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: EpisodeOfCare

Official URL: http://fhir.hl7.nl/zorgviewer/StructureDefinition/EpisodeOfCare | Version: 1.21.0
Draft as of 2025-10-28 | 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:

- Use this Profile: Probleemlijst

You can also check for usages in the FHIR IG Statistics

Changes since version 1.20.0:

- No changes

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 Constraints: ext-1
extension:dateLastEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter Constraints: ext-1
extension:title |  | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | planned | waitlist | active | onhold | finished | cancelled | entered-in-error Binding: EpisodeOfCareStatus (required): The status of the episode of care.
diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this episode of care
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
condition | S Σ | 1..1 | Reference(Condition) | Conditions/problems/diagnoses this episode of care is for
patient | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | The patient who is the focus of this episode of care
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EpisodeOfCare.status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | EpisodeOfCare | 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()`
dom-4 | error | EpisodeOfCare | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | EpisodeOfCare.extension:dateFirstEncounter, EpisodeOfCare.extension:dateLastEncounter, EpisodeOfCare.extension:title | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from nl-core-episodeofcare

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:dateFirstEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter Constraints: ext-1
extension:dateLastEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter Constraints: ext-1
extension:title |  | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business Identifier(s) relevant for this EpisodeOfCare
status | ?!S Σ | 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 | S Σ | 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(2.2.5)) | 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 | Additional Content defined by implementations 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 Constraints: ext-1
reference | Σ C | 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
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EpisodeOfCare.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
EpisodeOfCare.status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.
EpisodeOfCare.statusHistory.​status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.
EpisodeOfCare.type | Base | example | EpisodeOfCareType | 📦3.0.2 | FHIR Std.
EpisodeOfCare.diagnosis.​role | Base | preferred | DiagnosisRole | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | EpisodeOfCare | 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()`
dom-4 | error | EpisodeOfCare | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | EpisodeOfCare.extension:dateFirstEncounter, EpisodeOfCare.extension:dateLastEncounter, EpisodeOfCare.extension:title, EpisodeOfCare.careManager.extension:practitionerRole | Must 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:

- Condition (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Condition)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 Constraints: ext-1
extension:dateLastEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter Constraints: ext-1
extension:title |  | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | planned | waitlist | active | onhold | finished | cancelled | entered-in-error Binding: EpisodeOfCareStatus (required): The status of the episode of care.
diagnosis | Σ | 0..* | BackboneElement | The list of diagnosis relevant to this episode of care
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored
condition | S Σ | 1..1 | Reference(Condition) | Conditions/problems/diagnoses this episode of care is for
patient | Σ | 1..1 | Reference(nl-core-patient(2.2.5)) | The patient who is the focus of this episode of care
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EpisodeOfCare.status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | EpisodeOfCare | 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()`
dom-4 | error | EpisodeOfCare | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | EpisodeOfCare.extension:dateFirstEncounter, EpisodeOfCare.extension:dateLastEncounter, EpisodeOfCare.extension:title | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from nl-core-episodeofcare

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
language |  | 0..1 | code | Language of the resource content Binding: Common Languages (extensible): A human language.
Additional Bindings | Purpose
All Languages | Max Binding
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 | Additional Content defined by implementations Slice: Unordered, Open by value:url
extension:dateFirstEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateFirstEncounter Constraints: ext-1
extension:dateLastEncounter |  | 0..1 | dateTime | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-DateLastEncounter Constraints: ext-1
extension:title |  | 0..1 | string | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/EpisodeOfCare-Title Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Business Identifier(s) relevant for this EpisodeOfCare
status | ?!S Σ | 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 | S Σ | 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(2.2.5)) | 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 | Additional Content defined by implementations 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 Constraints: ext-1
reference | Σ C | 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
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
EpisodeOfCare.language | Base | extensible | Common Languages | 📦3.0.2 | FHIR Std.
EpisodeOfCare.status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.
EpisodeOfCare.statusHistory.​status | Base | required | EpisodeOfCareStatus | 📦3.0.2 | FHIR Std.
EpisodeOfCare.type | Base | example | EpisodeOfCareType | 📦3.0.2 | FHIR Std.
EpisodeOfCare.diagnosis.​role | Base | preferred | DiagnosisRole | 📦3.0.2 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-1 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain any narrative | `contained.text.empty()`
dom-2 | error | EpisodeOfCare | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | EpisodeOfCare | 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()`
dom-4 | error | EpisodeOfCare | 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()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() | (children().count() > id.count())`
ext-1 | error | EpisodeOfCare.extension:dateFirstEncounter, EpisodeOfCare.extension:dateLastEncounter, EpisodeOfCare.extension:title, EpisodeOfCare.careManager.extension:practitionerRole | Must 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:

- Condition (http://fhir.hl7.nl/zorgviewer/StructureDefinition/Condition)

Other representations of profile: CSV, Excel, Schematron