Scope and usage

This profile describes the MedComCoreEncounter. An encounter describes the interaction between a patient and one or more healthcare providers for the purpose of providing healthcare services or assessing the health status of a patient. An encounter can take place in an ambulatory, an emergency, at the citizen's home, virtually and so on.

The base expectations when describing an encounter in a Danish context is to include the subject of the encounter which shall be a MedComCorePatient as well as a status and class, which are described below. For some specific purposes, such as HospitalNotification, there is a need for a specialization of the MedComCoreEncounter. In these cases, it will be explicitly described which encounter to use and which changed are applied.

Please refer to the tab "Snapshot Table(Must support)" below for the definition of the required content of a MedComCoreEncounter.

Status and class

A status and class shall be included MedComCoreEncounter.

The status refers to the current state of the encounter. This will most often change due to the nature an encounter, as it will pass through many statuses which follows the workflow of the encounter. A status can be 'in-progress' describing that the patient is present or the meeting has begun, or 'finished' describing that the encounter is finished.

The class describes in which setting the encounter took place. A setting of the encounter can be 'emergency', 'ambulant' or 'inpatient'.

EpisodeOfCare identifier

The element Encounter.episodeOfCare may be included in MedComCoreEncounter.

The EpisodeOfCare identifier is used to technically connect several encounters concern the same meeting between a patient and one or more healthcare providers.

It is both possible to use a Landspatientregisteret-identifier (called LPR3-identifier) and a locally defined identifier as the EpisodeOfCare-identifier.

Whether a LPR3-identifier or a locally defined identifier is used, it shall be an UUID. The LPR3-identifier shall obey a rule stating that the UUID shall be of version 5, here more information about the LPR3-identifier can be found. Using a locally defined identifier, a system for the identifier shall be added.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SOΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Obligations Actor SHALL:in-narrative Producer of FHIR resources
class	SOΣ	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SOΣ	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	SOΣ	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.text.status	Base	required	NarrativeStatus	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Encounter.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Encounter.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
status	SO	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Obligations Actor SHALL:in-narrative Producer of FHIR resources
class	SO	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SO	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
episodeOfCare:lpr3identifier	S	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	O	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
account		0..0		The set of accounts that may be used for billing for this Encounter
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SOΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Obligations Actor SHALL:in-narrative Producer of FHIR resources
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SOΣ	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	Σ	0..*	CodeableConcept	Specific type of encounter Binding: EncounterType (example): The type of encounter.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	Σ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period		0..1	Period	Period of time during the encounter that the participant participated
individual	Σ	0..1	Reference(Practitioner | PractitionerRole | RelatedPerson)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	Σ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location		0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location		1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Encounter.text.status	Base	required	NarrativeStatus	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v6.5
Encounter.type	Base	example	Encounter type	📍4.0.1	FHIR Std.
Encounter.serviceType	Base	example	Service type	📍4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📍3.0.0	THO v6.5
Encounter.episodeOfCare.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.episodeOfCare:lpr3identifier.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.participant.​type	Base	extensible	Participant type	📍4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📍4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	preferred	Admit source	📍4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	example	hl7VS-re-admissionIndicator	📦2.0.0	THO v6.5
Encounter.hospitalization.​dietPreference	Base	example	Diet	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📍4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	example	Discharge disposition	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	example	Location type	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Encounter.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Encounter.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SOΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Obligations Actor SHALL:in-narrative Producer of FHIR resources
class	SOΣ	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SOΣ	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	SOΣ	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.text.status	Base	required	NarrativeStatus	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Encounter.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Encounter.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

Differential View

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
status	SO	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Obligations Actor SHALL:in-narrative Producer of FHIR resources
class	SO	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SO	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
episodeOfCare:lpr3identifier	S	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	O	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
account		0..0		The set of accounts that may be used for billing for this Encounter
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SOΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Obligations Actor SHALL:in-narrative Producer of FHIR resources
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SOΣ	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (3.0.0) (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	Σ	0..*	CodeableConcept	Specific type of encounter Binding: EncounterType (example): The type of encounter.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (3.0.0) (example): Indicates the urgency of the encounter.
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	0..1	Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SOΣ	1..1	Lpr3Identifier	Logical reference, when literal reference is not known Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Text alternative for the resource
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	Σ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period		0..1	Period	Period of time during the encounter that the participant participated
individual	Σ	0..1	Reference(Practitioner | PractitionerRole | RelatedPerson)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	Σ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location		0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location		1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	SO	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter Obligations Actor SHALL:in-narrative Producer of FHIR resources
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Encounter.text.status	Base	required	NarrativeStatus	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	required	MedComCoreEncounterClassCodes	📦2.0.0	DK MedCom Terminology v2.0
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📍3.0.0	THO v6.5
Encounter.type	Base	example	Encounter type	📍4.0.1	FHIR Std.
Encounter.serviceType	Base	example	Service type	📍4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📍3.0.0	THO v6.5
Encounter.episodeOfCare.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.episodeOfCare:lpr3identifier.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Encounter.participant.​type	Base	extensible	Participant type	📍4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📍4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	preferred	Admit source	📍4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	example	hl7VS-re-admissionIndicator	📦2.0.0	THO v6.5
Encounter.hospitalization.​dietPreference	Base	example	Diet	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📍4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	example	Discharge disposition	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	example	Location type	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
txt-1	error	Encounter.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes	htmlChecks()
txt-2	error	Encounter.text.div	The narrative SHALL have some non-whitespace content	htmlChecks()

This structure is derived from Encounter

Summary

Mandatory: 1 element(1 nested mandatory element)
Must-Support: 11 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• MedComCorePatient (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-patient)
• LPR3 Identifier (http://medcomfhir.dk/ig/core/StructureDefinition/lpr3-Identifier)
• MedComCoreOrganization (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-organization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Encounter.episodeOfCare