RIVO-Noord Zorgviewer Implementation Guide
1.19.0 - CI build Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.19.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

Resource Profile: EpisodeOfCare

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/EpisodeOfCare Version: 1.19.0
Draft as of 2025-09-03 Computable Name: EpisodeOfCare

Zorgepisode

Dit Profiel is het resultaat van de vergelijking tussen de zib2017 FHIR Profiel en de implementaties in Epic, Chipsoft, Topicus en Nexus. De elementen die in ieder geval in alle output beschikbaar zullen zijn. Voornamelijk bedoeld voor houvast van een client en voor validatie van output.

Zorginformatiebouwsteen

N.B. ZorgEpisode komt uit de Huisartsgegevensset en is een zib2020 en FHIR R4. Voor het deel dat wij gebruiken is deze volledig compatibel met zib2017 en STU3.

ZIB ZorgEpisode

Request

  1. Opvragen (search) zorgepisodes inclusief problemen

    GET <ontsluiten-bronsysteem-base>/EpisodeOfCare?patient=<fhir_patient_id>&_include=Condition:diagnosis

Bronsysteem herkennen

De Zorgviewer-backend of Ontsluiten bronsysteem MOET na bevragen van het bronsysteem aan elk resultaat resource een meta-tag toevoegen met de AGB, OID of URA identifier van de zorgaanbieder (zie Organization voor voorbeelden). Dit wordt vervolgens gebruikt in de "Bron" kolom in de Zorgviewer-frontend. N.B. We gebruiken hier een pre-adopt van de FHIR R4 Meta.source.

Toevoegen aan elke response, dus per resource (bij een read) of per Bundle (bij een search):

"meta": {
    "extension": [ {
        "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-Meta.source",
        "valueUri": "urn:oid:2.16.840.1.113883.2.4.3.8"
    } ]
}

Alternatief: Elke entry van een search response Bundle bevat een referentie naar de bijbehorende Patient (<resource>.subject|patient). Elke patient heeft een Patient.managingOrganization en in de gerefereerde Organization.identifier staat vervolgens o.a. de OID van het bronsysyeem. Of je gebruikt de identifiers om een volledige Organization op te zoeken in het adresboek en zie inhoud hier.

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.18.0:

  • New Content

    • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:dateFirstEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter
    .... extension:dateLastEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter
    .... extension:title 0..1 string Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
    ... patient Σ 1..1 Reference(nl-core-patient(2.2.4)) The patient who is the focus of this episode of care

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    EpisodeOfCare.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-1errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain any narrative
    : contained.text.empty()
    dom-2errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorEpisodeOfCareIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
    dom-4errorEpisodeOfCareIf 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()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() | (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    This structure is derived from nl-core-episodeofcare

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    ... diagnosis
    .... condition S 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... extension:dateFirstEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter
    .... extension:dateLastEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter
    .... extension:title 0..1 string Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
    ... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    Binding: EpisodeOfCareStatus (required): The status of the episode of care.
    ... statusHistory 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... status 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    Binding: EpisodeOfCareStatus (required): The status of the episode of care.
    .... period 1..1 Period Duration the EpisodeOfCare was in the specified status
    ... type Σ 0..* CodeableConcept Type/class - e.g. specialist referral, disease management
    Binding: EpisodeOfCareType (example): The type of the episode of care
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    Slice: Unordered, Open by value:url
    .... coding Σ 0..* Coding Code defined by a terminology system
    .... text Σ 0..1 string ConcernLabel
    ... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
    .... role Σ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
    Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents
    .... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
    ... patient Σ 1..1 Reference(nl-core-patient(2.2.4)) The patient who is the focus of this episode of care
    ... managingOrganization Σ 0..1 Reference(nl-core-organization(2.0.6)) Organization that assumes care
    ... period Σ 0..1 Period Interval during responsibility is assumed
    ... referralRequest 0..* Reference(ReferralRequest) Originating Referral Request(s)
    ... careManager 0..1 Reference(nl-core-practitioner(2.0.7)) Care manager/care co-ordinator for the patient
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... extension:practitionerRole 0..1 Reference(nl-core-practitionerrole(2.0.7)) Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... team 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
    ... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    EpisodeOfCare.languageextensibleCommon Languages
    http://hl7.org/fhir/ValueSet/languages
    From the FHIR Standard
    Additional Bindings Purpose
    All Languages Max Binding
    EpisodeOfCare.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard
    EpisodeOfCare.statusHistory.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard
    EpisodeOfCare.typeexampleEpisodeOfCareType
    http://hl7.org/fhir/ValueSet/episodeofcare-type
    From the FHIR Standard
    EpisodeOfCare.diagnosis.rolepreferredDiagnosisRole
    http://hl7.org/fhir/ValueSet/diagnosis-role
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-1errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain any narrative
    : contained.text.empty()
    dom-2errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorEpisodeOfCareIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
    dom-4errorEpisodeOfCareIf 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()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() | (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    This structure is derived from nl-core-episodeofcare

    Summary

    Must-Support: 2 elements

    Structures

    This structure refers to these other structures:

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... Slices for extension Content/Rules for all slices
    .... extension:dateFirstEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter
    .... extension:dateLastEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter
    .... extension:title 0..1 string Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
    ... patient Σ 1..1 Reference(nl-core-patient(2.2.4)) The patient who is the focus of this episode of care

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    EpisodeOfCare.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-1errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain any narrative
    : contained.text.empty()
    dom-2errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorEpisodeOfCareIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
    dom-4errorEpisodeOfCareIf 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()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() | (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    Differential View

    This structure is derived from nl-core-episodeofcare

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... status S 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    ... diagnosis
    .... condition S 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. EpisodeOfCare 0..* nl-core-episodeofcare(1.1.4) An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... extension:dateFirstEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter
    .... extension:dateLastEncounter 0..1 dateTime Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter
    .... extension:title 0..1 string Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier 0..* Identifier Business Identifier(s) relevant for this EpisodeOfCare
    ... status ?!SΣ 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    Binding: EpisodeOfCareStatus (required): The status of the episode of care.
    ... statusHistory 0..* BackboneElement Past list of status codes (the current status may be included to cover the start date of the status)
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... status 1..1 code planned | waitlist | active | onhold | finished | cancelled | entered-in-error
    Binding: EpisodeOfCareStatus (required): The status of the episode of care.
    .... period 1..1 Period Duration the EpisodeOfCare was in the specified status
    ... type Σ 0..* CodeableConcept Type/class - e.g. specialist referral, disease management
    Binding: EpisodeOfCareType (example): The type of the episode of care
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    Slice: Unordered, Open by value:url
    .... coding Σ 0..* Coding Code defined by a terminology system
    .... text Σ 0..1 string ConcernLabel
    ... diagnosis Σ 0..* BackboneElement The list of diagnosis relevant to this episode of care
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... extension 0..* Extension Additional Content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
    .... condition SΣ 1..1 Reference(Condition) Conditions/problems/diagnoses this episode of care is for
    .... role Σ 0..1 CodeableConcept Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …)
    Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents
    .... rank Σ 0..1 positiveInt Ranking of the diagnosis (for each role type)
    ... patient Σ 1..1 Reference(nl-core-patient(2.2.4)) The patient who is the focus of this episode of care
    ... managingOrganization Σ 0..1 Reference(nl-core-organization(2.0.6)) Organization that assumes care
    ... period Σ 0..1 Period Interval during responsibility is assumed
    ... referralRequest 0..* Reference(ReferralRequest) Originating Referral Request(s)
    ... careManager 0..1 Reference(nl-core-practitioner(2.0.7)) Care manager/care co-ordinator for the patient
    .... id 0..1 string xml:id (or equivalent in JSON)
    .... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... extension:practitionerRole 0..1 Reference(nl-core-practitionerrole(2.0.7)) Optional Extensions Element
    URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... team 0..* Reference(CareTeam) Other practitioners facilitating this episode of care
    ... account 0..* Reference(Account) The set of accounts that may be used for billing for this EpisodeOfCare

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    EpisodeOfCare.languageextensibleCommon Languages
    http://hl7.org/fhir/ValueSet/languages
    From the FHIR Standard
    Additional Bindings Purpose
    All Languages Max Binding
    EpisodeOfCare.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard
    EpisodeOfCare.statusHistory.statusrequiredEpisodeOfCareStatus
    http://hl7.org/fhir/ValueSet/episode-of-care-status
    From the FHIR Standard
    EpisodeOfCare.typeexampleEpisodeOfCareType
    http://hl7.org/fhir/ValueSet/episodeofcare-type
    From the FHIR Standard
    EpisodeOfCare.diagnosis.rolepreferredDiagnosisRole
    http://hl7.org/fhir/ValueSet/diagnosis-role
    From the FHIR Standard

    Constraints

    IdGradePath(s)DetailsRequirements
    dom-1errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain any narrative
    : contained.text.empty()
    dom-2errorEpisodeOfCareIf the resource is contained in another resource, it SHALL NOT contain nested Resources
    : contained.contained.empty()
    dom-3errorEpisodeOfCareIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
    dom-4errorEpisodeOfCareIf 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()
    ele-1error**ALL** elementsAll FHIR elements must have a @value or children
    : hasValue() | (children().count() > id.count())
    ext-1error**ALL** extensionsMust have either extensions or value[x], not both
    : extension.exists() != value.exists()

    This structure is derived from nl-core-episodeofcare

    Summary

    Must-Support: 2 elements

    Structures

    This structure refers to these other structures:

     

    Other representations of profile: CSV, Excel, Schematron