QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Resource Profile: QICore Encounter

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter | Version: 7.0.2
Standards status: Trial-use | Maturity Level: 4 | Computable Name: QICoreEncounter

Profile of Encounter for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:

- status: (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
- subject: (QI) The patient or group present at the encounter
- class: (QI) Classification of patient encounter
- type: (QI) Specific type of encounter

QI Elements:

- serviceProvider: (QI) The organization (facility) responsible for this encounter
- participant: (QI) List of participants involved in the encounter
- hospitalization: (QI) Details about the admission to a healthcare service
- reasonCode: (QI) Coded reason the encounter takes place
- period: (QI) The start and end time of the encounter
- reasonReference: (QI) Reason the encounter takes place (reference)
- location: (QI) List of locations where the patient has been

Primary code path: type
(PCPath) This element is the primary code path for this resource CQL Retrieve
Usage

The following example illustrates accessing an inpatient encounter:

    define "Ophthalmology Encounter Codes":
      [Encounter: class in "Inpatient Encounter Classes"] InpatientEncounter
        where InpatientEncounter.type in "Ophthalmology Encounter Codes"

See the patterns page for implementation and usage patterns.

### Examples

Inpatient Admission for Appendicitis

Usages:

- Refer to this Profile: QICore AdverseEvent, QICore Claim, QICore CommunicationRequest, QICore Condition Encounter Diagnosis... Show 11 more, QICore DiagnosticReport Profile for Laboratory Results Reporting, QICore DiagnosticReport Profile for Report and Note Exchange, QICore Encounter, QICore ImagingStudy, QICore Immunization, QICore Immunization Not Done, QICore MedicationAdministration, QICore MedicationRequest, QICore Laboratory Result Observation, QICore ServiceRequest and QICore Task
- Examples for this Profile: Encounter/encounter-ed-example and Encounter/example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
meta | S Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!S Σ | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class | S Σ | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type | S Σ | 1..* | CodeableConcept | (QI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
participant | S Σ | 0..* | BackboneElement | (QI) List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
period | S | 0..1 | Period | (QI) The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
hospitalization | S | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (QI) List of locations where the patient has been
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | error | Encounter | 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 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreEncounterProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
status |  | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class | S | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type |  | 1..* | CodeableConcept | (QI) Specific type of encounter
subject |  | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
participant |  | 0..* | BackboneElement | (QI) List of participants involved in the encounter
individual |  | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
period |  | 0..1 | Period | (QI) The start and end time of the encounter
reasonCode |  | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place
reasonReference | Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
hospitalization |  | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition |  | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location |  | 0..* | BackboneElement | (QI) List of locations where the patient has been
location |  | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | (QI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | (QI) List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 0..1 | Period | (QI) The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (QI) List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Encounter.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Encounter.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.identifier.​type | Base | extensible | IdentifierType | 📦4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.statusHistory.​status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.classHistory.​class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.serviceType | Base | example | Service type | 📦4.0.1 | FHIR Std.
Encounter.priority | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​admitSource | Base | preferred | Admit source | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​reAdmission | Base | example | hl7VS-re-admissionIndicator | 📦2.0.0 | THO v6.5
Encounter.hospitalization.​dietPreference | Base | example | Diet | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialCourtesy | Base | preferred | Special courtesy | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialArrangement | Base | preferred | Special arrangements | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5
Encounter.location.status | Base | required | EncounterLocationStatus | 📍4.0.1 | FHIR Std.
Encounter.location.physicalType | Base | example | Location type | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | error | Encounter | 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 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
- QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
- QICore Condition Problems Health Concerns (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns)
- QICore Condition Encounter Diagnosis (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis)
- QICore Procedure (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure)
- QICore Simple Observation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation)
- QICore ImmunizationRecommendation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationrecommendation)
- QICore Location (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)
- QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICore Encounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
meta | S Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
status | ?!S Σ | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class | S Σ | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type | S Σ | 1..* | CodeableConcept | (QI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
participant | S Σ | 0..* | BackboneElement | (QI) List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
period | S | 0..1 | Period | (QI) The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
hospitalization | S | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (QI) List of locations where the patient has been
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | error | Encounter | 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 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from USCoreEncounterProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
status |  | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class | S | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type |  | 1..* | CodeableConcept | (QI) Specific type of encounter
subject |  | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
participant |  | 0..* | BackboneElement | (QI) List of participants involved in the encounter
individual |  | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
period |  | 0..1 | Period | (QI) The start and end time of the encounter
reasonCode |  | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place
reasonReference | Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
hospitalization |  | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition |  | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location |  | 0..* | BackboneElement | (QI) List of locations where the patient has been
location |  | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile | An interaction during which services are provided to the patient
id | Σ | 0..1 | id | Logical id of this artifact
meta | S Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | S Σ | 0..1 | instant | When the resource last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | (QI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | (QI) Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | (QI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(QICore Patient) | (QI) The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | (QI) List of participants involved in the encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore RelatedPerson) | (QI) Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 0..1 | Period | (QI) The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | (QI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(QICore Condition Problems Health Concerns | QICore Condition Encounter Diagnosis | QICore Procedure | QICore Simple Observation | QICore ImmunizationRecommendation) | (QI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | (QI) Details about the admission to a healthcare service
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin |  | 0..1 | Reference(QICore Location) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(QICore Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (QI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (QI) List of locations where the patient has been
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(QICore Location) | (QI) Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | (QI) Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(QICore Organization) | (QI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(QICore Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
Encounter.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std.
Encounter.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.identifier.​type | Base | extensible | IdentifierType | 📦4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.statusHistory.​status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.classHistory.​class | Base | extensible | ActEncounterCode | 📦3.0.0 | THO v6.5
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.serviceType | Base | example | Service type | 📦4.0.1 | FHIR Std.
Encounter.priority | Base | example | ActPriority | 📦3.0.0 | THO v6.5
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​admitSource | Base | preferred | Admit source | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​reAdmission | Base | example | hl7VS-re-admissionIndicator | 📦2.0.0 | THO v6.5
Encounter.hospitalization.​dietPreference | Base | example | Diet | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialCourtesy | Base | preferred | Special courtesy | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialArrangement | Base | preferred | Special arrangements | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v6.5
Encounter.location.status | Base | required | EncounterLocationStatus | 📍4.0.1 | FHIR Std.
Encounter.location.physicalType | Base | example | Location type | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | error | Encounter | 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 | error | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 1 element
Must-Support: 1 element

Structures

This structure refers to these other structures:

- QICore Patient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICore Practitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICore PractitionerRole (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole)
- QICore RelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)
- QICore Condition Problems Health Concerns (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns)
- QICore Condition Encounter Diagnosis (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis)
- QICore Procedure (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure)
- QICore Simple Observation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation)
- QICore ImmunizationRecommendation (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunizationrecommendation)
- QICore Location (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location)
- QICore Organization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICore Encounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)

Maturity: 4

Other representations of profile: CSV, Excel, Schematron