Scope and usage

This profile is used as the Encounter resource for the HospitalNotification message. The HospitalNotificationEncounter inherits from the MedComCoreEncounter. Besides the references shown on the figure below, the MedComHospitalNotificationEncounter contains an episode of care identifier (Danish: forløbsid), a status describing the status of the encounter e.g., if the patient is onleave and the class of the admission, which can be either inpatient or emergency. Both status and class shall be included in all messages and depending on the status of the encounter, the status and class shall be assigned to different codes. Here you the find the combination of codes.

The HospitalNotification message is sent without patient consent, why only a limited data set is allowed to transmit due to Danish legislation. For this reason, is the HospitalNotificationEncounter profile quite narrow. More information about the legal aspects can be found here.

The figure below shows the references from a MedComHospitalNotificationEncounter.

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

Service Provider

The element Encounter.serviceProvider describes the organization or hospital department in charge of the patient's admission. The element references a MedComMessagingOrganization or MedComCoreOrganization, since MedComMessaigingOrganization inherits properties from MedComCoreOrganization.

The sender of a HospitalNotification (MessageHeader.sender) and the serviceProvider (Encounter.serviceProvider) may be the same hospital department, hence be represented referencing the same instance of a Organization resource, which shall be a MedComMessagingOrganization. However, the sender organisation may be a higher-level department (in the SOR register) than the serviceProvider organisation, and in this case they shall be represented referencing two different instances of a Organization resource.

​An example of different serviceProvider and sender organisation can be found here. Other examples will have the same organisation as serviceProvider and sender.

Episode of care identifier

The MedComHospitalNotificationEncounter profile requires at least one episode of care identifiers to be included, but allows more than one to be included. The episode of care identifier can be a locally defined UUID for the specific admission/contact or it can be an LPR3 identifier. The identifier is used for linking messages exchanged during a specific message flow. Hence, the episode of care identifier send and received in the initial HospitalNotification message must also be returned in e.g ReportOfAdmission (Danish: Indlæggelsesrapport), ProgressOfCarePlan (Danish: Plejeforløbsplan), CareCommunication (Danish: Korrespondancemeddelelse) etc.

In case only one episode of care identifier is included in the initial HospitalNotification message, either a locally defined UUID for the specific admission/contact or an LPR3 identifier: The following messages exchanged must apply/return this episode of care identifier, regardless of whether it is a locally defined UUID or an LPR3 identifier. If more identifiers are subsequently added, these can be ignored (or returned if possible).

In case more episode of care identifiers are included in the initial HospitalNotification message: The following messages exchanged must return the locally defined UUID for the specific admission/contact. The other identifiers can be ignored (or returned if possible).

System for locally defined episode of care identifiers

When a locally defined identifier for the specific admission/contact is included in a HospitalNotification message, a system for the identifier shall also be included. The system is used to destinguish between the LPR3 identifier and the locally defined identifier. The system is found at Encounter.episodeOfCare.identifier.system in the profile. The datatype of the system is Unique Resource Identifier Reference (uri), meaning that the system must be absolut or relative unique. It is recommended to use SOR-endpoint, which is also definied in the MessageHeader.source.endpoint. This is shown in the XML-snippet and examples below.

 <episodeOfCare>
    <identifier>
      <system value="https://sor2.sum.dsdn.dk/#id=265161000016000"/>
      <value value="bd481c38-a921-11ed-afa1-0242ac120002"/>
    </identifier>
  </episodeOfCare>

​A simplified example with two episode of care identifieres can be found here and a FHIR example with two episode of care identifieres can be found here Other examples will have just one episode of care identifier.

Timestamps

The Encounter profile contains four timestamps each representing a different time during a hospitalisation. Common for the four timestamps is that they represent the time of the event, e.g. the patient's physical attendance at the hospital (Encounter.period.start) or a patient going on leave from the hospital (Encounter.extension:leavePeriod.start).

Start and end of hospital stay

As described above, the timestamp of start and end of hospital stay are included in the elements Encounter.period.start and Encounter.period.end, respectively. Encounter.period.start shall always be present, also when sending a HospitalNotification describing a period of leave or end or hospital stay.

In cases where a patient is transferred to a hospital in the same region or in another region, or a hospitalisation changes from 'acute ambulant' to 'inpatient', a new start hospital stay HospitalNotification shall be sent. These three cases shall result in a new instance of the Encounter profile which has a new Encounter.period.start representing the time of the change in the hospitalisation. All cases are described in the Clinical guidelines for application.

Leave

To express the timestamps for a period of leave, the MedComHospitalNotificationLeavePeriodExtension shall be used.

When a patient goes on leave the Encounter.extension:leavePeriod.start shall be used, and when the patient returns from leave both Encounter.extension:leavePeriod.start and Encounter.extension:leavePeriod.end shall be present.

The cardinality of MedComHospitalNotificationLeavePeriodExtension is 0..1 meaning that only one period of leave can be included in a HospitalNotification to avoid confusion about which period of leave is the current. In case a patient goes on leave several times during the same hospitalisation, the period shall be described in separate HospitalNotifications, that are being sent when each period of leave occurs.

Death

When a patient dies either on arrival or during hospital stay, the timestamp Encounter.period.end represents the time the encounter ended i.e the time of death. The Encounter.period.start shall also be populated. If a patient dies on arrival Encounter.period.start shall be equal to Encounter.period.end, and if the patient dies during hospital stay Encounter.period.start shall represent the actual beginning of the hospital stay. A HospitalNotification can only be interpreted as describing a deceased patient when the element Patient.deaceased = 'true'.

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

This structure is derived from MedComCoreEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
status		1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
class		1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
type		0..0
serviceType		0..0
priority		0..0
episodeOfCare		1..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
reference		0..0
identifier		1..1	Identifier	Logical reference, when literal reference is not known
Slices for episodeOfCare				Content/Rules for all slices
episodeOfCare:lpr3identifier		0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
reference		0..0
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
basedOn		0..0
participant		0..0
appointment		0..0
period	S	1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Encounter start time.
end	S	0..1	dateTime	Encounter end time.
length		0..0
reasonCode		0..0
reasonReference		0..0
diagnosis		0..0
account		0..0	Reference(Account)
hospitalization		0..0
location		0..0
serviceProvider		1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
class	SΣ	1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	1..*	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	SΣ	1..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Encounter start time.
end	SΣC	0..1	dateTime	Encounter end time.
serviceProvider	S	1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SΣ	1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
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	SΣ	1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
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 (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	1..*	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
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	SΣ	1..1	Identifier	Logical reference, when literal reference is not known
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
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
display	Σ	0..1	string	Text alternative for the resource
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Encounter start time.
end	SΣC	0..1	dateTime	Encounter end time.
serviceProvider	S	1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.episodeOfCare.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.episodeOfCare:lpr3identifier.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition from the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

Differential View

This structure is derived from MedComCoreEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
status		1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
class		1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
type		0..0
serviceType		0..0
priority		0..0
episodeOfCare		1..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
reference		0..0
identifier		1..1	Identifier	Logical reference, when literal reference is not known
Slices for episodeOfCare				Content/Rules for all slices
episodeOfCare:lpr3identifier		0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
reference		0..0
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
basedOn		0..0
participant		0..0
appointment		0..0
period	S	1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Encounter start time.
end	S	0..1	dateTime	Encounter end time.
length		0..0
reasonCode		0..0
reasonReference		0..0
diagnosis		0..0
account		0..0	Reference(Account)
hospitalization		0..0
location		0..0
serviceProvider		1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
class	SΣ	1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	1..*	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	SΣ	1..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Encounter start time.
end	SΣC	0..1	dateTime	Encounter end time.
serviceProvider	S	1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter	C	0..*	MedComCoreEncounter	An interaction during which services are provided to the patient medcom-hospitalNotification-6: When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
leavePeriod	SΣ	0..1	Period	MedComHospitalNotificationLeavePeriodExtension URL: http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!SΣ	1..1	code	in-progress | onleave | finished | entered-in-error Binding: MedComHospitalNotificationEncounterStatusCodes (required)
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	SΣ	1..1	Coding	inpatient | emergency | other Binding: MedComHospitalNotificationEncounterClassCodes (required)
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 (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	1..*	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
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	SΣ	1..1	Identifier	Logical reference, when literal reference is not known
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
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Lpr3Identifier	An identifier intended for computation
display	Σ	0..1	string	Text alternative for the resource
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Encounter start time.
end	SΣC	0..1	dateTime	Encounter end time.
serviceProvider	S	1..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.status	required	MedComHospitalNotificationEncounterStatus http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterStatus
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	MedComHospitalNotificationEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-hospitalNotification-encounterClass
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.episodeOfCare.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.episodeOfCare:lpr3identifier.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition from the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-hospitalNotification-6	error	Encounter	When the status = 'onleave', the timestamp for beginning of a leave (extension.valuePeriod.start) shall be present. : where(status = 'onleave').extension.value.start.exists() or status != 'onleave'

This structure is derived from MedComCoreEncounter

Summary

Mandatory: 5 elements
Must-Support: 4 elements
Prohibited: 15 elements

Extensions

This structure refers to these extensions:

• http://medcomfhir.dk/ig/hospitalnotification/StructureDefinition/medcom-hospitalnotifiation-leave-period-extension