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 - TTL Representation

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

    # - resource -------------------------------------------------------------------

     a fhir:Encounter ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "encounter-ed-example"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter"^^xsd:anyURI ;
    fhir:l <http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<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>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "in-progress"] ; #
      fhir:class [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>     ] ;
    fhir:code [ fhir:v "IMP" ] ;
    fhir:display [ fhir:v "inpatient encounter" ]
      ] ; #
      fhir:type ( [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://www.ama-assn.org/go/cpt"^^xsd:anyURI ;
    fhir:l <http://www.ama-assn.org/go/cpt>       ] ;
    fhir:code [ fhir:v "99223" ] ;
    fhir:display [ fhir:v "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." ]     ] )
      ] ) ; #
      fhir:subject [
    fhir:l fhir:Patient/example ;
    fhir:reference [ fhir:v "Patient/example" ]
      ] ; #
      fhir:period [
    fhir:start [ fhir:v "2017-02-01T07:15:00+10:00"^^xsd:dateTime ]
      ] ; #
      fhir:location ( [
    fhir:location [
    fhir:l fhir:Location/example ;
    fhir:reference [ fhir:v "Location/example" ] ;
    fhir:display [ fhir:v "Emergency Waiting Room" ]     ] ;
    fhir:status [ fhir:v "active" ] ;
    fhir:period [
    fhir:start [ fhir:v "2017-02-01T07:15:00+10:00"^^xsd:dateTime ] ;
    fhir:end [ fhir:v "2017-02-01T08:45:00+10:00"^^xsd:dateTime ]     ]
      ] [
    fhir:location [
    fhir:l fhir:Location/example ;
    fhir:reference [ fhir:v "Location/example" ] ;
    fhir:display [ fhir:v "Emergency" ]     ] ;
    fhir:status [ fhir:v "active" ] ;
    fhir:period [
    fhir:start [ fhir:v "2017-02-01T08:45:00+10:00"^^xsd:dateTime ] ;
    fhir:end [ fhir:v "2017-02-01T09:27:00+10:00"^^xsd:dateTime ]     ]
      ] [
    fhir:location [
    fhir:l fhir:Location/example ;
    fhir:reference [ fhir:v "Location/example" ] ;
    fhir:display [ fhir:v "Ward 1, Room 42, Bed 1" ]     ] ;
    fhir:status [ fhir:v "active" ] ;
    fhir:period [
    fhir:start [ fhir:v "2017-02-01T09:27:00+10:00"^^xsd:dateTime ] ;
    fhir:end [ fhir:v "2017-02-01T12:15:00+10:00"^^xsd:dateTime ]     ]
      ] [
    fhir:location [
    fhir:l fhir:Location/example ;
    fhir:reference [ fhir:v "Location/example" ] ;
    fhir:display [ fhir:v "Ward 1, Room 42, Bed 1" ]     ] ;
    fhir:status [ fhir:v "reserved" ] ;
    fhir:period [
    fhir:start [ fhir:v "2017-02-01T12:15:00+10:00"^^xsd:dateTime ] ;
    fhir:end [ fhir:v "2017-02-01T12:45:00+10:00"^^xsd:dateTime ]     ]
      ] [
    fhir:location [
    fhir:l fhir:Location/example ;
    fhir:reference [ fhir:v "Location/example" ] ;
    fhir:display [ fhir:v "Ward 1, Room 42, Bed 1" ]     ] ;
    fhir:status [ fhir:v "active" ] ;
    fhir:period [
    fhir:start [ fhir:v "2017-02-01T12:45:00+10:00"^^xsd:dateTime ]     ]
      ] ) . #