## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter vs http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter

Left: | US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)
Right: | US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)

### Messages

Error | StructureDefinition.version | Values for version differ: '4.0.0' vs '8.0.0'
Information | StructureDefinition.date | Values for date differ: '2019-05-21' vs '2023-10-17'
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - US Realm Steering Committee' vs 'HL7 International / Cross-Group Projects'
Information | StructureDefinition.definition | Values for definition differ: 'This is basic constraint on Encounter for use in US Core resources.' vs '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.'
Warning | Encounter.meta | Elements differ in definition for mustSupport: 'false' vs 'true'
Information | StructureDefinition.short | Values for short differ: 'Additional content defined by implementations' vs 'Extension'
Information | StructureDefinition.definition | Values for definition differ: '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.' vs 'An Extension'
Information | Encounter.reasonReference | Element maximum cardinalities differ: '1' vs '2147483647'
Information | Encounter.hospitalization.dischargeDisposition | Example/preferred bindings differ at Encounter.hospitalization.dischargeDisposition using binding from USCoreEncounterProfile

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/Encounter |
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |
date | 2019-05-21 | 2023-10-17 | Values Differ
description | The Encounter referenced in the US Core profiles. | The US Core Encounter Profile inherits from the FHIR [Encounter](https://hl7.org/fhir/R4/encounter.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Encounter resource to record, search, and fetch basic encounter information for an individual patient. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | Values Differ
experimental | false |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreEncounterProfile |
publisher | HL7 International - US Realm Steering Committee | HL7 International / Cross-Group Projects | Values Differ
purpose |  |
status | active |
title | US Core Encounter Profile |
type | Encounter |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter |
version | 4.0.0 | 8.0.0 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Encounter |  | 0..* | Encounter | An interaction during which services are provided to the patient |  | 0..* | Encounter | An interaction during which services are provided to the patient |
id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact |
meta | Σ | 0..1 | Meta | Metadata about the resource | S Σ | 0..1 | Meta | Metadata about the resource | Elements differ in definition for mustSupport: 'false' vs 'true'
id |  |  |  |  |  | 0..1 | string | Unique id for inter-element referencing | Added this element
Slices for extension |  |  |  |  |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | Added this element
versionId |  |  |  |  | Σ | 0..1 | id | Version specific identifier | Added this element
lastUpdated |  |  |  |  | S Σ | 0..1 | instant | When the resource last changed | Added this element
source |  |  |  |  | Σ | 0..1 | uri | Identifies where the resource comes from | Added this element
profile |  |  |  |  | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | Added this element
security |  |  |  |  | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Added this element
tag |  |  |  |  | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Added this element
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | 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 |  | 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 |  | 0..* | Resource | Contained, inline Resources |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known | S Σ | 0..* | Identifier | Identifier(s) by which this encounter is known |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url |  | 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: ?? (required): Identifies the purpose for this identifier, if known . | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | Σ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (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 | 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 | 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 | 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) | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
status | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: ?? (required): Current state of the encounter. | ?!S Σ | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: ?? (required): Current state of the encounter. |
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses |  | 0..* | BackboneElement | List of past encounter statuses |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: ?? (required): Current state of the encounter. |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: ?? (required): Current state of the encounter. |
period |  | 1..1 | Period | The time that the episode was in the specified status |  | 1..1 | Period | The time that the episode was in the specified status |
class | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ?? (extensible): Classification of the encounter. | S Σ | 1..1 | Coding | Classification of patient encounter Binding: ?? (extensible): Classification of the encounter. |
classHistory |  | 0..* | BackboneElement | List of past encounter classes |  | 0..* | BackboneElement | List of past encounter classes |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ?? (extensible): Classification of the encounter. |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: ?? (extensible): Classification of the encounter. |
period |  | 1..1 | Period | The time that the episode was in the specified class |  | 1..1 | Period | The time that the episode was in the specified class |
type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: ?? (extensible): Valueset to describe the Encounter Type | S Σ | 1..* | CodeableConcept | Specific type of encounter Binding: ?? (extensible): Valueset to describe the Encounter Type |
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ?? (example): Broad categorization of the service that is to be provided. | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ?? (example): Broad categorization of the service that is to be provided. |
priority |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ?? (example): Indicates the urgency of the encounter. |  | 0..1 | CodeableConcept | Indicates the urgency of the encounter Binding: ?? (example): Indicates the urgency of the encounter. |
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | The patient or group present at the encounter | S Σ | 1..1 | Reference(US Core Patient Profile S | Group) | The patient or group present at the encounter |
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against | 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 |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter |
participant | S Σ | 0..* | BackboneElement | List of participants involved in the encounter | S Σ | 0..* | BackboneElement | List of participants involved in the encounter |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ?? (extensible): Role of participant in encounter. | S Σ | 0..* | CodeableConcept | Role of participant in encounter Binding: ?? (extensible): Role of participant in encounter. |
period | S | 0..1 | Period | Period of time during the encounter that the participant participated | S | 0..1 | Period | Period of time during the encounter that the participant participated |
individual | S Σ | 0..1 | Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson) | Persons involved in the encounter other than the patient | S Σ | 0..1 | Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core RelatedPerson Profile) | Persons involved in the encounter other than the patient |
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter |
period | S | 0..1 | Period | The start and end time of the encounter | S | 0..1 | Period | The start and end time of the encounter |
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent) |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent) |
reasonCode | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: ?? (preferred): Reason why the encounter takes place. | S Σ | 0..* | CodeableConcept | Coded reason the encounter takes place Binding: ?? (preferred): Reason why the encounter takes place. |
reasonReference | S Σ | 0..1 | Reference(US Core Condition Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference) | S Σ | 0..* | Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation) | Reason the encounter takes place (reference) | Element maximum cardinalities differ: '1' vs '2147483647'
diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this encounter |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!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 | 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: ?? (preferred): The type of diagnosis this condition represents. |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: ?? (preferred): The type of diagnosis this condition represents. |
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type) |  | 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 |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter |
hospitalization | S | 0..1 | BackboneElement | Details about the admission to a healthcare service | S | 0..1 | BackboneElement | Details about the admission to a healthcare service |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier |  | 0..1 | Identifier | Pre-admission identifier |
origin |  | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission |  | 0..1 | Reference(Location | Organization) | The location/organization from which the patient came before admission |
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: ?? (preferred): From where the patient was admitted. |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: ?? (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: ?? (example): The reason for re-admission of this hospitalization encounter. |  | 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: ?? (example): The reason for re-admission of this hospitalization encounter. |
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: ?? (example): Medical, cultural or ethical food preferences to help with catering requirements. |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: ?? (example): Medical, cultural or ethical food preferences to help with catering requirements. |
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: ?? (preferred): Special courtesies. |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: ?? (preferred): Special courtesies. |
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: ?? (preferred): Special arrangements. |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: ?? (preferred): Special arrangements. |
destination |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged |  | 0..1 | Reference(Location | Organization) | Location/organization to which the patient is discharged |
dischargeDisposition | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: ?? (example): Discharge Disposition. | S | 0..1 | CodeableConcept | Category or kind of location after discharge Binding: ?? (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17 | Example/preferred bindings differ at Encounter.hospitalization.dischargeDisposition using binding from USCoreEncounterProfile
location | S | 0..* | BackboneElement | List of locations where the patient has been | S | 0..* | BackboneElement | List of locations where the patient has been |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
location | S | 1..1 | Reference(Location) | Location the encounter takes place | S | 1..1 | Reference(US Core Location Profile) | Location the encounter takes place |
status |  | 0..1 | code | planned | active | reserved | completed Binding: ?? (required): The status of the location. |  | 0..1 | code | planned | active | reserved | completed Binding: ?? (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: ?? (example): Physical form of the location. |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: ?? (example): Physical form of the location. |
period |  | 0..1 | Period | Time period during which the patient was present at the location |  | 0..1 | Period | Time period during which the patient was present at the location |
serviceProvider | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter | S | 0..1 | Reference(US Core Organization Profile) | The organization (facility) responsible for this encounter |
partOf |  | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of |  | 0..1 | Reference(Encounter) | Another Encounter this encounter is part of |
Documentation for this format