Australian Digital Health Agency FHIR Implementation Guide
1.2.0-ci-build - draft Australia flag

Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

Resource Profile: ADHAEncounterCore - Detailed Descriptions

Active as of 2024-09-12

Definitions for the dh-encounter-core-1 resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Invariantsinv-dh-enc-04: If present, the service provider shall at least have a reference or display or a valid identifier (serviceProvider.exists() implies serviceProvider.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
2. Encounter.extension:encounterDescription
Slice NameencounterDescription
Must Supporttrue
4. Encounter.status
Must Supporttrue
6. Encounter.class
Must Supporttrue
8. Encounter.type
BindingThe codes SHOULD be taken from Encounter Type .
(preferred to https://healthterminologies.gov.au/fhir/ValueSet/encounter-type-1)
Must Supporttrue
10. Encounter.serviceType
BindingThe codes SHOULD be taken from Service Type .
(preferred to https://healthterminologies.gov.au/fhir/ValueSet/service-type-1)
Must Supporttrue
12. Encounter.subject
Control1..?
This element is affected by the following invariants: inv-dh-enc-01
TypeReference(ADHA Core Patient)
Must Supporttrue
Invariantsinv-dh-enc-01: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
14. Encounter.participant
Control1..?
Must Supporttrue
Invariantsinv-dh-enc-02: If present, an individual shall at least have a reference, an identifier or a display (individual.exists() implies individual.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
16. Encounter.participant.type
Must Supporttrue
18. Encounter.participant.individual
TypeReference(ADHA Core PractitionerRole, ADHA Core RelatedPerson)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
20. Encounter.period
Control1..?
Must Supporttrue
22. Encounter.reasonCode
Must Supporttrue
24. Encounter.reasonReference[x]
TypeReference(ADHA Core Condition, ADHA Core Observation, ADHA Core Procedure)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
26. Encounter.hospitalization
Must Supporttrue
28. Encounter.hospitalization.dischargeDisposition
Must Supporttrue
30. Encounter.location
Must Supporttrue
Invariantsinv-dh-enc-03: If present, location shall at least have a reference or display or a valid identifier (location.exists() implies location.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
32. Encounter.location.location
TypeReference(ADHA Core Location)
Must Supporttrue
34. Encounter.serviceProvider
TypeReference(ADHA Core Organization)
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

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.

ShortAn encounter in an Australian healthcare contextAn interaction during which services are provided to the patient
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVisit
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-dh-enc-04: If present, the service provider shall at least have a reference or display or a valid identifier (serviceProvider.exists() implies serviceProvider.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
2. Encounter.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Encounter.extension:encounterDescription
Slice NameencounterDescription
Definition

Description, overview or summary of a clinical event and its reasons.

ShortDescription, overview or summary of an encounter
Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Encounter Description) (Extension Type: string)
Is Modifierfalse
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Encounter.extension:associatedHealthcareService
Slice NameassociatedHealthcareService
Definition

Healthcare service relating to a resource.

ShortAssociated healthcare service
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Associated Healthcare Service) (Extension Type: Reference(HealthcareService))
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Encounter.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Encounter.status
Definition

planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Control1..1
BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

Current state of the encounter.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Encounter.class
Definition

Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

ShortClassification of patient encounter
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode - AU Extendedhttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
(extensible to http://terminology.hl7.org.au/ValueSet/v3-ActEncounterCode-extended)
TypeCoding
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Encounter.type
Definition

Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

ShortSpecific type of encounter
Comments

Since there are many ways to further classify encounters, this element is 0..*.

Control0..*
BindingThe codes SHOULD be taken from For example codes, see Encounter Type .http://hl7.org/fhir/ValueSet/encounter-type
(preferred to https://healthterminologies.gov.au/fhir/ValueSet/encounter-type-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Encounter.serviceType
Definition

Broad categorization of the service that is to be provided (e.g. cardiology).

ShortSpecific type of service
Control0..1
BindingThe codes SHOULD be taken from For example codes, see Service Type .http://hl7.org/fhir/ValueSet/service-type
(preferred to https://healthterminologies.gov.au/fhir/ValueSet/service-type-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Encounter.subject
Definition

The patient or group present at the encounter.

ShortThe patient or group present at the encounter
Comments

While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Control10..1
This element is affected by the following invariants: inv-dh-enc-01
TypeReference(ADHA Core Patient, Patient, Group)
Is Modifierfalse
Must Supporttrue
Summarytrue
Alternate Namespatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-enc-01: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
20. Encounter.participant
Definition

The list of people responsible for providing the service.

ShortList of participants involved in the encounter
Control10..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-enc-02: If present, an individual shall at least have a reference, an identifier or a display (individual.exists() implies individual.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
22. Encounter.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Encounter.participant.type
Definition

Role of participant in encounter.

ShortRole of participant in encounter
Comments

The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

Control0..*
BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
(extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

Role of participant in encounter.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Encounter.participant.individual
Definition

Persons involved in the encounter other than the patient.

ShortPersons involved in the encounter other than the patient
Control0..1
This element is affected by the following invariants: inv-dh-enc-02
TypeReference(ADHA Core PractitionerRole, ADHA Core RelatedPerson, Practitioner, PractitionerRole, RelatedPerson)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Encounter.period
Definition

The start and end time of the encounter.

ShortThe start and end time of the encounter
Comments

If not (yet) known, the end of the Period may be omitted.

Control10..1
TypePeriod
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Encounter.reasonCode
Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

ShortCoded reason the encounter takes place
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Control0..*
BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
(preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

Reason why the encounter takes place.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Alternate NamesIndication, Admission diagnosis
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Encounter.reasonReference
Definition

Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

ShortReason the encounter takes place (reference)
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Control0..*
TypeReference(ADHA Core Condition, ADHA Core Observation, ADHA Core Procedure, Condition, Procedure, Observation, ImmunizationRecommendation)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate NamesIndication, Admission diagnosis
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Encounter.hospitalization
Definition

Details about the admission to a healthcare service.

ShortDetails about the admission to a healthcare service
Comments

An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

Control0..1
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Encounter.hospitalization.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
38. Encounter.hospitalization.dischargeDisposition
Definition

Category or kind of location after discharge.

ShortSeparation ModeCategory or kind of location after discharge
Control0..1
BindingUnless not suitable, these codes SHALL be taken from For example codes, see Separation Mode .http://hl7.org/fhir/ValueSet/encounter-discharge-disposition
(extensible to https://healthterminologies.gov.au/fhir/ValueSet/separation-mode-1)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Encounter.location
Definition

List of locations where the patient has been during this encounter.

ShortList of locations where the patient has been
Comments

Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

Control0..*
TypeBackboneElement
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
inv-dh-enc-03: If present, location shall at least have a reference or display or a valid identifier (location.exists() implies location.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
42. Encounter.location.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. Encounter.location.location
Definition

The location where the encounter takes place.

ShortLocation the encounter takes place
Control1..1
This element is affected by the following invariants: inv-dh-enc-03
TypeReference(ADHA Core Location, Location)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Encounter.serviceProvider
Definition

The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

ShortThe organization (facility) responsible for this encounter
Control0..1
This element is affected by the following invariants: inv-dh-enc-04
TypeReference(ADHA Core Organization, Organization)
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. Encounter
Definition

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.

ShortAn encounter in an Australian healthcare context
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVisit
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
inv-dh-enc-04: If present, the service provider shall at least have a reference or display or a valid identifier (serviceProvider.exists() implies serviceProvider.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
2. Encounter.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. Encounter.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Encounter.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Encounter.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Encounter.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Encounter.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. Encounter.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. Encounter.extension:encounterDescription
    Slice NameencounterDescription
    Definition

    Description, overview or summary of a clinical event and its reasons.

    ShortDescription, overview or summary of an encounter
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Encounter Description) (Extension Type: string)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Encounter.extension:associatedHealthcareService
    Slice NameassociatedHealthcareService
    Definition

    Healthcare service relating to a resource.

    ShortAssociated healthcare service
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Associated Healthcare Service) (Extension Type: Reference(HealthcareService))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Encounter.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    22. Encounter.identifier
    Definition

    Identifier(s) by which this encounter is known.

    ShortIdentifier(s) by which this encounter is known
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Encounter.status
    Definition

    planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

    Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
    Comments

    Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

    Control1..1
    BindingThe codes SHALL be taken from EncounterStatus
    (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

    Current state of the encounter.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Encounter.statusHistory
    Definition

    The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

    ShortList of past encounter statuses
    Comments

    The current status is always found in the current version of the resource, not the status history.

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Encounter.statusHistory.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    30. Encounter.statusHistory.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    32. Encounter.statusHistory.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    34. Encounter.statusHistory.status
    Definition

    planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

    Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
    Control1..1
    BindingThe codes SHALL be taken from EncounterStatus
    (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

    Current state of the encounter.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Encounter.statusHistory.period
    Definition

    The time that the episode was in the specified status.

    ShortThe time that the episode was in the specified status
    Control1..1
    TypePeriod
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Encounter.class
    Definition

    Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

    ShortClassification of patient encounter
    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode - AU Extended
    (extensible to http://terminology.hl7.org.au/ValueSet/v3-ActEncounterCode-extended)
    TypeCoding
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Encounter.classHistory
    Definition

    The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

    ShortList of past encounter classes
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Encounter.classHistory.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    44. Encounter.classHistory.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    46. Encounter.classHistory.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    48. Encounter.classHistory.class
    Definition

    inpatient | outpatient | ambulatory | emergency +.

    Shortinpatient | outpatient | ambulatory | emergency +
    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
    (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

    Classification of the encounter.

    TypeCoding
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Encounter.classHistory.period
    Definition

    The time that the episode was in the specified class.

    ShortThe time that the episode was in the specified class
    Control1..1
    TypePeriod
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. Encounter.type
    Definition

    Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

    ShortSpecific type of encounter
    Comments

    Since there are many ways to further classify encounters, this element is 0..*.

    Control0..*
    BindingThe codes SHOULD be taken from Encounter Type .
    (preferred to https://healthterminologies.gov.au/fhir/ValueSet/encounter-type-1)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. Encounter.serviceType
    Definition

    Broad categorization of the service that is to be provided (e.g. cardiology).

    ShortSpecific type of service
    Control0..1
    BindingThe codes SHOULD be taken from Service Type .
    (preferred to https://healthterminologies.gov.au/fhir/ValueSet/service-type-1)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. Encounter.priority
    Definition

    Indicates the urgency of the encounter.

    ShortIndicates the urgency of the encounter
    Control0..1
    BindingFor example codes, see ActPriority
    (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

    Indicates the urgency of the encounter.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Encounter.subject
    Definition

    The patient or group present at the encounter.

    ShortThe patient or group present at the encounter
    Comments

    While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

    Control1..1
    This element is affected by the following invariants: inv-dh-enc-01
    TypeReference(ADHA Core Patient)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Alternate Namespatient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-enc-01: At least reference or a valid identifier shall be present (reference.exists() or identifier.where(system.count() + value.count() >1).exists())
    60. Encounter.episodeOfCare
    Definition

    Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

    ShortEpisode(s) of care that this encounter should be recorded against
    Control0..*
    TypeReference(EpisodeOfCare)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Encounter.basedOn
    Definition

    The request this encounter satisfies (e.g. incoming referral or procedure request).

    ShortThe ServiceRequest that initiated this encounter
    Control0..*
    TypeReference(ServiceRequest)
    Is Modifierfalse
    Summaryfalse
    Alternate NamesincomingReferral
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    64. Encounter.participant
    Definition

    The list of people responsible for providing the service.

    ShortList of participants involved in the encounter
    Control1..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-enc-02: If present, an individual shall at least have a reference, an identifier or a display (individual.exists() implies individual.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
    66. Encounter.participant.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    68. Encounter.participant.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    70. Encounter.participant.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    72. Encounter.participant.type
    Definition

    Role of participant in encounter.

    ShortRole of participant in encounter
    Comments

    The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from ParticipantType
    (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

    Role of participant in encounter.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Encounter.participant.period
    Definition

    The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

    ShortPeriod of time during the encounter that the participant participated
    Control0..1
    TypePeriod
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. Encounter.participant.individual
    Definition

    Persons involved in the encounter other than the patient.

    ShortPersons involved in the encounter other than the patient
    Control0..1
    This element is affected by the following invariants: inv-dh-enc-02
    TypeReference(ADHA Core PractitionerRole, ADHA Core RelatedPerson)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    78. Encounter.appointment
    Definition

    The appointment that scheduled this encounter.

    ShortThe appointment that scheduled this encounter
    Control0..*
    TypeReference(Appointment)
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    80. Encounter.period
    Definition

    The start and end time of the encounter.

    ShortThe start and end time of the encounter
    Comments

    If not (yet) known, the end of the Period may be omitted.

    Control1..1
    TypePeriod
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. Encounter.length
    Definition

    Quantity of time the encounter lasted. This excludes the time during leaves of absence.

    ShortQuantity of time the encounter lasted (less time absent)
    Comments

    May differ from the time the Encounter.period lasted because of leave of absence.

    Control0..1
    TypeDuration
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    84. Encounter.reasonCode
    Definition

    Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

    ShortCoded reason the encounter takes place
    Comments

    For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

    Control0..*
    BindingThe codes SHOULD be taken from EncounterReasonCodes
    (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

    Reason why the encounter takes place.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Alternate NamesIndication, Admission diagnosis
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. Encounter.reasonReference
    Definition

    Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

    ShortReason the encounter takes place (reference)
    Comments

    For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

    Control0..*
    TypeReference(ADHA Core Condition, ADHA Core Observation, ADHA Core Procedure)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Alternate NamesIndication, Admission diagnosis
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    88. Encounter.diagnosis
    Definition

    The list of diagnosis relevant to this encounter.

    ShortThe list of diagnosis relevant to this encounter
    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    90. Encounter.diagnosis.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    92. Encounter.diagnosis.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    94. Encounter.diagnosis.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    96. Encounter.diagnosis.condition
    Definition

    Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

    ShortThe diagnosis or procedure relevant to the encounter
    Comments

    For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

    Control1..1
    TypeReference(Condition, Procedure)
    Is Modifierfalse
    Summarytrue
    Alternate NamesAdmission diagnosis, discharge diagnosis, indication
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    98. Encounter.diagnosis.use
    Definition

    Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

    ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
    Control0..1
    BindingThe codes SHOULD be taken from DiagnosisRole
    (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

    The type of diagnosis this condition represents.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    100. Encounter.diagnosis.rank
    Definition

    Ranking of the diagnosis (for each role type).

    ShortRanking of the diagnosis (for each role type)
    Control0..1
    TypepositiveInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    102. Encounter.account
    Definition

    The set of accounts that may be used for billing for this Encounter.

    ShortThe set of accounts that may be used for billing for this Encounter
    Comments

    The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

    Control0..*
    TypeReference(Account)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    104. Encounter.hospitalization
    Definition

    Details about the admission to a healthcare service.

    ShortDetails about the admission to a healthcare service
    Comments

    An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

    The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

    Control0..1
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    106. Encounter.hospitalization.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    108. Encounter.hospitalization.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    110. Encounter.hospitalization.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    112. Encounter.hospitalization.preAdmissionIdentifier
    Definition

    Pre-admission identifier.

    ShortPre-admission identifier
    Control0..1
    TypeIdentifier
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    114. Encounter.hospitalization.origin
    Definition

    The location/organization from which the patient came before admission.

    ShortThe location/organization from which the patient came before admission
    Control0..1
    TypeReference(Location, Organization)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    116. Encounter.hospitalization.admitSource
    Definition

    From where patient was admitted (physician referral, transfer).

    ShortFrom where patient was admitted (physician referral, transfer)
    Control0..1
    BindingThe codes SHOULD be taken from AdmitSource
    (preferred to http://hl7.org/fhir/ValueSet/encounter-admit-source)

    From where the patient was admitted.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    118. Encounter.hospitalization.reAdmission
    Definition

    Whether this hospitalization is a readmission and why if known.

    ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
    Control0..1
    BindingFor example codes, see hl7VS-re-admissionIndicator
    (example to http://terminology.hl7.org/ValueSet/v2-0092)

    The reason for re-admission of this hospitalization encounter.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    120. Encounter.hospitalization.dietPreference
    Definition

    Diet preferences reported by the patient.

    ShortDiet preferences reported by the patient
    Comments

    For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

    Control0..*
    BindingFor example codes, see Diet
    (example to http://hl7.org/fhir/ValueSet/encounter-diet)

    Medical, cultural or ethical food preferences to help with catering requirements.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    122. Encounter.hospitalization.specialCourtesy
    Definition

    Special courtesies (VIP, board member).

    ShortSpecial courtesies (VIP, board member)
    Control0..*
    BindingThe codes SHOULD be taken from SpecialCourtesy
    (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

    Special courtesies.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    124. Encounter.hospitalization.specialArrangement
    Definition

    Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

    ShortWheelchair, translator, stretcher, etc.
    Control0..*
    BindingThe codes SHOULD be taken from SpecialArrangements
    (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

    Special arrangements.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    126. Encounter.hospitalization.destination
    Definition

    Location/organization to which the patient is discharged.

    ShortLocation/organization to which the patient is discharged
    Control0..1
    TypeReference(Location, Organization)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    128. Encounter.hospitalization.dischargeDisposition
    Definition

    Category or kind of location after discharge.

    ShortSeparation Mode
    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from Separation Mode .
    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/separation-mode-1)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    130. Encounter.location
    Definition

    List of locations where the patient has been during this encounter.

    ShortList of locations where the patient has been
    Comments

    Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    inv-dh-enc-03: If present, location shall at least have a reference or display or a valid identifier (location.exists() implies location.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists()))
    132. Encounter.location.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    134. Encounter.location.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    136. Encounter.location.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    138. Encounter.location.location
    Definition

    The location where the encounter takes place.

    ShortLocation the encounter takes place
    Control1..1
    This element is affected by the following invariants: inv-dh-enc-03
    TypeReference(ADHA Core Location)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    140. Encounter.location.status
    Definition

    The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.

    Shortplanned | active | reserved | completed
    Comments

    When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

    Control0..1
    BindingThe codes SHALL be taken from EncounterLocationStatus
    (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

    The status of the location.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    142. Encounter.location.physicalType
    Definition

    This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

    ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
    Comments

    This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

    There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

    Control0..1
    BindingFor example codes, see LocationType
    (example to http://hl7.org/fhir/ValueSet/location-physical-type)

    Physical form of the location.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    144. Encounter.location.period
    Definition

    Time period during which the patient was present at the location.

    ShortTime period during which the patient was present at the location
    Control0..1
    TypePeriod
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    146. Encounter.serviceProvider
    Definition

    The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

    ShortThe organization (facility) responsible for this encounter
    Control0..1
    This element is affected by the following invariants: inv-dh-enc-04
    TypeReference(ADHA Core Organization)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    148. Encounter.partOf
    Definition

    Another Encounter of which this encounter is a part of (administratively or in time).

    ShortAnother Encounter this encounter is part of
    Comments

    This is also used for associating a child's encounter back to the mother's encounter.

    Refer to the Notes section in the Patient resource for further details.

    Control0..1
    TypeReference(Encounter)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))