XpanDH Hospital Discharge Report
0.1.0 - ci-build 150

XpanDH Hospital Discharge Report, published by XpanDH 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/xpandh-hdr/ and changes regularly. See the Directory of published versions

Resource Profile: InpatientEncounterHDRXpandh - Detailed Descriptions

Draft as of 2024-11-05

Definitions for the inpatient-encounter-hdr-xpandh resource profile.

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

0. Encounter
2. Encounter.identifier
ShortIdentifier(s) by which this encounter is known.
NoteThis is a business identifier, not a resource identifier (see discussion)
4. Encounter.status
Definition

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

ShortStatus of this Hospital stay
BindingThe codes SHALL be taken from In-patient Encounter Type Value Set
(required to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/encounter-status-vs-eu-hdr)
6. Encounter.class
Definition

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

BindingUnless not suitable, these codes SHALL be taken from Encounter Class Value Set
(extensible to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-encounterClass-xpandh-vs)
8. Encounter.type
Definition

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

ShortSpecific type of Hospital stay
BindingFor example codes, see In-patient Encounter Type Value Set
(example to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-encounter-type-xpandh-vs)
10. Encounter.serviceType
ShortSpecific type of service.
12. Encounter.priority
ShortEncounter priority
BindingThe codes SHOULD be taken from Admission Urgency Value Set
(preferred to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-admission-urgency-xpandh-vs)
14. Encounter.subject
ShortThe pateint preesent at the encounter
Control1..?
TypeReference(Patient: HDR)
16. Encounter.basedOn
ShortThe request for which this encounter has been made
18. Encounter.participant
Definition

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

ShortList of participants involved in the encounters
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
  • 20. Encounter.participant.individual
    TypeReference(Practitioner, PractitionerRole, RelatedPerson)
    22. Encounter.participant:admitter
    Slice Nameadmitter
    ShortAdmitting professional
    Control0..*
    24. Encounter.participant:admitter.type
    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
        "code" : "ADM"
      }]
    }
    26. Encounter.participant:discharger
    Slice Namedischarger
    ShortDischarging professional
    Control0..*
    28. Encounter.participant:discharger.type
    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
        "code" : "DIS"
      }]
    }
    30. Encounter.participant:referrer
    Slice Namereferrer
    ShortReferring professional
    Control0..*
    32. Encounter.participant:referrer.type
    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
        "code" : "REF"
      }]
    }
    34. Encounter.period
    Definition

    The start and end time of this inpatient stay.

    ShortThe start and end time of this encounter.
    36. Encounter.reasonCode
    BindingThe codes SHOULD be taken from Condition Value Set
    (preferred to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-condition-xpandh-vs)
    38. Encounter.reasonReference
    TypeReference(Observation, Condition, Procedure)
    40. Encounter.diagnosis
    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.

    42. Encounter.hospitalization
    44. Encounter.hospitalization.admitSource
    ShortFrom where patient was admitted (physician referral, transfer).
    46. Encounter.hospitalization.destination
    TypeReference(Organization, Location)
    48. Encounter.location
    ShortLocations where the patient stayed
    50. Encounter.location.period
    ShortLocation period

    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.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())
    6. 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()))
    8. 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/ig/xpandh/hdr/ValueSet/encounter-status-vs-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()))
    10. 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/ig/xpandh/hdr/ValueSet/hdr-encounterClass-xpandh-vs)
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Encounter.type
    Definition

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


    Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).

    ShortSpecific type of Hospital staySpecific type of encounter
    Comments

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

    Control0..*
    BindingFor example codes, see In-patient Encounter Type Value Sethttp://hl7.org/fhir/ValueSet/encounter-type
    (example to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-encounter-type-xpandh-vs)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. 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 ServiceTypehttp://hl7.org/fhir/ValueSet/service-type
    (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()))
    16. Encounter.priority
    Definition

    Indicates the urgency of the encounter.

    ShortEncounter priorityIndicates the urgency of the encounter
    Control0..1
    BindingThe codes SHOULD be taken from For example codes, see Admission Urgency Value Sethttp://terminology.hl7.org/ValueSet/v3-ActPriority
    (preferred to http://hl7.eu/fhir/ig/xpandh/hdr/ValueSet/hdr-admission-urgency-xpandh-vs)
    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Encounter.subject
    Definition

    The patient or group present at the encounter.

    ShortThe pateint preesent 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: HDR, Patient, Group)
    Is Modifierfalse
    Summarytrue
    Alternate Namespatient
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Encounter.basedOn
    Definition

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

    ShortThe request for which this encounter has been madeThe ServiceRequest that initiated this encounter
    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()))
    22. 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
    • 24. 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())
      26. 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, PractitionerRole, RelatedPerson, Practitioner, PractitionerRole)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. 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
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. 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())
      32. 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()))
      34. 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
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. 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())
      38. 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()))
      40. 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
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. 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())
      44. 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()))
      46. 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
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. 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/ig/xpandh/hdr/ValueSet/hdr-condition-xpandh-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Alternate NamesIndication, Admission diagnosis
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. 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, ImmunizationRecommendation)
      Is Modifierfalse
      Summarytrue
      Alternate NamesIndication, Admission diagnosis
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. 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()))
      54. 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())
      56. 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, Procedure)
      Is Modifierfalse
      Summarytrue
      Alternate NamesAdmission diagnosis, discharge diagnosis, indication
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. Encounter.location
      Definition

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

      ShortLocations where the patient stayedList of locations where the patient has been
      Comments

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

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. 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())
      62. Encounter.location.location
      Definition

      The location where the encounter takes place.

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

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

      ShortLocation periodTime period during which the patient was present at the location
      Control0..1
      TypePeriod
      Is Modifierfalse
      Summaryfalse
      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
      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

      May be used to represent additional information that is not part of the basic definition of the resource. 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())
      16. Encounter.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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())
      18. 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()))
      20. 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/ig/xpandh/hdr/ValueSet/encounter-status-vs-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()))
      22. Encounter.statusHistory
      Definition

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

      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()))
      24. Encounter.statusHistory.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      26. 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())
      28. Encounter.statusHistory.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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.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()))
      32. 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()))
      34. 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/ig/xpandh/hdr/ValueSet/hdr-encounterClass-xpandh-vs)
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Encounter.classHistory
      Definition

      The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then 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()))
      38. Encounter.classHistory.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      40. 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())
      42. Encounter.classHistory.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element 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())
      44. 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()))
      46. 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()))
      48. 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/ig/xpandh/hdr/ValueSet/hdr-encounter-type-xpandh-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. 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()))
      52. 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/ig/xpandh/hdr/ValueSet/hdr-admission-urgency-xpandh-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. Encounter.subject
      Definition

      The patient or group present at the encounter.

      ShortThe pateint preesent 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: HDR)
      Is Modifierfalse
      Summarytrue
      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. 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()))
      58. 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()))
      60. 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
      • 62. 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
        64. 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())
        66. 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())
        68. 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()))
        70. 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()))
        72. 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, PractitionerRole, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Encounter.participant:admitter
        Slice Nameadmitter
        Definition

        The list of people responsible for providing the service.

        ShortAdmitting professional
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. 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
        78. 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())
        80. 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())
        82. 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()))
        84. 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()))
        86. 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, PractitionerRole, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Encounter.participant:discharger
        Slice Namedischarger
        Definition

        The list of people responsible for providing the service.

        ShortDischarging professional
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        90. 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
        92. 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())
        94. 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())
        96. 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()))
        98. 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()))
        100. 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, PractitionerRole, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Encounter.participant:referrer
        Slice Namereferrer
        Definition

        The list of people responsible for providing the service.

        ShortReferring professional
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. 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
        106. 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())
        108. 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())
        110. 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()))
        112. 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()))
        114. 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, PractitionerRole, RelatedPerson)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        116. 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()))
        118. 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
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. 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()))
        122. 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/ig/xpandh/hdr/ValueSet/hdr-condition-xpandh-vs)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        124. 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()))
        126. 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()))
        128. 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
        130. 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())
        132. 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())
        134. 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, Procedure)
        Is Modifierfalse
        Summarytrue
        Alternate NamesAdmission diagnosis, discharge diagnosis, indication
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. 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()))
        138. 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()))
        140. 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()))
        142. 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()))
        144. 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
        146. 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())
        148. 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())
        150. 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()))
        152. 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()))
        154. 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()))
        156. 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()))
        158. 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()))
        160. 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()))
        162. 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()))
        164. Encounter.hospitalization.destination
        Definition

        Location/organization to which the patient is discharged.

        ShortLocation/organization to which the patient is discharged
        Control0..1
        TypeReference(Organization, Location)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        166. 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()))
        168. 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()))
        170. 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
        172. 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())
        174. 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())
        176. Encounter.location.location
        Definition

        The location where the encounter takes place.

        ShortLocation the encounter takes place
        Control1..1
        TypeReference(Location)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        178. 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()))
        180. 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()))
        182. 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()))
        184. 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)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        186. 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()))