Status: DRAFT: For Review

Introduction

This profile describes the use of an Encounter resource to provide an overarching "Encounter Grouping". The purpose is to link together several underlying more detailed Encounters, thus representing the concept of a "visit", "stay", or "incident".

Please refer to the main Encounter Resource profile for a more complete description of the approach to modelling Encounters

The EncounterGrouping is a skeletal Encounter which requires a small number of mandatory fields:

• Class - a new class code of GROUPING is defined specifically to identify these overarching Encounters
• Status - mandatory in FHIR
• Period - the period of the overall "visit"
• Subject - the Patient involved

In addition as Must Support:

• Identifier - a local id if relevant
• Hospitalization - information about admission and discharge. (Collating together information already provided on the underlying Encounters). See the Encounter Resource Profile for further details of this structure.

Most other fields are removed, as this detail should instead be captured on the underlying Encounter records.

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

This structure is derived from UKCoreEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter			UKCoreEncounter
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
extension:emergencyCareDischargeStatus		0..0
extension:legalStatus		0..0
extension:OutcomeOfAttendance		0..0
Slices for identifier		0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	Identifier(s) by which this encounter is known.
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	S	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
class		1..1	Coding	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
system		1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
code		1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display		1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
classHistory		0..0
type		0..0
priority		0..0
subject		1..1	Reference(InterweavePatient)	The patient (NOT group) present at the encounter
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
episodeOfCare		0..0
basedOn		0..0
participant		0..0
appointment		0..0
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
reasonCode		0..0
reasonReference		0..0
diagnosis		0..0
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
Slices for extension				Content/Rules for all slices
extension:admissionMethod	S	0..1	ExtensionUKCoreAdmissionMethod	An extension to record how a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
origin		0..1	Reference(Location | Organization)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
location		0..0
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
Encounter.hospitalization.dischargeDisposition	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	UKCoreEncounter	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
dischargeMethod		0..1	CodeableConcept	An extension to support the method of discharge from a hospital. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod Binding: UK Core Discharge Method (extensible): The method by which a patient was discharged from hospital
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known.
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display	Σ	1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
subject	SΣ	1..1	Reference(InterweavePatient)	The patient (NOT group) present at the encounter
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
Slices for extension				Content/Rules for all slices
admissionMethod	S	0..1	CodeableConcept	An extension to record how a patient was admitted to hospital URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod Binding: UK Core Admission Method (extensible): The method by which a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
origin		0..1	Reference(Location | Organization)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements.
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
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	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG

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()

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	UKCoreEncounter	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dischargeMethod		0..1	CodeableConcept	An extension to support the method of discharge from a hospital. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod Binding: UK Core Discharge Method (extensible): The method by which a patient was discharged from hospital
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier: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
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown Binding: EncounterStatus (required): Current state of the encounter.
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	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display	Σ	1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: UK Core Care Setting Type (preferred): Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.
subject	SΣ	1..1	Reference(InterweavePatient)	The patient (NOT group) present at 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
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
admissionMethod	S	0..1	CodeableConcept	An extension to record how a patient was admitted to hospital URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod Binding: UK Core Admission Method (extensible): The method by which a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
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 from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
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	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
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	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements.
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
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	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Encounter.subject.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.origin.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
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.destination.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	preferred	UKCoreEncounterLocationType https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType from this IG

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()

Differential View

This structure is derived from UKCoreEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter			UKCoreEncounter
id	S	0..1	id	Logical id of this artifact
meta
id		0..0
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
version		0..0
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
id		0..0
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
version		0..0
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
extension:emergencyCareDischargeStatus		0..0
extension:legalStatus		0..0
extension:OutcomeOfAttendance		0..0
Slices for identifier		0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
assigner		0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	S	0..1	Identifier	Identifier(s) by which this encounter is known.
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	S	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
class		1..1	Coding	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
system		1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
code		1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display		1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
classHistory		0..0
type		0..0
priority		0..0
subject		1..1	Reference(InterweavePatient)	The patient (NOT group) present at the encounter
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
episodeOfCare		0..0
basedOn		0..0
participant		0..0
appointment		0..0
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
reasonCode		0..0
reasonReference		0..0
diagnosis		0..0
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
Slices for extension				Content/Rules for all slices
extension:admissionMethod	S	0..1	ExtensionUKCoreAdmissionMethod	An extension to record how a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
origin		0..1	Reference(Location | Organization)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
location		0..0
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
Encounter.hospitalization.dischargeDisposition	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	UKCoreEncounter	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
Slices for extension				Content/Rules for all slices
dischargeMethod		0..1	CodeableConcept	An extension to support the method of discharge from a hospital. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod Binding: UK Core Discharge Method (extensible): The method by which a patient was discharged from hospital
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known.
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display	Σ	1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
subject	SΣ	1..1	Reference(InterweavePatient)	The patient (NOT group) present at the encounter
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
Slices for extension				Content/Rules for all slices
admissionMethod	S	0..1	CodeableConcept	An extension to record how a patient was admitted to hospital URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod Binding: UK Core Admission Method (extensible): The method by which a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
origin		0..1	Reference(Location | Organization)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements.
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
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	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG

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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	UKCoreEncounter	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to. Should list (i) this profile (ii) base profile for this resource.
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://fhir.interweavedigital.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
dischargeMethod		0..1	CodeableConcept	An extension to support the method of discharge from a hospital. URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod Binding: UK Core Discharge Method (extensible): The method by which a patient was discharged from hospital
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known. Slice: Unordered, Open by value:system
identifier: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
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(InterweaveOrganization)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.interweavedigital.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	The status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown Binding: EncounterStatus (required): Current state of the encounter.
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	Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Binding: InterweaveEncounterClass (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://fhir.interweavedigital.nhs.uk/CodeSystem/Interweave-EncounterClass
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: GROUPING
display	Σ	1..1	string	Representation defined by the system Required Pattern: Grouping of related Encounters
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: UK Core Care Setting Type (preferred): Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.
subject	SΣ	1..1	Reference(InterweavePatient)	The patient (NOT group) present at 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
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
admissionMethod	S	0..1	CodeableConcept	An extension to record how a patient was admitted to hospital URL: https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod Binding: UK Core Admission Method (extensible): The method by which a patient was admitted to hospital
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
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 from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
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	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: InterweaveAdmissionSource (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
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	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements.
destination	S	0..1	Reference(Location | Organization)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
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	1..1	string	Reference to a resource (could be Contained)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: InterweaveDischargeDestination (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Source	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.meta.tag:Provenance	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.identifier:localIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier:localIdentifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	InterweaveEncounterClass https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-EncounterClass from this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.serviceType	preferred	UKCoreCareSettingType https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType from this IG
Encounter.subject.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.origin.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.hospitalization.admitSource	required	InterweaveAdmissionSource https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-AdmissionSource from this IG
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.destination.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	required	InterweaveDischargeDestination https://fhir.interweavedigital.nhs.uk/R4/ValueSet/Interweave-DischargeDestination from this IG
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	preferred	UKCoreEncounterLocationType https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType from this IG

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()

This structure is derived from UKCoreEncounter

Summary

Mandatory: 6 elements(18 nested mandatory elements)
Must-Support: 19 elements
Fixed: 3 elements
Prohibited: 21 elements

Structures

This structure refers to these other structures:

• InterweaveOrganization (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Organization)
• InterweavePatient (https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Interweave-Patient)

Extensions

This structure refers to these extensions:

• https://fhir.interweavedigital.nhs.uk/R4/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Encounter.meta.tag
• The element 1 is sliced based on the value of Encounter.identifier