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

Kenya Emergency FHIR 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-Emmergency-FHIR-IG/ and changes regularly. See the Directory of published versions

Resource Profile: EMIncidentEncounter - Detailed Descriptions

Active as of 2026-07-20

Definitions for the em-incident-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-incident-1: The Encounter period end must not occur before the Encounter period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
em-incident-2: The incident identifier must match the incident identifier on the referenced EpisodeOfCare when the EpisodeOfCare can be resolved by the validator. (episodeOfCare.resolve().exists() implies ( episodeOfCare.resolve().identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value = identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value ))
em-incident-3: The caller cannot be identified as the patient unless the caller reference resolves to the same Patient referenced by Encounter.subject. (extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'isPatient') .valueBoolean = true implies extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'individual') .valueReference.reference = subject.reference)
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.

Control10..*
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:caller
    Slice Namecaller
    Definition

    Captures the person who reported the emergency incident.

    The caller may be the Patient, a person related to the Patient, or an unlinked person such as a bystander. This extension is necessary because the base Encounter.participant.individual element does not permit Patient or Person references in FHIR R4/R4B.

    ShortPerson who reported the emergency incident
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Incident Caller) (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())
    8. Encounter.extension:supportingAgency
    Slice NamesupportingAgency
    Definition

    References another emergency-response organization participating in the incident, such as fire services, police, security services, or disaster management services.

    ShortOther emergency-response agency participating in the incident
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Supporting Agency) (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())
    10. Encounter.extension:respondingUnit
    Slice NamerespondingUnit
    Definition

    References an ambulance or other emergency-response vehicle assigned to the incident.

    ShortAmbulance or emergency-response vehicle assigned to the incident
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Emergency Responding Unit) (Extension Type: Reference(Device))
    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.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())
    14. 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)
    Control20..*
    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
    • 16. Encounter.identifier:dispatchId
      Slice NamedispatchId
      Definition

      Business identifier assigned by the dispatch or computer-aided dispatch system. Maps to incident.dispatch_id in the source system.


      Identifier(s) by which this encounter is known.

      ShortIdentifier assigned by the dispatch or CAD systemIdentifier(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()))
      18. Encounter.identifier:dispatchId.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()))
      20. Encounter.identifier:dispatchId.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/dispatch-id
      ExampleGeneral: http://www.acme.com/identifiers/patient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Encounter.identifier:dispatchId.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()))
      24. Encounter.identifier:incidentId
      Slice NameincidentId
      Definition

      Shared business identifier used to associate the incident Encounter with its parent EpisodeOfCare and related emergency-care resources.


      Identifier(s) by which this encounter is known.

      ShortShared identifier for the complete emergency incidentIdentifier(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:incidentId.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:incidentId.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/incident-id
      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:incidentId.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 incidentplanned | 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

      Indicates that this Encounter represents an EMS field response rather than a facility-based emergency department encounter.


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

      ShortEmergency medical services field responseClassification 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" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-encounter-class",
        "code" : "FLD",
        "display" : "Emergency medical services field response"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Encounter.type
      Definition

      Coded category of the emergency incident. This value should be consistent with the corresponding EpisodeOfCare.type.


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

      ShortNature or category of the emergency incidentSpecific type of encounter
      Comments

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

      Control10..1*
      BindingThe codes SHALL be taken from For example codes, see Emergency Incident Type Value Sethttp://hl7.org/fhir/ValueSet/encounter-type|4.0.1
      (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-incident-type)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Encounter.priority
      Definition

      Priority assigned during call intake and dispatch. This is distinct from the clinical acuity or triage category assigned by an emergency medical professional after patient assessment.


      Indicates the urgency of the encounter.

      ShortPriority assigned by the dispatcherIndicates the urgency of the encounter
      Control10..1
      BindingThe codes SHALL be taken from For example codes, see Emergency Dispatch Priority Value Sethttp://terminology.hl7.org/ValueSet/v3-ActPriority
      (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-dispatch-priority)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Encounter.subject
      Definition

      References either a verified Patient or a temporary unidentified Patient record created for emergency tracking.


      The patient or group present at the encounter.

      ShortPatient associated with the emergency incidentThe 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, 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()))
      42. Encounter.episodeOfCare
      Definition

      FHIR-native structural link to the emergency EpisodeOfCare. The shared incident identifier remains available as a business-level correlation and verification key.


      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 containing this incidentEpisode(s) of care that this encounter should be recorded against
      Control10..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()))
      44. Encounter.participant
      Definition

      The list of people responsible for providing the service.

      ShortList 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()))
      46. 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())
      48. Encounter.participant.type
      Definition

      Role of participant in encounter.

      ShortDispatcher or call-handler roleRole 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..1*
      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
      Must Supporttrue
      Summarytrue
      Pattern Value{
        "coding" : [{
          "system" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-participant-role",
          "code" : "dispatcher"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. 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
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Encounter.participant.individual
      Definition

      Persons involved in the encounter other than the patient.

      ShortDispatcher or call-handler who processed the emergency callPersons 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.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()))
      56. Encounter.period.start
      Definition

      Date and time at which the emergency incident was received or created in the dispatch system.


      The start of the period. The boundary is inclusive.

      ShortTime the emergency call or incident was openedStarting 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()))
      58. Encounter.period.end
      Definition

      Date and time at which responsibility for the patient was transferred to the receiving facility.


      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 handover at the receiving facility was completedEnd 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.

      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
      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()))
      60. Encounter.reasonCode
      Definition

      Caller- or dispatcher-reported description of the emergency, captured before clinical assessment by the responding emergency team.

      The element may contain coded incident information, free text, or both.


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

      ShortCaller-reported reason or chief complaintCoded 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
      Must Supporttrue
      Summarytrue
      Alternate NamesIndication, Admission diagnosis
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. 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()))
      64. 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())
      66. Encounter.hospitalization.destination
      Definition

      The intended or actual health facility receiving the patient.

      The referenced Location should use Location.managingOrganization to reference the corresponding healthcare Organization.


      Location/organization to which the patient is discharged.

      ShortReceiving health facility locationLocation/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()))
      68. 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()))
      70. 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())
      72. Encounter.location.location
      Definition

      The location where the encounter takes place.

      ShortScene of the emergency incidentLocation the encounter takes place
      Control1..1
      TypeReference(Location - Emergency Incident Scene, Location)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. 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 EncounterLocationStatushttp://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1
      (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
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. 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
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      78. 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.

      ShortEMS or dispatch organization responsible for the incidentThe organization (facility) responsible for this encounter
      Control0..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()))
      80. Encounter.partOf
      Definition

      This profile represents the root Encounter for the EMS incident. A subordinate point-of-care Encounter should reference this Encounter through its own partOf element.


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

      ShortNot permitted on the root incident EncounterAnother 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..01
      TypeReference(Encounter)
      Is Modifierfalse
      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-incident-1: The Encounter period end must not occur before the Encounter period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
      em-incident-2: The incident identifier must match the incident identifier on the referenced EpisodeOfCare when the EpisodeOfCare can be resolved by the validator. (episodeOfCare.resolve().exists() implies ( episodeOfCare.resolve().identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value = identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value ))
      em-incident-3: The caller cannot be identified as the patient unless the caller reference resolves to the same Patient referenced by Encounter.subject. (extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'isPatient') .valueBoolean = true implies extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'individual') .valueReference.reference = subject.reference)
      2. Encounter.extension
      Control1..?
      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:caller
        Slice Namecaller
        ShortPerson who reported the emergency incident
        Control1..1
        TypeExtension(Emergency Incident Caller) (Complex Extension)
        Must Supporttrue
        6. Encounter.extension:supportingAgency
        Slice NamesupportingAgency
        ShortOther emergency-response agency participating in the incident
        Control0..*
        TypeExtension(Emergency Supporting Agency) (Complex Extension)
        Must Supporttrue
        8. Encounter.extension:respondingUnit
        Slice NamerespondingUnit
        ShortAmbulance or emergency-response vehicle assigned to the incident
        Control0..*
        TypeExtension(Emergency Responding Unit) (Extension Type: Reference(Device))
        Must Supporttrue
        10. Encounter.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control2..?
        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
        • 12. Encounter.identifier:dispatchId
          Slice NamedispatchId
          Definition

          Business identifier assigned by the dispatch or computer-aided dispatch system. Maps to incident.dispatch_id in the source system.

          ShortIdentifier assigned by the dispatch or CAD system
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..1
          Must Supporttrue
          14. Encounter.identifier:dispatchId.use
          Pattern Valueofficial
          16. Encounter.identifier:dispatchId.system
          Control1..?
          Must Supporttrue
          Fixed Valuehttp://hie.go.ke/fhir/identifier/dispatch-id
          18. Encounter.identifier:dispatchId.value
          Control1..?
          Must Supporttrue
          20. Encounter.identifier:incidentId
          Slice NameincidentId
          Definition

          Shared business identifier used to associate the incident Encounter with its parent EpisodeOfCare and related emergency-care resources.

          ShortShared identifier for the complete emergency incident
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control1..1
          Must Supporttrue
          22. Encounter.identifier:incidentId.use
          Pattern Valueofficial
          24. Encounter.identifier:incidentId.system
          Control1..?
          Must Supporttrue
          Fixed Valuehttp://hie.go.ke/fhir/identifier/incident-id
          26. Encounter.identifier:incidentId.value
          Control1..?
          Must Supporttrue
          28. Encounter.status
          ShortCurrent workflow status of the emergency incident
          BindingThe codes SHALL be taken from EncounterStatus
          (required to http://hl7.org/fhir/ValueSet/encounter-status)
          Must Supporttrue
          30. Encounter.class
          Definition

          Indicates that this Encounter represents an EMS field response rather than a facility-based emergency department encounter.

          ShortEmergency medical services field response
          Must Supporttrue
          Pattern Value{
            "system" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-encounter-class",
            "code" : "FLD",
            "display" : "Emergency medical services field response"
          }
          32. Encounter.type
          Definition

          Coded category of the emergency incident. This value should be consistent with the corresponding EpisodeOfCare.type.

          ShortNature or category of the emergency incident
          Control1..1
          BindingThe codes SHALL be taken from Emergency Incident Type Value Set
          (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-incident-type)
          Must Supporttrue
          34. Encounter.priority
          Definition

          Priority assigned during call intake and dispatch. This is distinct from the clinical acuity or triage category assigned by an emergency medical professional after patient assessment.

          ShortPriority assigned by the dispatcher
          Control1..?
          BindingThe codes SHALL be taken from Emergency Dispatch Priority Value Set
          (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-dispatch-priority)
          Must Supporttrue
          36. Encounter.subject
          Definition

          References either a verified Patient or a temporary unidentified Patient record created for emergency tracking.

          ShortPatient associated with the emergency incident
          Control1..?
          TypeReference(Patient)
          Must Supporttrue
          38. Encounter.episodeOfCare
          Definition

          FHIR-native structural link to the emergency EpisodeOfCare. The shared incident identifier remains available as a business-level correlation and verification key.

          ShortEmergency episode containing this incident
          Control1..1
          Must Supporttrue
          40. Encounter.participant
          Control0..1
          Must Supporttrue
          42. Encounter.participant.type
          ShortDispatcher or call-handler role
          Control1..1
          Must Supporttrue
          Pattern Value{
            "coding" : [{
              "system" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-participant-role",
              "code" : "dispatcher"
            }]
          }
          44. Encounter.participant.period
          Must Supporttrue
          46. Encounter.participant.individual
          ShortDispatcher or call-handler who processed the emergency call
          Control1..?
          TypeReference(Practitioner, PractitionerRole)
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          48. Encounter.period
          Control1..?
          Must Supporttrue
          50. Encounter.period.start
          Definition

          Date and time at which the emergency incident was received or created in the dispatch system.

          ShortTime the emergency call or incident was opened
          Control1..?
          Must Supporttrue
          52. Encounter.period.end
          Definition

          Date and time at which responsibility for the patient was transferred to the receiving facility.

          ShortTime handover at the receiving facility was completed
          Control1..?
          Must Supporttrue
          54. Encounter.reasonCode
          Definition

          Caller- or dispatcher-reported description of the emergency, captured before clinical assessment by the responding emergency team.

          The element may contain coded incident information, free text, or both.

          ShortCaller-reported reason or chief complaint
          Control0..1
          Must Supporttrue
          56. Encounter.hospitalization
          Must Supporttrue
          58. Encounter.hospitalization.destination
          Definition

          The intended or actual health facility receiving the patient.

          The referenced Location should use Location.managingOrganization to reference the corresponding healthcare Organization.

          ShortReceiving health facility location
          TypeReference(Location - Emergency Destination Facility)
          Must Supporttrue
          60. Encounter.location
          Control0..1
          Must Supporttrue
          62. Encounter.location.location
          ShortScene of the emergency incident
          TypeReference(Location - Emergency Incident Scene)
          Must Supporttrue
          64. Encounter.location.status
          Must Supporttrue
          66. Encounter.location.period
          Must Supporttrue
          68. Encounter.serviceProvider
          ShortEMS or dispatch organization responsible for the incident
          Must Supporttrue
          70. Encounter.partOf
          Definition

          This profile represents the root Encounter for the EMS incident. A subordinate point-of-care Encounter should reference this Encounter through its own partOf element.

          ShortNot permitted on the root incident Encounter
          Control0..0

          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-incident-1: The Encounter period end must not occur before the Encounter period start. (period.end.empty() or period.start.empty() or period.end >= period.start)
          em-incident-2: The incident identifier must match the incident identifier on the referenced EpisodeOfCare when the EpisodeOfCare can be resolved by the validator. (episodeOfCare.resolve().exists() implies ( episodeOfCare.resolve().identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value = identifier .where(system = 'http://hie.go.ke/fhir/identifier/incident-id') .value ))
          em-incident-3: The caller cannot be identified as the patient unless the caller reference resolves to the same Patient referenced by Encounter.subject. (extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'isPatient') .valueBoolean = true implies extension .where(url = 'http://hie.go.ke/fhir/StructureDefinition/em-incident-caller') .extension .where(url = 'individual') .valueReference.reference = subject.reference)
          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
          Control1..*
          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:caller
            Slice Namecaller
            Definition

            Captures the person who reported the emergency incident.

            The caller may be the Patient, a person related to the Patient, or an unlinked person such as a bystander. This extension is necessary because the base Encounter.participant.individual element does not permit Patient or Person references in FHIR R4/R4B.

            ShortPerson who reported the emergency incident
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Emergency Incident Caller) (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:supportingAgency
            Slice NamesupportingAgency
            Definition

            References another emergency-response organization participating in the incident, such as fire services, police, security services, or disaster management services.

            ShortOther emergency-response agency participating in the incident
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Emergency Supporting Agency) (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.extension:respondingUnit
            Slice NamerespondingUnit
            Definition

            References an ambulance or other emergency-response vehicle assigned to the incident.

            ShortAmbulance or emergency-response vehicle assigned to the incident
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Emergency Responding Unit) (Extension Type: Reference(Device))
            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.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())
            24. 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)
            Control2..*
            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
            • 26. Encounter.identifier:dispatchId
              Slice NamedispatchId
              Definition

              Business identifier assigned by the dispatch or computer-aided dispatch system. Maps to incident.dispatch_id in the source system.

              ShortIdentifier assigned by the dispatch or CAD system
              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()))
              28. Encounter.identifier:dispatchId.id
              Definition

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

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              30. Encounter.identifier:dispatchId.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
              • 32. Encounter.identifier:dispatchId.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()))
                34. Encounter.identifier:dispatchId.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()))
                36. Encounter.identifier:dispatchId.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/dispatch-id
                ExampleGeneral: http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Encounter.identifier:dispatchId.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()))
                40. Encounter.identifier:dispatchId.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()))
                42. Encounter.identifier:dispatchId.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()))
                44. Encounter.identifier:incidentId
                Slice NameincidentId
                Definition

                Shared business identifier used to associate the incident Encounter with its parent EpisodeOfCare and related emergency-care resources.

                ShortShared identifier for the complete emergency incident
                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()))
                46. Encounter.identifier:incidentId.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
                48. Encounter.identifier:incidentId.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
                • 50. Encounter.identifier:incidentId.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()))
                  52. Encounter.identifier:incidentId.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()))
                  54. Encounter.identifier:incidentId.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/incident-id
                  ExampleGeneral: http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. Encounter.identifier:incidentId.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()))
                  58. Encounter.identifier:incidentId.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()))
                  60. Encounter.identifier:incidentId.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()))
                  62. Encounter.status
                  Definition

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

                  ShortCurrent workflow status of the emergency incident
                  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()))
                  64. 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()))
                  66. 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
                  68. 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())
                  70. 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())
                  72. 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()))
                  74. 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()))
                  76. Encounter.class
                  Definition

                  Indicates that this Encounter represents an EMS field response rather than a facility-based emergency department encounter.

                  ShortEmergency medical services field response
                  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" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-encounter-class",
                    "code" : "FLD",
                    "display" : "Emergency medical services field response"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. 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()))
                  80. 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
                  82. 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())
                  84. 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())
                  86. 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()))
                  88. 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()))
                  90. Encounter.type
                  Definition

                  Coded category of the emergency incident. This value should be consistent with the corresponding EpisodeOfCare.type.

                  ShortNature or category of the emergency incident
                  Comments

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

                  Control1..1
                  BindingThe codes SHALL be taken from Emergency Incident Type Value Set
                  (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-incident-type)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. 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()))
                  94. Encounter.priority
                  Definition

                  Priority assigned during call intake and dispatch. This is distinct from the clinical acuity or triage category assigned by an emergency medical professional after patient assessment.

                  ShortPriority assigned by the dispatcher
                  Control1..1
                  BindingThe codes SHALL be taken from Emergency Dispatch Priority Value Set
                  (required to https://nshr-uat.sha.go.ke/fhir/ValueSet/em-dispatch-priority)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  96. Encounter.subject
                  Definition

                  References either a verified Patient or a temporary unidentified Patient record created for emergency tracking.

                  ShortPatient associated with the emergency incident
                  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)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Alternate Namespatient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  98. Encounter.episodeOfCare
                  Definition

                  FHIR-native structural link to the emergency EpisodeOfCare. The shared incident identifier remains available as a business-level correlation and verification key.

                  ShortEmergency episode containing this incident
                  Control1..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()))
                  100. 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()))
                  102. Encounter.participant
                  Definition

                  The list of people responsible for providing the service.

                  ShortList 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()))
                  104. 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
                  106. 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())
                  108. 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())
                  110. Encounter.participant.type
                  Definition

                  Role of participant in encounter.

                  ShortDispatcher or call-handler role
                  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..1
                  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
                  Must Supporttrue
                  Summarytrue
                  Pattern Value{
                    "coding" : [{
                      "system" : "https://nshr-uat.sha.go.ke/fhir/CodeSystem/em-participant-role",
                      "code" : "dispatcher"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. 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
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  114. Encounter.participant.individual
                  Definition

                  Persons involved in the encounter other than the patient.

                  ShortDispatcher or call-handler who processed the emergency call
                  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()))
                  116. 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()))
                  118. 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()))
                  120. 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
                  122. 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
                  • 124. Encounter.period.start
                    Definition

                    Date and time at which the emergency incident was received or created in the dispatch system.

                    ShortTime the emergency call or incident was opened
                    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()))
                    126. Encounter.period.end
                    Definition

                    Date and time at which responsibility for the patient was transferred to the receiving facility.

                    ShortTime handover at the receiving facility was completed
                    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.

                    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
                    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()))
                    128. 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()))
                    130. Encounter.reasonCode
                    Definition

                    Caller- or dispatcher-reported description of the emergency, captured before clinical assessment by the responding emergency team.

                    The element may contain coded incident information, free text, or both.

                    ShortCaller-reported reason or chief complaint
                    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
                    Must Supporttrue
                    Summarytrue
                    Alternate NamesIndication, Admission diagnosis
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    132. Encounter.reasonReference
                    Definition

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

                    ShortReason the encounter takes place (reference)
                    Comments

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

                    Control0..*
                    TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesIndication, Admission diagnosis
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    134. Encounter.diagnosis
                    Definition

                    The list of diagnosis relevant to this encounter.

                    ShortThe list of diagnosis relevant to this encounter
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    136. 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
                    138. 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())
                    140. 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())
                    142. Encounter.diagnosis.condition
                    Definition

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

                    ShortThe diagnosis or procedure relevant to the encounter
                    Comments

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

                    Control1..1
                    TypeReference(Condition, Procedure)
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    144. 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()))
                    146. 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()))
                    148. 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()))
                    150. 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()))
                    152. 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
                    154. 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())
                    156. 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())
                    158. 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()))
                    160. 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()))
                    162. 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()))
                    164. 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()))
                    166. 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()))
                    168. 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()))
                    170. 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()))
                    172. Encounter.hospitalization.destination
                    Definition

                    The intended or actual health facility receiving the patient.

                    The referenced Location should use Location.managingOrganization to reference the corresponding healthcare Organization.

                    ShortReceiving health facility location
                    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()))
                    174. Encounter.hospitalization.dischargeDisposition
                    Definition

                    Category or kind of location after discharge.

                    ShortCategory or kind of location after discharge
                    Control0..1
                    BindingFor example codes, see DischargeDisposition
                    (example to http://hl7.org/fhir/ValueSet/encounter-discharge-disposition|4.0.1)

                    Discharge Disposition.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    176. 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()))
                    178. 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
                    180. 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())
                    182. 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())
                    184. Encounter.location.location
                    Definition

                    The location where the encounter takes place.

                    ShortScene of the emergency incident
                    Control1..1
                    TypeReference(Location - Emergency Incident Scene)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    186. 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
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    188. 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()))
                    190. 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
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    192. 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.

                    ShortEMS or dispatch organization responsible for the incident
                    Control0..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()))
                    194. Encounter.partOf
                    Definition

                    This profile represents the root Encounter for the EMS incident. A subordinate point-of-care Encounter should reference this Encounter through its own partOf element.

                    ShortNot permitted on the root incident Encounter
                    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..0
                    TypeReference(Encounter)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))