Kenya Emergency Care Implementation Guide
0.1.0 - ci-build Kenya flag

Kenya Emergency Care Implementation Guide, published by Digital Health Agency (DHA), Kenya. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Kenya-Emergency-FHIR-IG/ and changes regularly. See the Directory of published versions

Resource Profile: EMEDEncounter - Detailed Descriptions

Active as of 2026-08-07

Definitions for the em-ed-encounter resource profile.

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

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 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())
em-ed-1: The emergency department Encounter period end must not occur before its period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
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
Definition

An Extension


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

ShortExtensionAdditional 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())
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
  • 6. Encounter.extension:paymentMethod
    Slice NamepaymentMethod
    Definition

    Payment method recorded at emergency department registration.

    ShortPayment method recorded at registration
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Payment Method) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Encounter.extension:arrivalMode
    Slice NamearrivalMode
    Definition

    How the patient arrived at the emergency department.

    ShortHow the patient arrived at the emergency department
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Arrival Mode) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Encounter.extension:mobilityStatus
    Slice NamemobilityStatus
    Definition

    Patient's mobility status recorded at emergency department registration, independent of triage acuity.

    ShortAmbulatory or non-ambulatory at registration
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Mobility Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Encounter.extension:presentationType
    Slice NamepresentationType
    Definition

    Whether the presenting problem is acute or chronic, recorded at registration.

    ShortAcute or chronic presentation
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Presentation Type) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Encounter.extension:referralInfo
    Slice NamereferralInfo
    Definition

    Whether the patient was referred to the emergency department, e.g. from another facility or a clinic.

    ShortWhether this presentation is a referral
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Referral Information) (Extension Type: boolean)
    Is Modifierfalse
    Must Supporttrue
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Encounter.extension:traumaDetails
    Slice NametraumaDetails
    Definition

    Mechanism, intent, timing, and recent substance use for a trauma presentation.

    ShortMechanism, intent, timing, and substance use for a trauma presentation
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Trauma Details) (Complex Extension)
    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:dispositionDetails
    Slice NamedispositionDetails
    Definition

    Supplementary detail for the ED encounter disposition that does not fit Encounter.hospitalization.dischargeDisposition alone — the discharge-plan discussion flag, and the reason text for the leave-without-being-seen, death, and transfer dispositions.

    ShortSupplementary detail for the disposition
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Department Disposition Details) (Complex Extension)
    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())
    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)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Encounter.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 24. Encounter.identifier:hospitalRegistrationNumber
      Slice NamehospitalRegistrationNumber
      Definition

      Identifier(s) by which this encounter is known.

      ShortHospital registration number recorded on the ED chartIdentifier(s) by which this encounter is known
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Encounter.identifier:hospitalRegistrationNumber.use
      Definition

      The purpose of this identifier.

      Shortusual | official | temp | secondary | old (If known)
      Comments

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Control0..1
      BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Pattern Valueofficial
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Encounter.identifier:hospitalRegistrationNumber.system
      Definition

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      ShortThe namespace for the identifier value
      Comments

      Identifier.system is always case sensitive.

      Control10..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Fixed Valuehttp://hie.go.ke/fhir/identifier/hospital-registration-number
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Encounter.identifier:hospitalRegistrationNumber.value
      Definition

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      ShortThe value that is unique
      Comments

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      ExampleGeneral: 123456
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Encounter.status
      Definition

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

      ShortCurrent workflow status of the emergency department encounterplanned | 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)
      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()))
      34. Encounter.class
      Definition

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

      ShortFixed to emergencyClassification of patient encounter
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
      (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

      Classification of the encounter.

      TypeCoding
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "EMER",
        "display" : "emergency"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Encounter.priority
      Definition

      Reuses EMClinicalAcuityVS, the same acuity scale already bound to EMPOCEncounter.priority, rather than introducing a second triage-category terminology. The form's Emergency (Red)/Urgent (Yellow)/Routine (Green) categories map onto the red/yellow/green codes in that value set.


      Indicates the urgency of the encounter.

      ShortTriage category assigned after assessment (Red/Orange/Yellow/Green/Blue/Black)Indicates the urgency of the encounter
      Control10..1
      BindingThe codes SHALL be taken from For example codes, see Emergency Clinical Acuity Value Sethttp://terminology.hl7.org/ValueSet/v3-ActPriority
      (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-clinical-acuity)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Encounter.subject
      Definition

      The patient or group present at the encounter.

      ShortPatient receiving emergency department careThe 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
      TypeReference(Patient - Kenya Emergency, 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()))
      40. 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).

      ShortEmergency episode this encounter belongs to, if one existsEpisode(s) of care that this encounter should be recorded against
      Control0..1*
      TypeReference(EpisodeOfCare)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Encounter.participant
      Definition

      The list of people responsible for providing the service.

      ShortList of participants involved in the encounter
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ type
      • 44. 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())
        46. Encounter.participant:triageStaff
        Slice NametriageStaff
        Definition

        The list of people responsible for providing the service.

        ShortStaff member who performed triageList of participants involved in the encounter
        Control0..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Encounter.participant:triageStaff.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())
        50. Encounter.participant:triageStaff.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.

        Control10..*
        BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Pattern Value{
          "coding" : [{
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
            "code" : "triage-staff"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Encounter.participant:triageStaff.individual
        Definition

        Persons involved in the encounter other than the patient.

        ShortPersons involved in the encounter other than the patient
        Control10..1
        TypeReference(Practitioner, PractitionerRole, 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()))
        54. Encounter.participant:provider
        Slice Nameprovider
        Definition

        The list of people responsible for providing the service.

        ShortProvider who performed the assessment and led careList of participants involved in the encounter
        Control0..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Encounter.participant:provider.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())
        58. Encounter.participant:provider.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.

        Control10..*
        BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Pattern Value{
          "coding" : [{
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
            "code" : "provider"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Encounter.participant:provider.individual
        Definition

        Persons involved in the encounter other than the patient.

        ShortPersons involved in the encounter other than the patient
        Control10..1
        TypeReference(Practitioner, PractitionerRole, 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()))
        62. Encounter.participant:nurse
        Slice Namenurse
        Definition

        The list of people responsible for providing the service.

        ShortNurse responsible for the patient during the encounterList of participants involved in the encounter
        Control0..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Encounter.participant:nurse.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())
        66. Encounter.participant:nurse.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.

        Control10..*
        BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Pattern Value{
          "coding" : [{
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
            "code" : "nurse"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Encounter.participant:nurse.individual
        Definition

        Persons involved in the encounter other than the patient.

        ShortPersons involved in the encounter other than the patient
        Control10..1
        TypeReference(Practitioner, PractitionerRole, 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()))
        70. 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()))
        72. Encounter.period.start
        Definition

        The start of the period. The boundary is inclusive.

        ShortTime of arrival at the emergency departmentStarting time with inclusive boundary
        Comments

        If the low element is missing, the meaning is that the low boundary is not known.

        Control10..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        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()))
        74. Encounter.period.end
        Definition

        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        ShortTime of dispositionEnd time with inclusive boundary, if not ongoing
        Comments

        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

        Control0..1
        This element is affected by the following invariants: per-1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Encounter.reasonCode
        Definition

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

        ShortFree-text reason for presentation, if not yet captured as a chief-complaint ConditionCoded 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..1*
        BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason|4.0.1
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason|4.0.1)

        Reason why the encounter takes place.

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

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

        ShortChief-complaint Condition for this encounterReason 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..1*
        TypeReference(Condition, Condition, Procedure, Observation, ImmunizationRecommendation)
        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()))
        80. Encounter.diagnosis
        Definition

        The list of diagnosis relevant to this encounter.

        ShortWorking, differential, and discharge diagnosis Condition instancesThe list of diagnosis relevant to this encounter
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. 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())
        84. 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, Condition, Procedure)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Alternate NamesAdmission diagnosis, discharge diagnosis, indication
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. 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()))
        88. 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())
        90. Encounter.hospitalization.destination
        Definition

        Location/organization to which the patient is discharged.

        ShortReceiving facility when disposition is transferLocation/organization to which the patient is discharged
        Control0..1
        TypeReference(Location - Emergency Destination Facility, Location, Organization)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        92. Encounter.hospitalization.dischargeDisposition
        Definition

        Category or kind of location after discharge.

        ShortOutcome of the emergency department encounterCategory or kind of location after discharge
        Control0..1
        BindingThe codes SHALL be taken from For example codes, see Emergency Department Disposition Value Sethttp://hl7.org/fhir/ValueSet/encounter-discharge-disposition|4.0.1
        (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-disposition)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. 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..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        96. 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())
        98. Encounter.location.location
        Definition

        The location where the encounter takes place.

        ShortLocation the encounter takes place
        Control1..1
        TypeReference(Location)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        100. 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.

        ShortFacility operating the emergency departmentThe organization (facility) responsible for this encounter
        Control10..1
        TypeReference(Organization)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Encounter.partOf
        Definition

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

        ShortPrior pre-hospital encounter, if the patient arrived by EMSAnother 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 - Emergency Medical Incident, Encounter - Emergency Point of Care, Encounter)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        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 foundhere

        0. Encounter
        Invariantsem-ed-1: The emergency department Encounter period end must not occur before its period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
        2. Encounter.extension
        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
        • 4. Encounter.extension:paymentMethod
          Slice NamepaymentMethod
          ShortPayment method recorded at registration
          Control0..1
          TypeExtension(Emergency Department Payment Method) (Extension Type: CodeableConcept)
          Must Supporttrue
          6. Encounter.extension:arrivalMode
          Slice NamearrivalMode
          ShortHow the patient arrived at the emergency department
          Control0..1
          TypeExtension(Emergency Department Arrival Mode) (Extension Type: CodeableConcept)
          Must Supporttrue
          8. Encounter.extension:mobilityStatus
          Slice NamemobilityStatus
          ShortAmbulatory or non-ambulatory at registration
          Control0..1
          TypeExtension(Emergency Department Mobility Status) (Extension Type: CodeableConcept)
          Must Supporttrue
          10. Encounter.extension:presentationType
          Slice NamepresentationType
          ShortAcute or chronic presentation
          Control0..1
          TypeExtension(Emergency Department Presentation Type) (Extension Type: CodeableConcept)
          Must Supporttrue
          12. Encounter.extension:referralInfo
          Slice NamereferralInfo
          ShortWhether this presentation is a referral
          Control0..1
          TypeExtension(Emergency Department Referral Information) (Extension Type: boolean)
          Must Supporttrue
          14. Encounter.extension:traumaDetails
          Slice NametraumaDetails
          ShortMechanism, intent, timing, and substance use for a trauma presentation
          Control0..1
          TypeExtension(Emergency Department Trauma Details) (Complex Extension)
          Must Supporttrue
          16. Encounter.extension:dispositionDetails
          Slice NamedispositionDetails
          ShortSupplementary detail for the disposition
          Control0..1
          TypeExtension(Emergency Department Disposition Details) (Complex Extension)
          Must Supporttrue
          18. Encounter.identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..?
          Must Supporttrue
          SlicingThis element introduces a set of slices on Encounter.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ system
          • 20. Encounter.identifier:hospitalRegistrationNumber
            Slice NamehospitalRegistrationNumber
            ShortHospital registration number recorded on the ED chart
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..1
            Must Supporttrue
            22. Encounter.identifier:hospitalRegistrationNumber.use
            Pattern Valueofficial
            24. Encounter.identifier:hospitalRegistrationNumber.system
            Control1..?
            Must Supporttrue
            Fixed Valuehttp://hie.go.ke/fhir/identifier/hospital-registration-number
            26. Encounter.identifier:hospitalRegistrationNumber.value
            Control1..?
            Must Supporttrue
            28. Encounter.status
            ShortCurrent workflow status of the emergency department encounter
            BindingThe codes SHALL be taken from EncounterStatus
            (required to http://hl7.org/fhir/ValueSet/encounter-status)
            Must Supporttrue
            30. Encounter.class
            ShortFixed to emergency
            Must Supporttrue
            Pattern Value{
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "EMER",
              "display" : "emergency"
            }
            32. Encounter.priority
            Definition

            Reuses EMClinicalAcuityVS, the same acuity scale already bound to EMPOCEncounter.priority, rather than introducing a second triage-category terminology. The form's Emergency (Red)/Urgent (Yellow)/Routine (Green) categories map onto the red/yellow/green codes in that value set.

            ShortTriage category assigned after assessment (Red/Orange/Yellow/Green/Blue/Black)
            Control1..?
            BindingThe codes SHALL be taken from Emergency Clinical Acuity Value Set
            (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-clinical-acuity)
            Must Supporttrue
            34. Encounter.subject
            ShortPatient receiving emergency department care
            Control1..?
            TypeReference(Patient - Kenya Emergency)
            Must Supporttrue
            36. Encounter.episodeOfCare
            ShortEmergency episode this encounter belongs to, if one exists
            Control0..1
            Must Supporttrue
            38. Encounter.participant
            Must Supporttrue
            SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ type
            • 40. Encounter.participant:triageStaff
              Slice NametriageStaff
              ShortStaff member who performed triage
              Control0..1
              Must Supporttrue
              42. Encounter.participant:triageStaff.type
              Control1..?
              Pattern Value{
                "coding" : [{
                  "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                  "code" : "triage-staff"
                }]
              }
              44. Encounter.participant:triageStaff.individual
              Control1..?
              TypeReference(Practitioner, PractitionerRole)
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              46. Encounter.participant:provider
              Slice Nameprovider
              ShortProvider who performed the assessment and led care
              Control0..1
              Must Supporttrue
              48. Encounter.participant:provider.type
              Control1..?
              Pattern Value{
                "coding" : [{
                  "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                  "code" : "provider"
                }]
              }
              50. Encounter.participant:provider.individual
              Control1..?
              TypeReference(Practitioner, PractitionerRole)
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              52. Encounter.participant:nurse
              Slice Namenurse
              ShortNurse responsible for the patient during the encounter
              Control0..1
              Must Supporttrue
              54. Encounter.participant:nurse.type
              Control1..?
              Pattern Value{
                "coding" : [{
                  "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                  "code" : "nurse"
                }]
              }
              56. Encounter.participant:nurse.individual
              Control1..?
              TypeReference(Practitioner, PractitionerRole)
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              58. Encounter.period
              Control1..?
              Must Supporttrue
              60. Encounter.period.start
              ShortTime of arrival at the emergency department
              Control1..?
              Must Supporttrue
              62. Encounter.period.end
              ShortTime of disposition
              Must Supporttrue
              64. Encounter.reasonCode
              ShortFree-text reason for presentation, if not yet captured as a chief-complaint Condition
              Control0..1
              66. Encounter.reasonReference
              ShortChief-complaint Condition for this encounter
              Control0..1
              TypeReference(Condition)
              Must Supporttrue
              68. Encounter.diagnosis
              ShortWorking, differential, and discharge diagnosis Condition instances
              Must Supporttrue
              70. Encounter.diagnosis.condition
              TypeReference(Condition)
              Must Supporttrue
              72. Encounter.hospitalization
              Must Supporttrue
              74. Encounter.hospitalization.destination
              ShortReceiving facility when disposition is transfer
              TypeReference(Location - Emergency Destination Facility)
              Must Supporttrue
              76. Encounter.hospitalization.dischargeDisposition
              ShortOutcome of the emergency department encounter
              BindingThe codes SHALL be taken from Emergency Department Disposition Value Set
              (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-disposition)
              Must Supporttrue
              78. Encounter.location
              Control0..1
              Must Supporttrue
              80. Encounter.location.location
              Must Supporttrue
              82. Encounter.serviceProvider
              ShortFacility operating the emergency department
              Control1..?
              Must Supporttrue
              84. Encounter.partOf
              ShortPrior pre-hospital encounter, if the patient arrived by EMS
              TypeReference(Encounter - Emergency Medical Incident, Encounter - Emergency Point of Care)
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles

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

              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 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())
              em-ed-1: The emergency department Encounter period end must not occur before its period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
              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|4.0.1)

              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:paymentMethod
                Slice NamepaymentMethod
                Definition

                Payment method recorded at emergency department registration.

                ShortPayment method recorded at registration
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Payment Method) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                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())
                18. Encounter.extension:arrivalMode
                Slice NamearrivalMode
                Definition

                How the patient arrived at the emergency department.

                ShortHow the patient arrived at the emergency department
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Arrival Mode) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                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())
                20. Encounter.extension:mobilityStatus
                Slice NamemobilityStatus
                Definition

                Patient's mobility status recorded at emergency department registration, independent of triage acuity.

                ShortAmbulatory or non-ambulatory at registration
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Mobility Status) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                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())
                22. Encounter.extension:presentationType
                Slice NamepresentationType
                Definition

                Whether the presenting problem is acute or chronic, recorded at registration.

                ShortAcute or chronic presentation
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Presentation Type) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                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())
                24. Encounter.extension:referralInfo
                Slice NamereferralInfo
                Definition

                Whether the patient was referred to the emergency department, e.g. from another facility or a clinic.

                ShortWhether this presentation is a referral
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Referral Information) (Extension Type: boolean)
                Is Modifierfalse
                Must Supporttrue
                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())
                26. Encounter.extension:traumaDetails
                Slice NametraumaDetails
                Definition

                Mechanism, intent, timing, and recent substance use for a trauma presentation.

                ShortMechanism, intent, timing, and substance use for a trauma presentation
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Trauma Details) (Complex Extension)
                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())
                28. Encounter.extension:dispositionDetails
                Slice NamedispositionDetails
                Definition

                Supplementary detail for the ED encounter disposition that does not fit Encounter.hospitalization.dischargeDisposition alone — the discharge-plan discussion flag, and the reason text for the leave-without-being-seen, death, and transfer dispositions.

                ShortSupplementary detail for the disposition
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Emergency Department Disposition Details) (Complex Extension)
                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())
                30. 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())
                32. 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)
                Control1..*
                TypeIdentifier
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Encounter.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ system
                • 34. Encounter.identifier:hospitalRegistrationNumber
                  Slice NamehospitalRegistrationNumber
                  Definition

                  Identifier(s) by which this encounter is known.

                  ShortHospital registration number recorded on the ED chart
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. Encounter.identifier:hospitalRegistrationNumber.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
                  38. Encounter.identifier:hospitalRegistrationNumber.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())
                  SlicingThis element introduces a set of slices on Encounter.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 40. Encounter.identifier:hospitalRegistrationNumber.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                    Control0..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                    Identifies the purpose for this identifier, if known .

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                    Pattern Valueofficial
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    42. Encounter.identifier:hospitalRegistrationNumber.type
                    Definition

                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                    ShortDescription of identifier
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.0.1)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. Encounter.identifier:hospitalRegistrationNumber.system
                    Definition

                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Fixed Valuehttp://hie.go.ke/fhir/identifier/hospital-registration-number
                    ExampleGeneral: http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. Encounter.identifier:hospitalRegistrationNumber.value
                    Definition

                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                    ShortThe value that is unique
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    ExampleGeneral: 123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. Encounter.identifier:hospitalRegistrationNumber.period
                    Definition

                    Time period during which identifier is/was valid for use.

                    ShortTime period when id is/was valid for use
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. Encounter.identifier:hospitalRegistrationNumber.assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

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

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

                    ShortCurrent workflow status of the emergency department encounter
                    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)
                    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()))
                    54. 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()))
                    56. 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
                    58. 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())
                    60. 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())
                    62. 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()))
                    64. 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()))
                    66. Encounter.class
                    Definition

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

                    ShortFixed to 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
                    Must Supporttrue
                    Summarytrue
                    Pattern Value{
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                      "code" : "EMER",
                      "display" : "emergency"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. 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()))
                    70. 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
                    72. 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())
                    74. 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())
                    76. 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()))
                    78. 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()))
                    80. 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..*
                    BindingFor example codes, see EncounterType
                    (example to http://hl7.org/fhir/ValueSet/encounter-type|4.0.1)

                    The type of encounter.

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

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

                    ShortSpecific type of service
                    Control0..1
                    BindingFor example codes, see ServiceType
                    (example to http://hl7.org/fhir/ValueSet/service-type|4.0.1)

                    Broad categorization of the service that is to be provided.

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

                    Reuses EMClinicalAcuityVS, the same acuity scale already bound to EMPOCEncounter.priority, rather than introducing a second triage-category terminology. The form's Emergency (Red)/Urgent (Yellow)/Routine (Green) categories map onto the red/yellow/green codes in that value set.

                    ShortTriage category assigned after assessment (Red/Orange/Yellow/Green/Blue/Black)
                    Control1..1
                    BindingThe codes SHALL be taken from Emergency Clinical Acuity Value Set
                    (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-clinical-acuity)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. Encounter.subject
                    Definition

                    The patient or group present at the encounter.

                    ShortPatient receiving emergency department care
                    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
                    TypeReference(Patient - Kenya Emergency)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Alternate Namespatient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. 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).

                    ShortEmergency episode this encounter belongs to, if one exists
                    Control0..1
                    TypeReference(EpisodeOfCare)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    90. 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()))
                    92. Encounter.participant
                    Definition

                    The list of people responsible for providing the service.

                    ShortList of participants involved in the encounter
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • pattern @ type
                    • 94. 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
                      96. 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())
                      98. 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())
                      100. 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|4.0.1)

                      Role of participant in encounter.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      102. 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()))
                      104. Encounter.participant.individual
                      Definition

                      Persons involved in the encounter other than the patient.

                      ShortPersons involved in the encounter other than the patient
                      Control0..1
                      TypeReference(Practitioner, PractitionerRole, RelatedPerson)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. Encounter.participant:triageStaff
                      Slice NametriageStaff
                      Definition

                      The list of people responsible for providing the service.

                      ShortStaff member who performed triage
                      Control0..1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. Encounter.participant:triageStaff.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
                      110. Encounter.participant:triageStaff.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())
                      112. Encounter.participant:triageStaff.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())
                      114. Encounter.participant:triageStaff.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.

                      Control1..*
                      BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

                      Role of participant in encounter.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Pattern Value{
                        "coding" : [{
                          "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                          "code" : "triage-staff"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      116. Encounter.participant:triageStaff.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()))
                      118. Encounter.participant:triageStaff.individual
                      Definition

                      Persons involved in the encounter other than the patient.

                      ShortPersons involved in the encounter other than the patient
                      Control1..1
                      TypeReference(Practitioner, PractitionerRole)
                      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()))
                      120. Encounter.participant:provider
                      Slice Nameprovider
                      Definition

                      The list of people responsible for providing the service.

                      ShortProvider who performed the assessment and led care
                      Control0..1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. Encounter.participant:provider.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
                      124. Encounter.participant:provider.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())
                      126. Encounter.participant:provider.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())
                      128. Encounter.participant:provider.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.

                      Control1..*
                      BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

                      Role of participant in encounter.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Pattern Value{
                        "coding" : [{
                          "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                          "code" : "provider"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      130. Encounter.participant:provider.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()))
                      132. Encounter.participant:provider.individual
                      Definition

                      Persons involved in the encounter other than the patient.

                      ShortPersons involved in the encounter other than the patient
                      Control1..1
                      TypeReference(Practitioner, PractitionerRole)
                      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()))
                      134. Encounter.participant:nurse
                      Slice Namenurse
                      Definition

                      The list of people responsible for providing the service.

                      ShortNurse responsible for the patient during the encounter
                      Control0..1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      136. Encounter.participant:nurse.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
                      138. Encounter.participant:nurse.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())
                      140. Encounter.participant:nurse.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())
                      142. Encounter.participant:nurse.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.

                      Control1..*
                      BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

                      Role of participant in encounter.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Pattern Value{
                        "coding" : [{
                          "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-participant-role",
                          "code" : "nurse"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      144. Encounter.participant:nurse.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()))
                      146. Encounter.participant:nurse.individual
                      Definition

                      Persons involved in the encounter other than the patient.

                      ShortPersons involved in the encounter other than the patient
                      Control1..1
                      TypeReference(Practitioner, PractitionerRole)
                      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()))
                      148. 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()))
                      150. 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()))
                      152. Encounter.period.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
                      154. Encounter.period.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())
                      SlicingThis element introduces a set of slices on Encounter.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 156. Encounter.period.start
                        Definition

                        The start of the period. The boundary is inclusive.

                        ShortTime of arrival at the emergency department
                        Comments

                        If the low element is missing, the meaning is that the low boundary is not known.

                        Control1..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        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()))
                        158. Encounter.period.end
                        Definition

                        The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                        ShortTime of disposition
                        Comments

                        The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                        Control0..1
                        This element is affected by the following invariants: per-1
                        TypedateTime
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summarytrue
                        Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        160. 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()))
                        162. Encounter.reasonCode
                        Definition

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

                        ShortFree-text reason for presentation, if not yet captured as a chief-complaint Condition
                        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..1
                        BindingThe codes SHOULD be taken from EncounterReasonCodes
                        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason|4.0.1)

                        Reason why the encounter takes place.

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

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

                        ShortChief-complaint Condition for this 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).

                        Control0..1
                        TypeReference(Condition)
                        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()))
                        166. Encounter.diagnosis
                        Definition

                        The list of diagnosis relevant to this encounter.

                        ShortWorking, differential, and discharge diagnosis Condition instances
                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        168. 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
                        170. 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())
                        172. 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())
                        174. 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)
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        176. 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|4.0.1)

                        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()))
                        178. 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()))
                        180. 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()))
                        182. 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()))
                        184. 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
                        186. 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())
                        188. 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())
                        190. 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()))
                        192. 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()))
                        194. 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|4.0.1)

                        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()))
                        196. 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()))
                        198. 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|4.0.1)

                        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()))
                        200. 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|4.0.1)

                        Special courtesies.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        202. 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|4.0.1)

                        Special arrangements.

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

                        Location/organization to which the patient is discharged.

                        ShortReceiving facility when disposition is transfer
                        Control0..1
                        TypeReference(Location - Emergency Destination Facility)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        206. Encounter.hospitalization.dischargeDisposition
                        Definition

                        Category or kind of location after discharge.

                        ShortOutcome of the emergency department encounter
                        Control0..1
                        BindingThe codes SHALL be taken from Emergency Department Disposition Value Set
                        (required to https://fhir.dha.go.ke/ig/emergency/ValueSet/em-disposition)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        208. 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..1
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        210. 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
                        212. 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())
                        214. 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())
                        216. Encounter.location.location
                        Definition

                        The location where the encounter takes place.

                        ShortLocation the encounter takes place
                        Control1..1
                        TypeReference(Location)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        218. 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()))
                        220. 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|4.0.1)

                        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()))
                        222. 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()))
                        224. 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.

                        ShortFacility operating the emergency department
                        Control1..1
                        TypeReference(Organization)
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        226. Encounter.partOf
                        Definition

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

                        ShortPrior pre-hospital encounter, if the patient arrived by EMS
                        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 - Emergency Medical Incident, Encounter - Emergency Point of Care)
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))