encounter is known
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              18. Encounter.identifier.use
              Definition

              The purpose of this identifier.

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

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

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

              Identifies the purpose for this identifier, if known .

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

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

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

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

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

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

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

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

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

              ShortThe value that is unique
              Comments

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

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

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

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

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

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

              Current state of the encounter.

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

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

              ShortClassification of patient encounter
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
              (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

              Classification of the encounter.

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

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

              ShortSpecific type of encounter
              Comments

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

              Control10..*
              BindingUnless not suitable, these codes SHALL be taken from For example codes, see US Core Encounter Typehttp://hl7.org/fhir/ValueSet/encounter-type
              (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type)

              Valueset to describe the Encounter Type


              The type of encounter.

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

              The patient or group present at the encounter.

              ShortThe patient or group present at the encounter
              Comments

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

              Control10..1
              TypeReference(Patient - Child Vital Records, Patient, Group)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Alternate Namespatient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. Encounter.participant
              Definition

              The list of people responsible for providing the service.

              ShortList of participants involved in the encounter
              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Encounter.participant. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 34. Encounter.participant.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

                Role of participant in encounter.

                ShortRole of participant in encounter
                Comments

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

                Control0..*
                BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
                (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                Role of participant in encounter.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Encounter.participant.period
                Definition

                The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

                Persons involved in the encounter other than the patient.

                ShortPersons involved in the encounter other than the patient
                Control0..1
                TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core RelatedPerson Profile, Practitioner, PractitionerRole, RelatedPerson)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesReference(US Core Practitioner Profile)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. Encounter.participant:attendant
                Slice Nameattendant
                Definition

                The attendant at birth is defined as the individual at the delivery who is responsible for the delivery. For example, if an intern or nurse-midwife delivers an infant under the supervision of an obstetrician who is present in the delivery room, the obstetrician is to be reported as the attendant. However, a person who is not physically present at the delivery should not be reported as the attendant. For example, if the obstetrician is not physically present, the intern or nurse-midwife MUST be reported as the attendant.


                The list of people responsible for providing the service.

                ShortThe person responsible for delivering the child.List of participants involved in the encounter
                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. Encounter.participant:attendant.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

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

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

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

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

                Role of participant in encounter.

                ShortRole of participant in encounter
                Comments

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

                Control10..*
                BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
                (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                Role of participant in encounter.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • pattern @ $this
                • 48. Encounter.participant:attendant.type:requiredType
                  Slice NamerequiredType
                  Definition

                  Birth attendant [Extended Identifier]


                  Role of participant in encounter.

                  ShortBirth attendant [Extended Identifier]Role of participant in encounter
                  Comments

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

                  Control10..1*
                  BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
                  (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                  Role of participant in encounter.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "87286-1"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Encounter.participant:attendant.period
                  Definition

                  The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

                  Persons involved in the encounter other than the patient.

                  ShortPersons involved in the encounter other than the patient
                  Control10..1
                  TypeReference(Practitioner - Birth Attendant, Practitioner, PractitionerRole, RelatedPerson)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. Encounter.participant:certifier
                  Slice Namecertifier
                  Definition

                  The individual who certifies to the fact that the birth occurred. May be, but need not be, the same as the attendant at birth.


                  The list of people responsible for providing the service.

                  ShortThe individual who certifies to the fact that the birth occurred.List of participants involved in the encounter
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Encounter.participant:certifier.modifierExtension
                  Definition

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

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

                  Role of participant in encounter.

                  ShortRole of participant in encounter
                  Comments

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

                  Control10..*
                  BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
                  (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                  Role of participant in encounter.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • pattern @ $this
                  • 60. Encounter.participant:certifier.type:requiredType
                    Slice NamerequiredType
                    Definition

                    Birth certifier [Extended Identifier]


                    Role of participant in encounter.

                    ShortBirth certifier [Extended Identifier]Role of participant in encounter
                    Comments

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

                    Control10..1*
                    BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
                    (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                    Role of participant in encounter.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "87287-9"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. Encounter.participant:certifier.period
                    Definition

                    The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

                    Date certified.


                    The start of the period. The boundary is inclusive.

                    ShortDate certifiedStarting time with inclusive boundary
                    Comments

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

                    Control0..1
                    This element is affected by the following invariants: per-1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. Encounter.participant:certifier.individual
                    Definition

                    Persons involved in the encounter other than the patient.

                    ShortPersons involved in the encounter other than the patient
                    Control10..1
                    TypeReference(Practitioner - Birth Certifier, Practitioner, PractitionerRole, RelatedPerson)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Encounter.period
                    Definition

                    The start and end time of the encounter.

                    ShortThe start and end time of the encounter
                    Comments

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

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

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

                    ShortCoded reason the encounter takes place
                    Comments

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

                    Control0..*
                    BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
                    (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

                    Reason why the encounter takes place.

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

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

                    ShortReason the encounter takes place (reference)
                    Comments

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

                    Control0..*
                    TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Condition, Procedure)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile)
                    Summarytrue
                    Alternate NamesIndication, Admission diagnosis
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. Encounter.hospitalization
                    Definition

                    Details about the admission to a healthcare service.

                    ShortDetails about the admission to a healthcare service
                    Comments

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

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

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

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

                    If infant transferred, facility transferred to


                    Location/organization to which the patient is discharged.

                    ShortIf infant transferred, facility transferred toLocation/organization to which the patient is discharged
                    Control0..1
                    TypeReference(Birth and Fetal Death Location, Location, Organization)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. Encounter.hospitalization.dischargeDisposition
                    Definition

                    If infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility): the patient was transferred to another healthcare facility.


                    Category or kind of location after discharge.

                    ShortIf infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility) from codesystem https://terminology.hl7.org/5.4.0/CodeSystem-discharge-disposition.htmlCategory or kind of location after discharge
                    Control0..1
                    BindingThe codes SHOULD be taken from For example codes, see US Core Discharge Dispositionhttp://hl7.org/fhir/ValueSet/encounter-discharge-disposition
                    (preferred to http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition)

                    National Uniform Billing Committee, manual UB-04, UB form locator 17


                    Discharge Disposition.

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

                    Information about the location of birth


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

                    ShortInformation about the location of birthList of locations where the patient has been
                    Comments

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

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

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

                    The location where the encounter takes place.

                    ShortFacility where birth occurredLocation the encounter takes place
                    Control1..1
                    TypeReference(Birth and Fetal Death Location, Location)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. Encounter.location.physicalType
                    Definition

                    Place where birth occurred (type of place)


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

                    ShortThe value set contains the list of values used to indicate the type of place where birth or delivery occurred.The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
                    Comments

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

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

                    Control0..1
                    BindingThe codes SHOULD be taken from For example codes, see Birth Delivery Occurredhttp://hl7.org/fhir/ValueSet/location-physical-type
                    (preferred to http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-birth-delivery-occurred)

                    Birth or Delivery Occurred (NCHS)


                    Physical form of the location.

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

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

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

                    Reference to the mother's maternity encounter


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

                    ShortReference to the mother's maternity encounterAnother Encounter this encounter is part of
                    Comments

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

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

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

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

                    0. Encounter
                    Definition

                    -

                    ShortAn interaction during which services are provided to the patient
                    Comments

                    -

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

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

                    ShortLogical id of this artifact
                    Comments

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

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

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

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

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

                    ShortA set of rules under which this content was created
                    Comments

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

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

                    The base language in which the resource is written.

                    ShortLanguage of the resource content
                    Comments

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

                    Control0..1
                    BindingThe codes SHOULD be taken from CommonLanguages
                    (preferred to http://hl7.org/fhir/ValueSet/languages)

                    A human language.

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

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

                    ShortText summary of the resource, for human interpretation
                    Comments

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

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

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

                    ShortContained, inline Resources
                    Comments

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

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

                    An Extension

                    ShortExtension
                    Control1..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Encounter.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 16. Encounter.extension:role
                      Slice Namerole
                      Definition

                      Used to indicate whether an instance relates to the father or the mother.

                      ShortDifferentiates Birth and Maternity Encounters.
                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Role Vital Records) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      18. Encounter.extension:role.id
                      Definition

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

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

                      An Extension

                      ShortExtension
                      Control0..0
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingThis element introduces a set of slices on Encounter.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 22. Encounter.extension:role.url
                        Definition

                        Source of the definition for the extension code - a logical name or a URL.

                        Shortidentifies the meaning of the extension
                        Comments

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        Fixed Valuehttp://hl7.org/fhir/us/vr-common-library/StructureDefinition/Extension-role-vr
                        24. Encounter.extension:role.value[x]
                        Definition

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        ShortValue set used to indicate father or mother.
                        Control1..1
                        BindingUnless not suitable, these codes SHALL be taken from Role Vital Records
                        (extensible to http://hl7.org/fhir/us/vr-common-library/ValueSet/ValueSet-role-vr)

                        Vital Records Role

                        TypeCodeableConcept
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Is Modifierfalse
                        Summaryfalse
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                            "code" : "CHILD"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        26. Encounter.modifierExtension
                        Definition

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

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

                        ShortExtensions that cannot be ignored
                        Comments

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

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

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

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

                        Identifier(s) by which this encounter is known.

                        ShortIdentifier(s) by which this encounter is known
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. Encounter.identifier.id
                        Definition

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

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

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

                        ShortAdditional content defined by implementations
                        Comments

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

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

                          The purpose of this identifier.

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

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

                          Control0..1
                          BindingThe codes SHALL be taken from IdentifierUse
                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                          Identifies the purpose for this identifier, if known .

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

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

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

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

                          ShortDescription of identifier
                          Comments

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

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

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

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

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

                          ShortThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

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

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

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

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

                          ShortThe value that is unique
                          Comments

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

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

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

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

                          Organization that issued/manages the identifier.

                          ShortOrganization that issued id (may be just text)
                          Comments

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

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

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

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

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

                          Control1..1
                          BindingThe codes SHALL be taken from EncounterStatus
                          (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

                          Current state of the encounter.

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

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

                          ShortList of past encounter statuses
                          Comments

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

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

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

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

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

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

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

                          Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
                          Control1..1
                          BindingThe codes SHALL be taken from EncounterStatus
                          (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

                          Current state of the encounter.

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

                          The time that the episode was in the specified status.

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

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

                          ShortClassification of patient encounter
                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
                          (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

                          Classification of the encounter.

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

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

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

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

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

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

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

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

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

                          inpatient | outpatient | ambulatory | emergency +.

                          Shortinpatient | outpatient | ambulatory | emergency +
                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
                          (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

                          Classification of the encounter.

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

                          The time that the episode was in the specified class.

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

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

                          ShortSpecific type of encounter
                          Comments

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

                          Control1..*
                          BindingUnless not suitable, these codes SHALL be taken from US Core Encounter Type
                          (extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type)

                          Valueset to describe the Encounter Type

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

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

                          ShortSpecific type of service
                          Control0..1
                          BindingFor example codes, see ServiceType
                          (example to http://hl7.org/fhir/ValueSet/service-type)

                          Broad categorization of the service that is to be provided.

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

                          Indicates the urgency of the encounter.

                          ShortIndicates the urgency of the encounter
                          Control0..1
                          BindingFor example codes, see ActPriority
                          (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

                          Indicates the urgency of the encounter.

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

                          The patient or group present at the encounter.

                          ShortThe patient or group present at the encounter
                          Comments

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

                          Control1..1
                          TypeReference(Patient - Child Vital Records)
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Alternate Namespatient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. Encounter.episodeOfCare
                          Definition

                          Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

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

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

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

                          The list of people responsible for providing the service.

                          ShortList of participants involved in the encounter
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Encounter.participant. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ type
                          • 88. Encounter.participant.id
                            Definition

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

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

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            Role of participant in encounter.

                            ShortRole of participant in encounter
                            Comments

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

                            Control0..*
                            BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                            (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                            Role of participant in encounter.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            96. Encounter.participant.period
                            Definition

                            The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

                            Persons involved in the encounter other than the patient.

                            ShortPersons involved in the encounter other than the patient
                            Control0..1
                            TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core RelatedPerson Profile)
                            Is Modifierfalse
                            Must Supporttrue
                            Must Support TypesReference(US Core Practitioner Profile)
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            100. Encounter.participant:attendant
                            Slice Nameattendant
                            Definition

                            The attendant at birth is defined as the individual at the delivery who is responsible for the delivery. For example, if an intern or nurse-midwife delivers an infant under the supervision of an obstetrician who is present in the delivery room, the obstetrician is to be reported as the attendant. However, a person who is not physically present at the delivery should not be reported as the attendant. For example, if the obstetrician is not physically present, the intern or nurse-midwife MUST be reported as the attendant.

                            ShortThe person responsible for delivering the child.
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. Encounter.participant:attendant.id
                            Definition

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

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

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

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

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            Role of participant in encounter.

                            ShortRole of participant in encounter
                            Comments

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

                            Control1..*
                            BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                            (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                            Role of participant in encounter.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • pattern @ $this
                            • 110. Encounter.participant:attendant.type:requiredType
                              Slice NamerequiredType
                              Definition

                              Birth attendant [Extended Identifier]

                              ShortBirth attendant [Extended Identifier]
                              Comments

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

                              Control1..1
                              BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                              (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                              Role of participant in encounter.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "87286-1"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              112. Encounter.participant:attendant.period
                              Definition

                              The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

                              Persons involved in the encounter other than the patient.

                              ShortPersons involved in the encounter other than the patient
                              Control1..1
                              TypeReference(Practitioner - Birth Attendant)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              116. Encounter.participant:certifier
                              Slice Namecertifier
                              Definition

                              The individual who certifies to the fact that the birth occurred. May be, but need not be, the same as the attendant at birth.

                              ShortThe individual who certifies to the fact that the birth occurred.
                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              118. Encounter.participant:certifier.id
                              Definition

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

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

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

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

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

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

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

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

                              Role of participant in encounter.

                              ShortRole of participant in encounter
                              Comments

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

                              Control1..*
                              BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                              (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                              Role of participant in encounter.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Encounter.participant.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • pattern @ $this
                              • 126. Encounter.participant:certifier.type:requiredType
                                Slice NamerequiredType
                                Definition

                                Birth certifier [Extended Identifier]

                                ShortBirth certifier [Extended Identifier]
                                Comments

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

                                Control1..1
                                BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                                Role of participant in encounter.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "87287-9"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                128. Encounter.participant:certifier.period
                                Definition

                                The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

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

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

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

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  Date certified.

                                  ShortDate certified
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: per-1
                                  TypedateTime
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  136. Encounter.participant:certifier.period.end
                                  Definition

                                  The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. 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.

                                  ShortEnd time with inclusive boundary, if not ongoing
                                  Comments

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

                                  Control0..1
                                  This element is affected by the following invariants: per-1
                                  TypedateTime
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  138. Encounter.participant:certifier.individual
                                  Definition

                                  Persons involved in the encounter other than the patient.

                                  ShortPersons involved in the encounter other than the patient
                                  Control1..1
                                  TypeReference(Practitioner - Birth Certifier)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  140. Encounter.appointment
                                  Definition

                                  The appointment that scheduled this encounter.

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

                                  The start and end time of the encounter.

                                  ShortThe start and end time of the encounter
                                  Comments

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

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

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

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

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

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

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

                                  ShortCoded reason the encounter takes place
                                  Comments

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

                                  Control0..*
                                  BindingThe codes SHOULD be taken from EncounterReasonCodes
                                  (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

                                  Reason why the encounter takes place.

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

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

                                  ShortReason the encounter takes place (reference)
                                  Comments

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

                                  Control0..*
                                  TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Must Support TypesReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile)
                                  Summarytrue
                                  Alternate NamesIndication, Admission diagnosis
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  150. Encounter.diagnosis
                                  Definition

                                  The list of diagnosis relevant to this encounter.

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

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

                                  ShortThe diagnosis or procedure relevant to the encounter
                                  Comments

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

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

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

                                  ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                  Control0..1
                                  BindingThe codes SHOULD be taken from DiagnosisRole
                                  (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

                                  The type of diagnosis this condition represents.

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

                                  Ranking of the diagnosis (for each role type).

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

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

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

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

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

                                  Details about the admission to a healthcare service.

                                  ShortDetails about the admission to a healthcare service
                                  Comments

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

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

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  Pre-admission identifier.

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

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

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

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

                                  ShortFrom where patient was admitted (physician referral, transfer)
                                  Control0..1
                                  BindingThe codes SHOULD be taken from AdmitSource
                                  (preferred to http://hl7.org/fhir/ValueSet/encounter-admit-source)

                                  From where the patient was admitted.

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

                                  Whether this hospitalization is a readmission and why if known.

                                  ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
                                  Control0..1
                                  BindingFor example codes, see hl7VS-re-admissionIndicator
                                  (example to http://terminology.hl7.org/ValueSet/v2-0092)

                                  The reason for re-admission of this hospitalization encounter.

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

                                  Diet preferences reported by the patient.

                                  ShortDiet preferences reported by the patient
                                  Comments

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

                                  Control0..*
                                  BindingFor example codes, see Diet
                                  (example to http://hl7.org/fhir/ValueSet/encounter-diet)

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

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

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

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

                                  Special courtesies (VIP, board member).

                                  ShortSpecial courtesies (VIP, board member)
                                  Control0..*
                                  BindingThe codes SHOULD be taken from SpecialCourtesy
                                  (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

                                  Special courtesies.

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

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

                                  ShortWheelchair, translator, stretcher, etc.
                                  Control0..*
                                  BindingThe codes SHOULD be taken from SpecialArrangements
                                  (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

                                  Special arrangements.

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

                                  If infant transferred, facility transferred to

                                  ShortIf infant transferred, facility transferred to
                                  Control0..1
                                  TypeReference(Birth and Fetal Death Location)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  190. Encounter.hospitalization.dischargeDisposition
                                  Definition

                                  If infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility): the patient was transferred to another healthcare facility.

                                  ShortIf infant transferred within 24 hours of delivery, set code = "other-hcf" (Other healthcare facility) from codesystem https://terminology.hl7.org/5.4.0/CodeSystem-discharge-disposition.html
                                  Control0..1
                                  BindingThe codes SHOULD be taken from US Core Discharge Disposition
                                  (preferred to http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition)

                                  National Uniform Billing Committee, manual UB-04, UB form locator 17

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

                                  Information about the location of birth

                                  ShortInformation about the location of birth
                                  Comments

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

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

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

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

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  The location where the encounter takes place.

                                  ShortFacility where birth occurred
                                  Control1..1
                                  TypeReference(Birth and Fetal Death Location)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  202. Encounter.location.status
                                  Definition

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

                                  Shortplanned | active | reserved | completed
                                  Comments

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

                                  Control0..1
                                  BindingThe codes SHALL be taken from EncounterLocationStatus
                                  (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

                                  The status of the location.

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

                                  Place where birth occurred (type of place)

                                  ShortThe value set contains the list of values used to indicate the type of place where birth or delivery occurred.
                                  Comments

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

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

                                  Control0..1
                                  BindingThe codes SHOULD be taken from Birth Delivery Occurred
                                  (preferred to http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-birth-delivery-occurred)

                                  Birth or Delivery Occurred (NCHS)

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

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

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

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

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

                                  Reference to the mother's maternity encounter

                                  ShortReference to the mother's maternity encounter
                                  Comments

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

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

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