2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : Encounter example of emergency visit that escalated into inpatient patient - XML Representation

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    <Encounter xmlns="http://hl7.org/fhir">
      <id value="encounter-ed-example"/>
      <meta>
        <profile
                 value="http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter"/>
      </meta>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Encounter encounter-ed-example</b></p><a name="encounter-ed-example"> </a><a name="hcencounter-ed-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-us-quality-core-encounter.html">US Quality Core Encounter</a></p></div><p><b>status</b>: In Progress</p><p><b>class</b>: <a href="http://hl7.org/fhir/R4/v3/ActCode/cs.html#v3-ActCode-IMP">v3 Code System ActCode: IMP</a> (inpatient encounter)</p><p><b>type</b>: <span title="Codes:{http://www.ama-assn.org/go/cpt 99223}">Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.</span></p><p><b>subject</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>period</b>: 2017-02-01 07:15:00+1000 --&gt; (ongoing)</p><blockquote><p><b>location</b></p><p><b>location</b>: <a href="Location-example.html">Emergency Waiting Room</a></p><p><b>status</b>: Active</p><p><b>period</b>: 2017-02-01 07:15:00+1000 --&gt; 2017-02-01 08:45:00+1000</p></blockquote><blockquote><p><b>location</b></p><p><b>location</b>: <a href="Location-example.html">Emergency</a></p><p><b>status</b>: Active</p><p><b>period</b>: 2017-02-01 08:45:00+1000 --&gt; 2017-02-01 09:27:00+1000</p></blockquote><blockquote><p><b>location</b></p><p><b>location</b>: <a href="Location-example.html">Ward 1, Room 42, Bed 1</a></p><p><b>status</b>: Active</p><p><b>period</b>: 2017-02-01 09:27:00+1000 --&gt; 2017-02-01 12:15:00+1000</p></blockquote><blockquote><p><b>location</b></p><p><b>location</b>: <a href="Location-example.html">Ward 1, Room 42, Bed 1</a></p><p><b>status</b>: Reserved</p><p><b>period</b>: 2017-02-01 12:15:00+1000 --&gt; 2017-02-01 12:45:00+1000</p></blockquote><blockquote><p><b>location</b></p><p><b>location</b>: <a href="Location-example.html">Ward 1, Room 42, Bed 1</a></p><p><b>status</b>: Active</p><p><b>period</b>: 2017-02-01 12:45:00+1000 --&gt; (ongoing)</p></blockquote></div>
      </text>
      <status value="in-progress"/>
      <class>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="IMP"/>
        <display value="inpatient encounter"/>
      </class>
      <type>
        <coding>
          <system value="http://www.ama-assn.org/go/cpt"/>
          <code value="99223"/>
          <display
                   value="Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded."/>
        </coding>
      </type>
      <subject>🔗
        <reference value="Patient/example"/>
      </subject>
      <period>
        <start value="2017-02-01T07:15:00+10:00"/>
      </period>
      <location>
        <location>🔗
          <reference value="Location/example"/>
          <display value="Emergency Waiting Room"/>
        </location>
        <status value="active"/>
        <period>
          <start value="2017-02-01T07:15:00+10:00"/>
          <end value="2017-02-01T08:45:00+10:00"/>
        </period>
      </location>
      <location>
        <location>🔗
          <reference value="Location/example"/>
          <display value="Emergency"/>
        </location>
        <status value="active"/>
        <period>
          <start value="2017-02-01T08:45:00+10:00"/>
          <end value="2017-02-01T09:27:00+10:00"/>
        </period>
      </location>
      <location>
        <location>🔗
          <reference value="Location/example"/>
          <display value="Ward 1, Room 42, Bed 1"/>
        </location>
        <status value="active"/>
        <period>
          <start value="2017-02-01T09:27:00+10:00"/>
          <end value="2017-02-01T12:15:00+10:00"/>
        </period>
      </location>
      <location>
        <location>🔗
          <reference value="Location/example"/>
          <display value="Ward 1, Room 42, Bed 1"/>
        </location>
        <status value="reserved"/>
        <period>
          <start value="2017-02-01T12:15:00+10:00"/>
          <end value="2017-02-01T12:45:00+10:00"/>
        </period>
      </location>
      <location>
        <location>🔗
          <reference value="Location/example"/>
          <display value="Ward 1, Room 42, Bed 1"/>
        </location>
        <status value="active"/>
        <period>
          <start value="2017-02-01T12:45:00+10:00"/>
        </period>
      </location>
    </Encounter>