RIVO-Noord Zorgviewer Implementation Guide
1.21.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.21.0 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: Encounter - Detailed Descriptions

Draft as of 2025-10-28

Definitions for the Encounter resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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. This is the base resource type for everything.
Short | EncounterBase Resource
Control | 0..*
Alternate Names | Visit, Contact
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.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-3: If 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()`)
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.
Short | A 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. 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. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
6. Encounter.status
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Short | planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments | Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes). This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|3.0.2 (required to `http://hl7.org/fhir/ValueSet/encounter-status` ) Current state of the encounter
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Encounter.class
Definition | The type of contact. inpatient | outpatient | ambulatory | emergency +.
Short | ContactTypeinpatient | outpatient | ambulatory | emergency +
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from ContactTypeCodelijst http://hl7.org/fhir/ValueSet/v3-ActEncounterCode|2014-03-26 (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.1--20171231000000` ) ContactTypeCodelijst Classification of the encounter
Type | Coding
Summary | true
Alternate Names | ContactType
10. Encounter.subject
Definition | The patient ro group present at the encounter.
Short | The patient ro group present at the encounter
Comments | While the encounter is always about the patient, the patient may 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).
Control | 10..1
Type | Reference(nl-core-patient, Patient, Group)
Summary | true
Alternate Names | patient

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

0. Encounter

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.
Short | Encounter
Control | 0..*
Alternate Names | Visit, Contact
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.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-3: If 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()`)
2. Encounter.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. Encounter.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Summary | true
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.
Short | A 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Encounter.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Common Languages (extensible to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
All Languages | Max Binding
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
10. Encounter.text
Definition | A human-readable narrative that contains a summary of the resource, and may 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.
Short | Text 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 in formation is added later.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
14. Encounter.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
16. 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. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
18. Encounter.identifier
Definition | Identifier(s) by which this encounter is known.
Short | Identifier(s) by which this encounter is known
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Summary | true
20. Encounter.status
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Short | planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments | Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes). This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from EncounterStatus (required to `http://hl7.org/fhir/ValueSet/encounter-status` ) Current state of the encounter
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
22. 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.
Short | List of past encounter statuses
Comments | The current status is always found in the current version of the resource, not the status history.
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
24. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
26. Encounter.statusHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
28. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
30. Encounter.statusHistory.status
Definition | planned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Short | planned | arrived | triaged | in-progress | onleave | finished | cancelled +
Control | 1..1
Binding | The codes SHALL be taken from EncounterStatus (required to `http://hl7.org/fhir/ValueSet/encounter-status` ) Current state of the encounter
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
32. Encounter.statusHistory.period
Definition | The time that the episode was in the specified status.
Short | The time that the episode was in the specified status
Control | 1..1
Type | Period
34. Encounter.class
Definition | The type of contact.
Short | ContactType
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ContactTypeCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.1--20171231000000` ) ContactTypeCodelijst
Type | Coding
Summary | true
Alternate Names | ContactType
36. 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 transisions 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 kindof discharge from emergency to inpatient.
Short | List of past encounter classes
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
38. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
40. Encounter.classHistory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
42. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
44. Encounter.classHistory.class
Definition | inpatient | outpatient | ambulatory | emergency +.
Short | inpatient | outpatient | ambulatory | emergency +
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ActEncounterCode (extensible to `http://hl7.org/fhir/ValueSet/v3-ActEncounterCode` ) Classification of the encounter
Type | Coding
46. Encounter.classHistory.period
Definition | The time that the episode was in the specified class.
Short | The time that the episode was in the specified class
Control | 1..1
Type | Period
48. Encounter.type
Definition | Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Short | Specific type of encounter
Comments | Since there are many ways to further classify encounters, this element is 0..*.
Control | 0..*
Binding | For example codes, see EncounterType (example to `http://hl7.org/fhir/ValueSet/encounter-type` ) The type of encounter
Type | CodeableConcept
Summary | true
50. Encounter.priority
Definition | Indicates the urgency of the encounter.
Short | Indicates the urgency of the encounter
Control | 0..1
Binding | For example codes, see ActPriority (example to `http://hl7.org/fhir/ValueSet/v3-ActPriority` ) Indicates the urgency of the encounter.
Type | CodeableConcept
52. Encounter.subject
Definition | The patient ro group present at the encounter.
Short | The patient ro group present at the encounter
Comments | While the encounter is always about the patient, the patient may 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).
Control | 1..1
Type | Reference(nl-core-patient)
Summary | true
Alternate Names | patient
54. Encounter.episodeOfCare
Definition | Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).
Short | Episode(s) of care that this encounter should be recorded against
Control | 0..*
Type | Reference(nl-core-episodeofcare)
Summary | true
56. Encounter.incomingReferral
Definition | The referral request this encounter satisfies (incoming referral).
Short | The ReferralRequest that initiated this encounter
Control | 0..*
Type | Reference(ReferralRequest)
58. Encounter.participant
Definition | The list of people responsible for providing the service.
Short | List of participants involved in the encounter
Control | 0..*
Type | BackboneElement
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
60. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
62. Encounter.participant.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
64. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
66. Encounter.participant.type
Definition | Role of participant in encounter.
Short | Role of participant in encounter
Comments | The participant type indicates how an individual partitipates 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ParticipantType (extensible to `http://hl7.org/fhir/ValueSet/encounter-participant-type` ) Role of participant in encounter
Type | CodeableConcept
Summary | true
68. Encounter.participant.type.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
70. Encounter.participant.type.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Encounter.participant.type.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
72. Encounter.participant.type.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Slicing | This element introduces a set of slices on `Encounter.participant.type.coding`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
74. Encounter.participant.type.coding:healthProfessionalRole
Slice Name | healthProfessionalRole
Definition | The role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner.
Short | HealthProfessionalRole
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Binding | The codes SHALL be taken from ZorgverlenerRolCodelijst (required to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000` )
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Alternate Names | ZorgverlenerRol
76. Encounter.participant.type.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
78. 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.
Short | Period of time during the encounter that the participant participated
Control | 0..1
Type | Period
80. Encounter.participant.individual
Definition | The healthcare provider with whom the contact took place. The specialty and role of the healthcare provider can be entered in the HealthcareProvider information model as well.
Short | ContactWith
Control | 0..1
Type | Reference(nl-core-relatedperson, nl-core-practitioner)
Summary | true
Alternate Names | ContactMet
82. Encounter.participant.individual.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
84. Encounter.participant.individual.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Encounter.participant.individual.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
86. Encounter.participant.individual.extension:practitionerRole
Slice Name | practitionerRole
Definition | Optional Extension Element - found in all resources.
Short | Optional Extensions Element
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.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(PractitionerRole Reference) (Extension Type: Reference)
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
88. Encounter.participant.individual.reference
Definition | A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Short | Literal reference, Relative, internal or absolute URL
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Control | 0..1 This element is affected by the following invariants: ref-1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
90. Encounter.participant.individual.identifier
Definition | An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Short | Logical reference, when literal reference is not known
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Summary | true
92. Encounter.participant.individual.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text alternative for the resource
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
94. Encounter.appointment
Definition | The appointment that scheduled this encounter.
Short | The appointment that scheduled this encounter
Control | 0..1
Type | Reference(Appointment)
Summary | true
96. Encounter.period
Definition | The start and end time of the encounter.
Short | The start and end time of the encounter
Comments | If not (yet) known, the end of the Period may be omitted.
Control | 0..1
Type | Period
98. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
100. Encounter.period.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This 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
102. Encounter.period.start
Definition | The date and time at which the contact took place.
Short | StartDateTime
Comments | If the low element is missing, the meaning is that the low boundary is not known.
Control | 1..1 This element is affected by the following invariants: per-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | BeginDatumTijd
104. Encounter.period.end
Definition | The date and time at which the contact ended. If the contact takes place over a period of time, this indicates the end of the period, in the case of an admission, for example. If the end of the period is missing, it means that the period is ongoing. 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.
Short | EndDateTime
Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Control | 0..1 This element is affected by the following invariants: per-1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | EindDatumTijd
Meaning if Missing | If the end of the period is missing, it means that the period is ongoing
106. Encounter.length
Definition | Quantity of time the encounter lasted. This excludes the time during leaves of absence.
Short | Quantity of time the encounter lasted (less time absent)
Comments | May differ from the time the Encounter.period lasted because of leave of absence.
Control | 0..1
Type | Duration
108. Encounter.reason
Definition | A deviating result which serves as the reason for the contact.
Short | DeviatingResult
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).
Control | 0..*
Binding | The codes SHOULD be taken from Encounter Reason Codes (preferred to `http://hl7.org/fhir/ValueSet/encounter-reason` ) Reason why the encounter takes place.
Type | CodeableConcept
Summary | true
Alternate Names | Indication, Admission diagnosis, AfwijkendeUitslag
110. Encounter.reason.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
112. Encounter.reason.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Slicing | This element introduces a set of slices on `Encounter.reason.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
114. Encounter.reason.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Summary | true
Requirements | Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
116. Encounter.reason.text
Definition | A deviating result which serves as the reason for the contact.
Short | DeviatingResult
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Alternate Names | AfwijkendeUitslag
118. Encounter.diagnosis
Definition | The list of diagnosis relevant to this encounter.
Short | The list of diagnosis relevant to this encounter
Control | 0..*
Type | BackboneElement
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
120. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
122. Encounter.diagnosis.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
124. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
126. Encounter.diagnosis.condition
Definition | The problem that led to the contact or the procedure carried out during the contact. 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.
Short | ContactReason
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).
Control | 1..1
Type | Reference(HCIM Procedure, HCIM Problem)
Alternate Names | Admission diagnosis, discharge diagnosis, indication, Probleem, Procedure
128. Encounter.diagnosis.role
Definition | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Short | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Control | 0..1
Binding | The codes SHOULD be taken from DiagnosisRole (preferred to `http://hl7.org/fhir/ValueSet/diagnosis-role` ) The type of diagnosis this condition represents
Type | CodeableConcept
130. Encounter.diagnosis.rank
Definition | Ranking of the diagnosis (for each role type).
Short | Ranking of the diagnosis (for each role type)
Control | 0..1
Type | positiveInt
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
132. Encounter.account
Definition | The set of accounts that may be used for billing for this Encounter.
Short | The 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.
Control | 0..*
Type | Reference(Account)
134. Encounter.hospitalization
Definition | Details about the admission to a healthcare service.
Short | Details 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.
Control | 0..1
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
136. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
138. Encounter.hospitalization.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
140. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
142. Encounter.hospitalization.preAdmissionIdentifier
Definition | Pre-admission identifier.
Short | Pre-admission identifier
Control | 0..1
Type | Identifier
144. Encounter.hospitalization.origin
Definition | The location from which the patient came before admission.
Short | The location from which the patient came before admission
Control | 0..1
Type | Reference(Location)
146. Encounter.hospitalization.admitSource
Definition | Location from which the patient came before the encounter. In most cases this will only be used when the patient is admitted.
Short | Origin
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from HerkomstCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.2--20171231000000` ) HerkomstCodelijst
Type | CodeableConcept
Alternate Names | Herkomst
148. Encounter.hospitalization.reAdmission
Definition | Whether this hospitalization is a readmission and why if known.
Short | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
Control | 0..1
Binding | For example codes, see v2 Re-Admission Indicator (example to `http://hl7.org/fhir/ValueSet/v2-0092` ) The reason for re-admission of this hospitalization encounter.
Type | CodeableConcept
150. Encounter.hospitalization.dietPreference
Definition | Diet preferences reported by the patient.
Short | Diet preferences reported by the patient
Comments | For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).
Control | 0..*
Binding | For example codes, see Diet (example to `http://hl7.org/fhir/ValueSet/encounter-diet` ) Medical, cultural or ethical food preferences to help with catering requirements.
Type | CodeableConcept
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.
152. Encounter.hospitalization.specialCourtesy
Definition | Special courtesies (VIP, board member).
Short | Special courtesies (VIP, board member)
Control | 0..*
Binding | The codes SHOULD be taken from SpecialCourtesy (preferred to `http://hl7.org/fhir/ValueSet/encounter-special-courtesy` ) Special courtesies
Type | CodeableConcept
154. 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.
Short | Wheelchair, translator, stretcher, etc.
Control | 0..*
Binding | The codes SHOULD be taken from SpecialArrangements (preferred to `http://hl7.org/fhir/ValueSet/encounter-special-arrangements` ) Special arrangements
Type | CodeableConcept
156. Encounter.hospitalization.destination
Definition | Location to which the patient is discharged.
Short | Location to which the patient is discharged
Control | 0..1
Type | Reference(Location)
158. Encounter.hospitalization.dischargeDisposition
Definition | Location to which the patient will go after the encounter. In most cases this will only be used when the patient is discharged.
Short | Destination
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from BestemmingCodelijst (extensible to `http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.3--20171231000000` ) BestemmingCodelijst
Type | CodeableConcept
Alternate Names | Bestemming
160. Encounter.location
Definition | List of locations where the patient has been during this encounter.
Short | List 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".
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`)
162. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
164. Encounter.location.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
166. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
168. Encounter.location.location
Definition | The location where the encounter takes place.
Short | Location the encounter takes place
Control | 1..1
Type | Reference(Location)
170. Encounter.location.status
Definition | The status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.
Short | planned | 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.
Control | 0..1
Binding | The codes SHALL be taken from EncounterLocationStatus (required to `http://hl7.org/fhir/ValueSet/encounter-location-status` ) The status of the location.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
172. Encounter.location.period
Definition | Time period during which the patient was present at the location.
Short | Time period during which the patient was present at the location
Control | 0..1
Type | Period
174. Encounter.serviceProvider
Definition | The physical location at which the contact took place.
Short | Location
Control | 0..1
Type | Reference(nl-core-organization)
Alternate Names | Locatie
176. Encounter.partOf
Definition | Another Encounter of which this encounter is a part of (administratively or in time).
Short | Another 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.
Control | 0..1
Type | Reference(Encounter)