Introduction

This profile is used to represent de-identified Encounter information. The de-identification process has to remove all data elements not explicitly identified as “SUPPORTED” in the profile.

The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed.

According to the HHS guidance, dates should not have a precision of more than the year. This means month and day cannot be included. This includes diagnosis dates, visit dates, onset dates etc.

In FHIR Resources, text elements and reference.display elements which provide human readable information to the providers may be generated using programs and tools from the data present within the resource. For e.g a Encounter resource text element may contain information such as the visit date. This type of information will enable identification of the individuals. In order to avoid inadvertent revealing of PII/PHI, text elements cannot be included in the De-identified FHIR resource and the submission will be rejected when text elements are present by the validation process.

Age Computation

The Data Submitter has to compute the age using the visit date of the encounter to be included in the UDS+ report.

Capturing Location Information

The Encounter.location.location points to a Location Resource. The Location.type element can be used to indicate the type of location where the service was provided. The existing Location.type value set can be used to indicate that the service was provided in a SCHOOL based setting. This will be used to compute Table 4, LINE 24 of the UDS Report. For Table 4, Line 26 use the public-housing code defined in UDS+ value set that is referenced in the UDS+ Location profile.

Ids and References

The original Encounter resource id should not be included in the De-identified Encounter instance. Instead a new id should be created and provided as part of the FHIR resource. This Data Submitter should be capable of using the generated id to relink the data to the original Encounter. All resource references to the Encounter submitted as part of the UDS+ report should refer to newly generated id.

Resource references cannot contain text element as it may contain PHI/PII. The text element for following references are not allowed

• subject
• reasonReference

Date Truncation

The Data Submitter has to truncate the following dates to only have a precision of year

• period and its sub elements.
• participant.period

The following is new content for 1.0.2.

Examples

Examples of identifiable data and its corresponding de-identifiable data is present in Reporting Guidance.

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

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	S	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
text		0..0
contained		0..0
Slices for extension				Content/Rules for all slices
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of patient encounter
type	S	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject	S	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
display		0..0
participant	S	0..*	BackboneElement	List of participants involved in the encounter
type	S	0..*	CodeableConcept	Role of participant in encounter
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	S	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
reasonCode	S	0..*	CodeableConcept	Coded reason the encounter takes place
reasonReference	S	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
condition	S	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	List of locations where the patient has been
location	S	1..1	Reference(UDS Plus Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Core Organization Profile)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	SΣ	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject	SΣ	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	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	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	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(UDS Plus Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Core Organization Profile)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	SΣ	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
meta	Σ	0..1	Meta	Metadata about the resource
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SΣ	1..1	code	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	SΣ	1..1	Coding	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	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
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	SΣ	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
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	SΣ	0..*	BackboneElement	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	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	SΣ	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	SΣ	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	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	S	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	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(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: 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(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	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(UDS Plus Location)	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	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
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

Differential View

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	S	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
text		0..0
contained		0..0
Slices for extension				Content/Rules for all slices
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of patient encounter
type	S	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject	S	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
display		0..0
participant	S	0..*	BackboneElement	List of participants involved in the encounter
type	S	0..*	CodeableConcept	Role of participant in encounter
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	S	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
reasonCode	S	0..*	CodeableConcept	Coded reason the encounter takes place
reasonReference	S	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
condition	S	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	List of locations where the patient has been
location	S	1..1	Reference(UDS Plus Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Core Organization Profile)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	SΣ	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
subject	SΣ	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	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	S	0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	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(UDS Plus Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Core Organization Profile)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	De-Identified UDS Plus Encounter
id	SΣ	0..1	id	The de-identified Encounter identifier created by the health center to send data to UDS+ Data Receiver
meta	Σ	0..1	Meta	Metadata about the resource
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
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
uds-plus-age-extension	S	1..1	Quantity	Age of the Patient computed using birthDate and the visit dates of the encounter URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SΣ	1..1	code	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	SΣ	1..1	Coding	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	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): The set of codes indicating the type of encounter
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	SΣ	1..1	Reference(De-Identified UDS Plus Patient)	The patient or group present at the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
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	SΣ	0..*	BackboneElement	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	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	SC	0..1	Period	Period of time during the encounter that the participant participated uds-plus-enc-1: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-2: All Period.emd data elements should be truncated to a year only for de-identified resources.
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	SC	0..1	Period	The start and end time of the encounter uds-plus-enc-3: All Period.start data elements should be truncated to a year only for de-identified resources. uds-plus-enc-4: All Period.emd data elements should be truncated to a year only for de-identified resources.
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(De-Identified UDS Plus Diagnosis)	Reason the encounter takes place (reference)
diagnosis	SΣ	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	SΣ	1..1	Reference(De-Identified UDS Plus Diagnosis)	The diagnosis or procedure relevant to the encounter
use	S	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	S	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	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(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: 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(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): The set of codes indicating the discharge disposition
location	S	0..*	BackboneElement	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(UDS Plus Location)	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	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
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition (a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
uds-plus-enc-1	error	Encounter.participant.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-2	error	Encounter.participant.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4
uds-plus-enc-3	error	Encounter.period	All Period.start data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.start.exists() implies $this.start.toString().length() = 4
uds-plus-enc-4	error	Encounter.period	All Period.emd data elements should be truncated to a year only for de-identified resources. : $this is Period and $this.end.exists() implies $this.end.toString().length() = 4

This structure is derived from Encounter

Summary

Mandatory: 5 elements(2 nested mandatory elements)
Must-Support: 22 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

• De-Identified UDS Plus Patient (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/de-identified-uds-plus-patient)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• De-Identified UDS Plus Diagnosis (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-diagnosis)
• UDS Plus Location (http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-location)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)

Extensions

This structure refers to these extensions:

• http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension

Maturity: 2