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8.11.12.1 Operation $everything on Encounter

Patient Administration icon Work Group Maturity Level: 2Trial Use Compartments: N/A

This operation is used to return all the information related to an encounter described in the resource on which this operation is invoked. The response is a bundle of type "searchset". At a minimum, the encounter resource itself is returned, along with any other resources that the server has available for the given encounter for the user. The server also returns whatever resources are needed to support the records - e.g. linked practitioners, locations, organizations etc. The principle intended use for this operation is to provide a patient with access to their record, or to allow a client to retrieve everything for an encounter for efficient display).

The server SHOULD return all resources it has that:

  • are included in the encounter compartment for the identified encounter (have a reference to the encounter)
  • are referenced by the standard extenstion for associating an encounter (where no reference element exists) http://hl7.org/fhir/StructureDefinition/encounter-associatedEncounter
  • the server believes are relevant to the context of the encounter for any other reason (internally defined/decided)
  • any resource referenced by the above, including binaries and attachments (to make a more complete package)

Implementation guides may make additional rules about how much information that is returned.

Note that for many resources, the exact nature of the link to encounter can be ambiguous (e.g. for a DiagnosticReport, is it the encounter when it was initiated, or when it was reported?).

The canonical URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/Encounter-everything

Formal Definition (as a OperationDefinition).

URL: [base]/Encounter/[id]/$everything

This is an idempotent operation

In Parameters:
Name Scope Cardinality Type Binding Profile Documentation
_since 0..1 instant

Resources updated after this period will be included in the response. The intent of this parameter is to allow a client to request only records that have changed since the last request, based on either the return header time, or or (for asynchronous use), the transaction time

_type 0..* code

One or more parameters, each containing one or more comma-delimited FHIR resource types to include in the return resources. In the absense of any specified types, the server returns all resource types

_count 0..1 integer

See discussion below on the utility of paging through the results of the $everything operation

Out Parameters:
Name Scope Cardinality Type Binding Profile Documentation
return 1..1 Bundle

The bundle type is "searchset"

Note: as this is the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource

The key difference between this operation and simply searching the encounter compartment is that it frees the client from needing to determine what it could or should ask for, particularly with regard to included resources.

It is assumed that the server has identified and secured the context appropriately, and can either associate the authorization context with a single encounter, or determine whether the context has the rights to the nominated encounter, if there is one, or can determine an appropriate list of encouners to provide data for from the context of the request. If there is no nominated encounter (GET /[base]/Encounter/$everything) and the context is not associated with a single encounter record, the actual list of encounters is all encounters that the user associated with the request has access to. In such cases, the server may choose to return an error rather than all the records. Specifying the relationship between the context, a user and encounter records is outside the scope of this specification (though see The SMART App Launch Implementation Guide icon).

When this operation is used to access multiple encounter records at once, the return bundle could be rather a lot of data; servers may choose to require that such requests are made asynchronously, and associated with bulk data formats. Alternatively, clients may choose to page through the result set (or servers may require this). Paging through the results is done the same as for Searching, using the _count parameter, and Bundle links. Unlike searching, there is no inherent user-display order for the $everything operation. Servers MAY consider sorting the returned resources in descending order of last record update.

The _since parameter is provided to support periodic queries to get additional information that has changed about the encounter since the last query. This means that the _since parameter is based on record time. The value of the _since parameter should be set to the time from the server. If using direct response, this is the timestamp in the response header. If using the async interface, this is the transaction timestamp in the json response. Servers should ensure that the timestamps a managed such that the client does not miss any changes. Clients should be able to handle getting the same response more than once in the case that the transaction falls on a time boundary. Clients should ensure that the other query parameters are constant to ensure a coherent set of records when doing periodic queries.

8.11.12.1.1 Examples

Request: Get all resources linked to a single patient


GET /open/Encounter/example/$everything
[some headers]

Response: Everything linked to the nominated patient (in this case, built automatically by the publication tooling)


HTTP/1.1 200 OK
[other headers]

<Bundle xml="http://hl7.org/fhir">
  <id value="fd45d5f5-759b-4697-a639-c9fdb0fbb450"/>
  <type value="searchset"/>
  <entry>
    <fullUrl value="http://hl7.org/fhir/Encounter/example"/>
    <resource>
     <?xml version="1.0" encoding="UTF-8"?>
     
     <Encounter xmlns="http://hl7.org/fhir">
       <id value="example"/>
       <text>
         <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">Encounter with patient @example</div>
       </text>
       <status value="in-progress"/>
       <class>
         <coding>
           <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
           <code value="IMP"/>
           <display value="inpatient encounter"/>
         </coding>
       </class>
       <subject>
         <reference value="Patient/example"/>
       </subject>
       <subjectStatus>
         <coding>
           <system value="http://terminology.hl7.org/CodeSystem/encounter-subject-status"/>
           <code value="receiving-care"/>
         </coding>
       </subjectStatus>
       <careTeam>
         <reference value="CareTeam/example"/>
       </careTeam>
     </Encounter>
    </resource>
  </entry>
</Bundle>

 

For more information about operations, including how they are invoked, see Operations.