HL7 Europe Hospital Discharge Report
0.0.1-ci - ci-build 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

Resource Profile: EncounterEuHdrObligation - Detailed Descriptions

Page standards status: Informative Maturity Level: 0

Definitions for the encounter-obl-eu-hdr resource profile.

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

0. Encounter
Definition

An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

ShortAn interaction during which services are provided to the patient
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesVisit
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Encounter.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Encounter.extension:note
Slice Namenote
Definition

Additional notes that apply to this resource or element.

ShortEnconter note
Comments

This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

Control0..*
TypeExtension(Note) (Extension Type: Annotation)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Encounter.extension:legalStatus
Slice NamelegalStatus
Definition

Legal status/situation at admission. This extension may be used for representing the basis on which the patient is staying in a healthcare organisation. This can be either voluntary or involuntary. A patient can also receive healthcare based on a forensic status. (voluntary, involuntary, admission by legal authority).

ShortLegal status/situation at admission
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(Encounter: Legal Status) (Extension Type: CodeableConcept)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Encounter.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Encounter.status
Definition

At the discharge report status of the encounter should be always = "finished"


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

ShortStatus of this Hospital stayplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

Control1..1
BindingThe codes SHALL be taken from In-patient Encounter Type Value Sethttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
(required to http://hl7.eu/fhir/hdr/ValueSet/encounter-status-eu-hdr)
Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Encounter.class
Definition

Concepts representing classification of inpatient encounter such as inpatient, emergency or others due to local variations.


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

ShortClassification of patient encounter
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Encounter Class Value Sethttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
(extensible to http://hl7.eu/fhir/hdr/ValueSet/hdr-encounterClass-eu-hdr)
TypeCoding
Is Modifierfalse
Obligations
    ObligationsActor
    SHALL:handleHDRConsumer
    SHALL:able-to-populateHDRCreator
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Encounter.subject
    Definition

    The patient or group present at the encounter.

    ShortThe patient present at the encounterThe patient or group present at the encounter
    Comments

    While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

    Control10..1
    TypeReference(Patient (EU core), Patient, Group)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:handleHDRConsumer
      SHALL:able-to-populateHDRCreator
      Summarytrue
      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Encounter.participant
      Definition

      Slice per type of participant: admitter, discharger,..


      The list of people responsible for providing the service.

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Encounter.participant:admitter
        Slice Nameadmitter
        Definition

        The list of people responsible for providing the service.

        ShortAdmitting professionalList of participants involved in the encounter
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:handleHDRConsumer
          SHOULD:able-to-populateHDRCreator
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Encounter.participant:admitter.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          24. Encounter.participant:admitter.type
          Definition

          Role of participant in encounter.

          ShortRole of participant in encounter
          Comments

          The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

          Role of participant in encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code" : "ADM"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Encounter.participant:discharger
          Slice Namedischarger
          Definition

          The list of people responsible for providing the service.

          ShortDischarging professionalList of participants involved in the encounter
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:handleHDRConsumer
            SHOULD:able-to-populateHDRCreator
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Encounter.participant:discharger.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. Encounter.participant:discharger.type
            Definition

            Role of participant in encounter.

            ShortRole of participant in encounter
            Comments

            The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

            Role of participant in encounter.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code" : "DIS"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Encounter.participant:referrer
            Slice Namereferrer
            Definition

            The list of people responsible for providing the service.

            ShortReferring professionalList of participants involved in the encounter
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:handleHDRConsumer
              SHOULD:able-to-populateHDRCreator
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. Encounter.participant:referrer.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              36. Encounter.participant:referrer.type
              Definition

              Role of participant in encounter.

              ShortRole of participant in encounter
              Comments

              The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

              Role of participant in encounter.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Pattern Value{
                "coding" : [{
                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                  "code" : "REF"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. Encounter.period
              Definition

              The start and end time of this inpatient stay.


              The start and end time of the encounter.

              ShortThe start and end time of this encounter.The start and end time of the encounter
              Comments

              If not (yet) known, the end of the Period may be omitted.

              Control0..1
              TypePeriod
              Is Modifierfalse
              Obligations
                ObligationsActor
                SHALL:handleHDRConsumer
                SHOULD:able-to-populateHDRCreator
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Encounter.reasonCode
                Definition

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

                ShortCoded reason the encounter takes place
                Comments

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

                Control0..*
                BindingThe codes SHOULD be taken from Condition Value Sethttp://hl7.org/fhir/ValueSet/encounter-reason
                (preferred to http://hl7.eu/fhir/hdr/ValueSet/condition-eu-hdr)
                TypeCodeableConcept
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  SHALL:handleHDRConsumer
                  SHOULD:able-to-populateHDRCreator
                  Summarytrue
                  Alternate NamesIndication, Admission diagnosis
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                  0. Encounter
                  2. Encounter.class
                  Obligations
                    ObligationsActor
                    SHALL:handleHDRConsumer
                    SHALL:able-to-populateHDRCreator
                    4. Encounter.subject
                    Obligations
                      ObligationsActor
                      SHALL:handleHDRConsumer
                      SHALL:able-to-populateHDRCreator
                      6. Encounter.participant:admitter
                      Slice Nameadmitter
                      Obligations
                        ObligationsActor
                        SHALL:handleHDRConsumer
                        SHOULD:able-to-populateHDRCreator
                        8. Encounter.participant:discharger
                        Slice Namedischarger
                        Obligations
                          ObligationsActor
                          SHALL:handleHDRConsumer
                          SHOULD:able-to-populateHDRCreator
                          10. Encounter.participant:referrer
                          Slice Namereferrer
                          Obligations
                            ObligationsActor
                            SHALL:handleHDRConsumer
                            SHOULD:able-to-populateHDRCreator
                            12. Encounter.period
                            Obligations
                              ObligationsActor
                              SHALL:handleHDRConsumer
                              SHOULD:able-to-populateHDRCreator
                              14. Encounter.reasonCode
                              Obligations
                                ObligationsActor
                                SHALL:handleHDRConsumer
                                SHOULD:able-to-populateHDRCreator
                                16. Encounter.diagnosis
                                18. Encounter.diagnosis.condition
                                Obligations
                                  ObligationsActor
                                  SHALL:handleHDRConsumer
                                  SHOULD:able-to-populateHDRCreator

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

                                  0. Encounter
                                  Definition

                                  An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

                                  ShortAn interaction during which services are provided to the patient
                                  Control0..*
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate NamesVisit
                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                  2. Encounter.id
                                  Definition

                                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                  ShortLogical id of this artifact
                                  Comments

                                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                  Control0..1
                                  Typeid
                                  Is Modifierfalse
                                  Summarytrue
                                  4. Encounter.meta
                                  Definition

                                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                  ShortMetadata about the resource
                                  Control0..1
                                  TypeMeta
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  6. Encounter.implicitRules
                                  Definition

                                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                  ShortA set of rules under which this content was created
                                  Comments

                                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                  Control0..1
                                  Typeuri
                                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  8. Encounter.language
                                  Definition

                                  The base language in which the resource is written.

                                  ShortLanguage of the resource content
                                  Comments

                                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                  Control0..1
                                  BindingThe codes SHOULD be taken from CommonLanguages
                                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                                  A human language.

                                  Additional BindingsPurpose
                                  AllLanguagesMax Binding
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  10. Encounter.text
                                  Definition

                                  A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                  ShortText summary of the resource, for human interpretation
                                  Comments

                                  Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                  Control0..1
                                  TypeNarrative
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesnarrative, html, xhtml, display
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  12. Encounter.contained
                                  Definition

                                  These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                  ShortContained, inline Resources
                                  Comments

                                  This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                  Control0..*
                                  TypeResource
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesinline resources, anonymous resources, contained resources
                                  14. Encounter.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 16. Encounter.extension:note
                                    Slice Namenote
                                    Definition

                                    Additional notes that apply to this resource or element.

                                    ShortEnconter note
                                    Comments

                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                    Control0..*
                                    TypeExtension(Note) (Extension Type: Annotation)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    18. Encounter.extension:legalStatus
                                    Slice NamelegalStatus
                                    Definition

                                    Legal status/situation at admission. This extension may be used for representing the basis on which the patient is staying in a healthcare organisation. This can be either voluntary or involuntary. A patient can also receive healthcare based on a forensic status. (voluntary, involuntary, admission by legal authority).

                                    ShortLegal status/situation at admission
                                    Control0..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Encounter: Legal Status) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    20. Encounter.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                    Summaryfalse
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    22. Encounter.identifier
                                    Definition

                                    Identifier(s) by which this encounter is known.

                                    ShortIdentifier(s) by which this encounter is known.
                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control0..*
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    24. Encounter.status
                                    Definition

                                    At the discharge report status of the encounter should be always = "finished"

                                    ShortStatus of this Hospital stay
                                    Comments

                                    Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

                                    Control1..1
                                    BindingThe codes SHALL be taken from In-patient Encounter Type Value Set
                                    (required to http://hl7.eu/fhir/hdr/ValueSet/encounter-status-eu-hdr)
                                    Typecode
                                    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    26. Encounter.statusHistory
                                    Definition

                                    The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.

                                    ShortList of past encounter statuses
                                    Comments

                                    The current status is always found in the current version of the resource, not the status history.

                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    28. Encounter.statusHistory.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    30. Encounter.statusHistory.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    32. Encounter.statusHistory.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                    Summarytrue
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content, modifiers
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    34. Encounter.statusHistory.status
                                    Definition

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

                                    Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
                                    Control1..1
                                    BindingThe codes SHALL be taken from EncounterStatus
                                    (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

                                    Current state of the encounter.

                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    36. Encounter.statusHistory.period
                                    Definition

                                    The time that the episode was in the specified status.

                                    ShortThe time that the episode was in the specified status
                                    Control1..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    38. Encounter.class
                                    Definition

                                    Concepts representing classification of inpatient encounter such as inpatient, emergency or others due to local variations.

                                    ShortClassification of patient encounter
                                    Control1..1
                                    BindingUnless not suitable, these codes SHALL be taken from Encounter Class Value Set
                                    (extensible to http://hl7.eu/fhir/hdr/ValueSet/hdr-encounterClass-eu-hdr)
                                    TypeCoding
                                    Is Modifierfalse
                                    Obligations
                                      ObligationsActor
                                      SHALL:handleHDRConsumer
                                      SHALL:able-to-populateHDRCreator
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      40. Encounter.classHistory
                                      Definition

                                      The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

                                      ShortList of past encounter classes
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      42. Encounter.classHistory.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      44. Encounter.classHistory.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      46. Encounter.classHistory.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      48. Encounter.classHistory.class
                                      Definition

                                      inpatient | outpatient | ambulatory | emergency +.

                                      Shortinpatient | outpatient | ambulatory | emergency +
                                      Control1..1
                                      BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
                                      (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

                                      Classification of the encounter.

                                      TypeCoding
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      50. Encounter.classHistory.period
                                      Definition

                                      The time that the episode was in the specified class.

                                      ShortThe time that the episode was in the specified class
                                      Control1..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      52. Encounter.type
                                      Definition

                                      Allows to classify encounter using information about care provision regimen during an inpatient encounter.

                                      ShortSpecific type of Hospital stay
                                      Comments

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

                                      Control0..*
                                      BindingFor example codes, see In-patient Encounter Type Value Set
                                      (example to http://hl7.eu/fhir/hdr/ValueSet/hdr-encounter-type-eu-hdr)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      54. Encounter.serviceType
                                      Definition

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

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

                                      Broad categorization of the service that is to be provided.

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

                                      Indicates the urgency of the encounter.

                                      ShortEncounter priority
                                      Control0..1
                                      BindingThe codes SHOULD be taken from Admission Urgency Value Set
                                      (preferred to http://hl7.eu/fhir/hdr/ValueSet/admission-urgency-eu-hdr)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      58. Encounter.subject
                                      Definition

                                      The patient or group present at the encounter.

                                      ShortThe patient present at the encounter
                                      Comments

                                      While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

                                      Control1..1
                                      TypeReference(Patient (EU core))
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActor
                                        SHALL:handleHDRConsumer
                                        SHALL:able-to-populateHDRCreator
                                        Summarytrue
                                        Alternate Namespatient
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        60. 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).

                                        ShortEpisode(s) of care that this encounter should be recorded against
                                        Control0..*
                                        TypeReference(EpisodeOfCare)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        62. Encounter.basedOn
                                        Definition

                                        The request this encounter satisfies (e.g. incoming referral or procedure request).

                                        ShortThe request for which this encounter has been made
                                        Control0..*
                                        TypeReference(ServiceRequest)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate NamesincomingReferral
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        64. Encounter.participant
                                        Definition

                                        Slice per type of participant: admitter, discharger,..

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

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          68. Encounter.participant.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          70. Encounter.participant.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          72. Encounter.participant.type
                                          Definition

                                          Role of participant in encounter.

                                          ShortRole of participant in encounter
                                          Comments

                                          The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

                                          Control0..*
                                          BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                                          Role of participant in encounter.

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

                                          The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                          ShortPeriod of time during the encounter that the participant participated
                                          Control0..1
                                          TypePeriod
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          76. Encounter.participant.individual
                                          Definition

                                          Persons involved in the encounter other than the patient.

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

                                          The list of people responsible for providing the service.

                                          ShortAdmitting professional
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:handleHDRConsumer
                                            SHOULD:able-to-populateHDRCreator
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            80. Encounter.participant:admitter.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            82. Encounter.participant:admitter.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            84. Encounter.participant:admitter.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            86. Encounter.participant:admitter.type
                                            Definition

                                            Role of participant in encounter.

                                            ShortRole of participant in encounter
                                            Comments

                                            The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

                                            Role of participant in encounter.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summarytrue
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                                "code" : "ADM"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            88. Encounter.participant:admitter.period
                                            Definition

                                            The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                            ShortPeriod of time during the encounter that the participant participated
                                            Control0..1
                                            TypePeriod
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            90. Encounter.participant:admitter.individual
                                            Definition

                                            Persons involved in the encounter other than the patient.

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

                                            The list of people responsible for providing the service.

                                            ShortDischarging professional
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Obligations
                                              ObligationsActor
                                              SHALL:handleHDRConsumer
                                              SHOULD:able-to-populateHDRCreator
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              94. Encounter.participant:discharger.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              96. Encounter.participant:discharger.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              98. Encounter.participant:discharger.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              100. Encounter.participant:discharger.type
                                              Definition

                                              Role of participant in encounter.

                                              ShortRole of participant in encounter
                                              Comments

                                              The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

                                              Role of participant in encounter.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summarytrue
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                                  "code" : "DIS"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              102. Encounter.participant:discharger.period
                                              Definition

                                              The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                              ShortPeriod of time during the encounter that the participant participated
                                              Control0..1
                                              TypePeriod
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              104. Encounter.participant:discharger.individual
                                              Definition

                                              Persons involved in the encounter other than the patient.

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

                                              The list of people responsible for providing the service.

                                              ShortReferring professional
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Obligations
                                                ObligationsActor
                                                SHALL:handleHDRConsumer
                                                SHOULD:able-to-populateHDRCreator
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                108. Encounter.participant:referrer.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                110. Encounter.participant:referrer.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                112. Encounter.participant:referrer.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                114. Encounter.participant:referrer.type
                                                Definition

                                                Role of participant in encounter.

                                                ShortRole of participant in encounter
                                                Comments

                                                The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

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

                                                Role of participant in encounter.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summarytrue
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                                    "code" : "REF"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                116. Encounter.participant:referrer.period
                                                Definition

                                                The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

                                                ShortPeriod of time during the encounter that the participant participated
                                                Control0..1
                                                TypePeriod
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                118. Encounter.participant:referrer.individual
                                                Definition

                                                Persons involved in the encounter other than the patient.

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

                                                The appointment that scheduled this encounter.

                                                ShortThe appointment that scheduled this encounter
                                                Control0..*
                                                TypeReference(Appointment)
                                                Is Modifierfalse
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                122. Encounter.period
                                                Definition

                                                The start and end time of this inpatient stay.

                                                ShortThe start and end time of this encounter.
                                                Comments

                                                If not (yet) known, the end of the Period may be omitted.

                                                Control0..1
                                                TypePeriod
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handleHDRConsumer
                                                  SHOULD:able-to-populateHDRCreator
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  124. Encounter.length
                                                  Definition

                                                  Quantity of time the encounter lasted. This excludes the time during leaves of absence.

                                                  ShortQuantity of time the encounter lasted (less time absent)
                                                  Comments

                                                  May differ from the time the Encounter.period lasted because of leave of absence.

                                                  Control0..1
                                                  TypeDuration
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  126. Encounter.reasonCode
                                                  Definition

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

                                                  ShortCoded reason the encounter takes place
                                                  Comments

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

                                                  Control0..*
                                                  BindingThe codes SHOULD be taken from Condition Value Set
                                                  (preferred to http://hl7.eu/fhir/hdr/ValueSet/condition-eu-hdr)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handleHDRConsumer
                                                    SHOULD:able-to-populateHDRCreator
                                                    Summarytrue
                                                    Alternate NamesIndication, Admission diagnosis
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    128. Encounter.reasonReference
                                                    Definition

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

                                                    ShortReason the encounter takes place (reference)
                                                    Comments

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

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

                                                    The list of diagnosis relevant to this encounter.

                                                    ShortThe list of diagnosis relevant to this encounter, see comment
                                                    Comments

                                                    While Encounter.diagnosis could be optionally populated, mainly for administrative purposes, we strongly recommend to put all clinical relevant diagnoses, stated at start, during and at the end of the hospital stay, into the corresponding section(s) of the HDR.

                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    132. Encounter.diagnosis.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    134. Encounter.diagnosis.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    136. Encounter.diagnosis.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    138. Encounter.diagnosis.condition
                                                    Definition

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

                                                    ShortThe diagnosis or procedure relevant to the encounter
                                                    Comments

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

                                                    Control1..1
                                                    TypeReference(Condition)
                                                    Is Modifierfalse
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handleHDRConsumer
                                                      SHOULD:able-to-populateHDRCreator
                                                      Summarytrue
                                                      Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      140. Encounter.diagnosis.use
                                                      Definition

                                                      Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

                                                      ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from DiagnosisRole
                                                      (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

                                                      The type of diagnosis this condition represents.

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

                                                      Ranking of the diagnosis (for each role type).

                                                      ShortRanking of the diagnosis (for each role type)
                                                      Control0..1
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      144. Encounter.account
                                                      Definition

                                                      The set of accounts that may be used for billing for this Encounter.

                                                      ShortThe set of accounts that may be used for billing for this Encounter
                                                      Comments

                                                      The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

                                                      Control0..*
                                                      TypeReference(Account)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      146. Encounter.hospitalization
                                                      Definition

                                                      Details about the admission to a healthcare service.

                                                      ShortDetails about the admission to a healthcare service
                                                      Comments

                                                      An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

                                                      The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      148. Encounter.hospitalization.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      150. Encounter.hospitalization.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      152. Encounter.hospitalization.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      154. Encounter.hospitalization.preAdmissionIdentifier
                                                      Definition

                                                      Pre-admission identifier.

                                                      ShortPre-admission identifier
                                                      Control0..1
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      156. Encounter.hospitalization.origin
                                                      Definition

                                                      The location/organization from which the patient came before admission.

                                                      ShortThe location/organization from which the patient came before admission
                                                      Control0..1
                                                      TypeReference(Location, Organization)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      158. Encounter.hospitalization.admitSource
                                                      Definition

                                                      From where patient was admitted (physician referral, transfer).

                                                      ShortFrom where patient was admitted (physician referral, transfer).
                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from AdmitSource
                                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-admit-source)

                                                      From where the patient was admitted.

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

                                                      Whether this hospitalization is a readmission and why if known.

                                                      ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
                                                      Control0..1
                                                      BindingFor example codes, see hl7VS-re-admissionIndicator
                                                      (example to http://terminology.hl7.org/ValueSet/v2-0092)

                                                      The reason for re-admission of this hospitalization encounter.

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

                                                      Diet preferences reported by the patient.

                                                      ShortDiet preferences reported by the patient
                                                      Comments

                                                      For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

                                                      Control0..*
                                                      BindingFor example codes, see Diet
                                                      (example to http://hl7.org/fhir/ValueSet/encounter-diet)

                                                      Medical, cultural or ethical food preferences to help with catering requirements.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      164. Encounter.hospitalization.specialCourtesy
                                                      Definition

                                                      Special courtesies (VIP, board member).

                                                      ShortSpecial courtesies (VIP, board member)
                                                      Control0..*
                                                      BindingThe codes SHOULD be taken from SpecialCourtesy
                                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

                                                      Special courtesies.

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

                                                      Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

                                                      ShortWheelchair, translator, stretcher, etc.
                                                      Control0..*
                                                      BindingThe codes SHOULD be taken from SpecialArrangements
                                                      (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

                                                      Special arrangements.

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

                                                      Location/organization to which the patient is discharged.

                                                      ShortLocation/organization to which the patient is discharged
                                                      Control0..1
                                                      TypeReference(Organization (EU core), Location (EU base))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      170. Encounter.hospitalization.dischargeDisposition
                                                      Definition

                                                      Category or kind of location after discharge.

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

                                                      Discharge Disposition.

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

                                                      List of locations where the patient has been during this encounter.

                                                      ShortLocations where the patient stayed
                                                      Comments

                                                      Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      174. Encounter.location.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      176. Encounter.location.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      178. Encounter.location.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      180. Encounter.location.location
                                                      Definition

                                                      The location where the encounter takes place.

                                                      ShortLocation the encounter takes place
                                                      Control1..1
                                                      TypeReference(Location (EU base))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      182. Encounter.location.status
                                                      Definition

                                                      The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.

                                                      Shortplanned | active | reserved | completed
                                                      Comments

                                                      When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

                                                      Control0..1
                                                      BindingThe codes SHALL be taken from EncounterLocationStatus
                                                      (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

                                                      The status of the location.

                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      184. Encounter.location.physicalType
                                                      Definition

                                                      This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

                                                      ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
                                                      Comments

                                                      This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

                                                      There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

                                                      Control0..1
                                                      BindingFor example codes, see LocationType
                                                      (example to http://hl7.org/fhir/ValueSet/location-physical-type)

                                                      Physical form of the location.

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

                                                      Time period during which the patient was present at the location.

                                                      ShortLocation period
                                                      Control0..1
                                                      TypePeriod
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      188. Encounter.serviceProvider
                                                      Definition

                                                      The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

                                                      ShortThe organization (facility) responsible for this encounter
                                                      Control0..1
                                                      TypeReference(Organization (EU core))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      190. Encounter.partOf
                                                      Definition

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

                                                      ShortAnother Encounter this encounter is part of
                                                      Comments

                                                      This is also used for associating a child's encounter back to the mother's encounter.

                                                      Refer to the Notes section in the Patient resource for further details.

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