IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

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Resource Profile: EpisodeOfCare: IDEA4RC

This profile defines how to represent the Hospital Patient Records model in FHIR for the purpose of the IDEA4RC project.

Usages:

• Use this Profile: Bundle: IDEA4RC
• Refer to this Profile: Encounter: IDEA4RC
• Examples for this Profile: EpisodeOfCare/episodeOfCare-id-13

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare		0..*	EpisodeOfCare	An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of the EpisodeOfCare Binding: EpisodeOfCareStatus (required): The status of the episode of care.
patient	Σ	1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization	Σ	1..1	Reference(Organization)	Organization that assumes care
display	Σ	1..1	string	Hospital Name
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
EpisodeOfCare.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	EpisodeOfCare	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from EpisodeOfCare

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare			EpisodeOfCare
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
status		1..1	code	Status of the EpisodeOfCare
diagnosis
condition		1..1	Reference(Condition: Primary Cancer)	Conditions/problems/diagnoses this episode of care is for
patient		1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization		1..1	Reference(Organization)	Organization that assumes care
display		1..1	string	Hospital Name
period
start		1..1	dateTime	First Contact Date
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare		0..*	EpisodeOfCare	An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business Identifier(s) relevant for this EpisodeOfCare
status	?!Σ	1..1	code	Status of the EpisodeOfCare Binding: EpisodeOfCareStatus (required): The status of the episode of care.
statusHistory		0..*	BackboneElement	Past list of status codes (the current status may be included to cover the start date of the status)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | waitlist | active | onhold | finished | cancelled | entered-in-error Binding: EpisodeOfCareStatus (required): The status of the episode of care.
period		1..1	Period	Duration the EpisodeOfCare was in the specified status
type	Σ	0..*	CodeableConcept	Type/class - e.g. specialist referral, disease management Binding: EpisodeOfCareType (example): The type of the episode of care.
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this episode of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition: Primary Cancer)	Conditions/problems/diagnoses this episode of care is for
role	Σ	0..1	CodeableConcept	Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	Σ	0..1	positiveInt	Ranking of the diagnosis (for each role type)
patient	Σ	1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization	Σ	1..1	Reference(Organization)	Organization that assumes care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Hospital Name
period	Σ	0..1	Period	Interval during responsibility is assumed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	1..1	dateTime	First Contact Date
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
referralRequest		0..*	Reference(ServiceRequest)	Originating Referral Request(s)
careManager		0..1	Reference(Practitioner | PractitionerRole)	Care manager/care coordinator for the patient
team		0..*	Reference(CareTeam)	Other practitioners facilitating this episode of care
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this EpisodeOfCare
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
EpisodeOfCare.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
EpisodeOfCare.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard
EpisodeOfCare.statusHistory.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard
EpisodeOfCare.type	example	EpisodeOfCareType http://hl7.org/fhir/ValueSet/episodeofcare-type|4.0.1 From the FHIR Standard
EpisodeOfCare.diagnosis.role	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role|4.0.1 From the FHIR Standard
EpisodeOfCare.managingOrganization.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	EpisodeOfCare	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 2 elements(1 nested mandatory element)

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)
• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare		0..*	EpisodeOfCare	An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	Status of the EpisodeOfCare Binding: EpisodeOfCareStatus (required): The status of the episode of care.
patient	Σ	1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization	Σ	1..1	Reference(Organization)	Organization that assumes care
display	Σ	1..1	string	Hospital Name
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
EpisodeOfCare.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	EpisodeOfCare	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from EpisodeOfCare

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare			EpisodeOfCare
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
status		1..1	code	Status of the EpisodeOfCare
diagnosis
condition		1..1	Reference(Condition: Primary Cancer)	Conditions/problems/diagnoses this episode of care is for
patient		1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization		1..1	Reference(Organization)	Organization that assumes care
display		1..1	string	Hospital Name
period
start		1..1	dateTime	First Contact Date
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
EpisodeOfCare		0..*	EpisodeOfCare	An association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:definedAt		0..1	boolean	Same custodian flag URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business Identifier(s) relevant for this EpisodeOfCare
status	?!Σ	1..1	code	Status of the EpisodeOfCare Binding: EpisodeOfCareStatus (required): The status of the episode of care.
statusHistory		0..*	BackboneElement	Past list of status codes (the current status may be included to cover the start date of the status)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | waitlist | active | onhold | finished | cancelled | entered-in-error Binding: EpisodeOfCareStatus (required): The status of the episode of care.
period		1..1	Period	Duration the EpisodeOfCare was in the specified status
type	Σ	0..*	CodeableConcept	Type/class - e.g. specialist referral, disease management Binding: EpisodeOfCareType (example): The type of the episode of care.
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this episode of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition: Primary Cancer)	Conditions/problems/diagnoses this episode of care is for
role	Σ	0..1	CodeableConcept	Role that this diagnosis has within the episode of care (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank	Σ	0..1	positiveInt	Ranking of the diagnosis (for each role type)
patient	Σ	1..1	Reference(Patient: IDEA4RC)	The patient who is the focus of this episode of care
managingOrganization	Σ	1..1	Reference(Organization)	Organization that assumes care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Hospital Name
period	Σ	0..1	Period	Interval during responsibility is assumed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	1..1	dateTime	First Contact Date
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
referralRequest		0..*	Reference(ServiceRequest)	Originating Referral Request(s)
careManager		0..1	Reference(Practitioner | PractitionerRole)	Care manager/care coordinator for the patient
team		0..*	Reference(CareTeam)	Other practitioners facilitating this episode of care
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this EpisodeOfCare
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
EpisodeOfCare.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
EpisodeOfCare.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard
EpisodeOfCare.statusHistory.status	required	EpisodeOfCareStatus http://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1 From the FHIR Standard
EpisodeOfCare.type	example	EpisodeOfCareType http://hl7.org/fhir/ValueSet/episodeofcare-type|4.0.1 From the FHIR Standard
EpisodeOfCare.diagnosis.role	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role|4.0.1 From the FHIR Standard
EpisodeOfCare.managingOrganization.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	EpisodeOfCare	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	EpisodeOfCare	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	EpisodeOfCare	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from EpisodeOfCare

Summary

Mandatory: 2 elements(1 nested mandatory element)

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)
• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/same-custodian-flag

Other representations of profile: CSV, Excel, Schematron