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8.12 Resource EncounterHistory - Content

Patient Administration icon Work GroupMaturity Level: 0 Trial UseSecurity Category: Patient Compartments: Encounter, Group, Patient

A record of significant events/milestones key data throughout the history of an Encounter, often tracked for specific purposes such as billing.

8.12.1 Scope and Usage

The EncounterHistory is used to be able to record an ongoing history of significant events/changes that occur during a patient encounter. This information is not always up to date/accurate while entering encounter information and is often back-dated as more detailed information becomes available, or corrections need to be made during the completion of the encounter while it is being processed in coding or billing.

Note to Implementers: In FHIR R4 and earlier this data was in the Encounter statusHistory and classHistory backbone elements, however with longer duration encounters (where a patient encounter might be considered active for years) this would become increasingly inefficient, so was re-factored into this resource.
The design notes for this change are on confluence icon.

8.12.2 Boundaries and Relationships

The Encounter resource stores the complete set of current/most recent data about an Encounter. The EncounterHistory contains a snapshot of some key aspects (properties) of the encounter to track changes to the encounter over time - specifically those that contribute to significant changes/events/milestones during the encounter - such as moving between departments or locations.

Note that this historical information is different than what is tracked in the versions of the Encounter resource. Past movements of a patient are often updated after the fact to correct what actually happened.
FHIR History (_history) doesn't cater for this need as the information isn't always accurate and can be corrected/back populated too. Another challenge with _history is that it also includes corrections to errors in data entry which could not be differentiated from actual movements/changes.

No clinical resources are expected to ever refer to a specific EncounterHistory event, they are only attributed to the Encounter as a whole. If a resource is desiring to connect to a portion of an encounter (and wanting to use EncounterHistory) this is an indication that you should be using a child Encounter through the partOf property.

8.12.3 References to this Resource

No references for this Resource.

8.12.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. EncounterHistory TU DomainResource A record of significant events/milestones key data throughout the history of an Encounter

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... encounter 0..1 Reference(Encounter) The Encounter associated with this set of historic values
... identifier Σ 0..* Identifier Identifier(s) by which this encounter is known

... status ?!Σ 1..1 code planned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
Binding: Encounter Status (Required)
... type Σ 0..* CodeableConcept Specific type of encounter
Binding: Encounter Type (Example)

... serviceType Σ 0..* CodeableReference(HealthcareService) Specific type of service
Binding: Service Type (Example)

... subject Σ 0..1 Reference(Patient | Group) The patient or group related to this encounter
... subjectStatus 0..1 CodeableConcept The current status of the subject in relation to the Encounter
Binding: Encounter Subject Status (Example)
... actualPeriod 0..1 Period The actual start and end time associated with this set of values associated with the encounter
... plannedStartDate 0..1 dateTime The planned start date/time (or admission date) of the encounter
... plannedEndDate 0..1 dateTime The planned end date/time (or discharge date) of the encounter
... length 0..1 Duration Actual quantity of time the encounter lasted (less time absent)
... location 0..* BackboneElement Location of the patient at this point in the encounter

.... location 1..1 Reference(Location) Location the encounter takes place
.... form 0..1 CodeableConcept The physical type of the location (usually the level in the location hierarchy - bed, room, ward, virtual etc.)
Binding: Location Form (Example)

doco Documentation for this format icon

See the Extensions for this resource

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

8.12.4.1 Terminology Bindings

Path ValueSet Type Documentation
EncounterHistory.status EncounterStatus Required

Current state of the encounter.
EncounterHistory.class ActEncounterCode icon Extensible

Domain provides codes that qualify the ActEncounterClass (ENC)
EncounterHistory.type EncounterType Example

This example value set defines a set of codes that can be used to indicate the type of encounter: a specific code indicating type of service provided.
EncounterHistory.serviceType ServiceType Example

This value set defines an example set of codes of service-types.
EncounterHistory.subjectStatus EncounterSubjectStatus Example

This example value set defines a set of codes that can be used to indicate the status of the subject within the encounter
EncounterHistory.location.form LocationForm (a valid code from Location type icon) Example

This example value set defines a set of codes that can be used to indicate the physical form of the Location.

8.12.5 Notes

8.12.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
encounter reference The Encounter associated with this set of history values EncounterHistory.encounter
(Encounter)		 29 Resources
identifier token Identifier(s) by which this encounter is known EncounterHistory.identifier
patient reference The patient present at the encounter EncounterHistory.subject.where(resolve() is Patient)
(Patient)
status token Status of the Encounter history entry EncounterHistory.status
subject reference The patient or group present at the encounter EncounterHistory.subject
(Group, Patient)