Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: UKCoreEncounter - Detailed Descriptions

Active as of 2023-12-12

Definitions for the UKCore-Encounter resource profile.

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

0. Encounter
2. Encounter.extension
SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Encounter.extension:dischargeMethod
    Slice NamedischargeMethod
    Definition

    This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

    ShortAn extension to support the method of discharge from a hospital.
    Control0..1
    TypeExtension(Extension UK Core Discharge Method) (Extension Type: CodeableConcept)
    6. Encounter.extension:emergencyCareDischargeStatus
    Slice NameemergencyCareDischargeStatus
    Definition

    This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

    ShortAn extension to support the status of an individual on discharge from an Emergency Care Department.
    Control0..1
    TypeExtension(Extension UK Core Emergency Care Discharge Status) (Extension Type: CodeableConcept)
    8. Encounter.extension:legalStatus
    Slice NamelegalStatus
    Definition

    Information relating to a patient's legal status on admission or discharge.

    ShortInformation relating to a patient's legal status on admission or discharge.
    Control0..*
    TypeExtension(Extension UK Core Legal Status) (Complex Extension)
    10. Encounter.extension:OutcomeOfAttendance
    Slice NameOutcomeOfAttendance
    Definition

    This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

    ShortAn extension to support the outcome of an Outpatient attendance.
    Control0..1
    TypeExtension(Extension UK Core Outcome Of Attendance) (Extension Type: CodeableConcept)
    12. Encounter.identifier
    ShortIdentifier(s) by which this encounter is known.
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    14. Encounter.status
    ShortThe status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown
    Must Supporttrue
    16. Encounter.class
    ShortConcepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.
    Must Supporttrue
    18. Encounter.type
    BindingThe codes SHOULD be taken from UK Core Encounter Type
    (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType)

    A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record).

    20. Encounter.serviceType
    BindingThe codes SHOULD be taken from UK Core Care Setting Type
    (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType)

    Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.

    22. Encounter.subject
    ShortThe patient or group present at the encounter.
    Must Supporttrue
    24. Encounter.participant
    ShortThe list of people responsible for providing the service.
    Must Supporttrue
    26. Encounter.reasonCode
    ShortReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
    Must Supporttrue
    28. Encounter.reasonReference
    ShortReason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation.
    Must Supporttrue
    30. Encounter.hospitalization
    32. Encounter.hospitalization.extension
    SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 34. Encounter.hospitalization.extension:admissionMethod
      Slice NameadmissionMethod
      Definition

      This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.

      ShortAn extension to support the method by which an individual was admitted into hospital.
      Control0..1
      TypeExtension(Extension UK Core Admission Method) (Extension Type: CodeableConcept)
      36. Encounter.hospitalization.admitSource
      BindingThe codes SHOULD be taken from UK Core Source Of Admission
      (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-SourceOfAdmission)

      The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home.

      38. Encounter.hospitalization.dischargeDisposition
      BindingThe codes SHOULD be taken from UK Core Discharge Destination
      (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-DischargeDestination)

      The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth.

      40. Encounter.location
      42. Encounter.location.physicalType
      BindingThe codes SHOULD be taken from UK Core Encounter Location Type
      (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType)

      A set of codes that define the physical type of location where an encounter takes place.

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

      0. Encounter
      Definition

      An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

      ShortAn interaction during which services are provided to the patient
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate NamesVisit
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Encounter.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Encounter.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Encounter.extension:dischargeMethod
        Slice NamedischargeMethod
        Definition

        This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

        ShortAn extension to support the method of discharge from a hospital.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Discharge Method) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Encounter.extension:emergencyCareDischargeStatus
        Slice NameemergencyCareDischargeStatus
        Definition

        This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

        ShortAn extension to support the status of an individual on discharge from an Emergency Care Department.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Emergency Care Discharge Status) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. Encounter.extension:legalStatus
        Slice NamelegalStatus
        Definition

        Information relating to a patient's legal status on admission or discharge.

        ShortInformation relating to a patient's legal status on admission or discharge.
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Legal Status) (Complex Extension)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Encounter.extension:OutcomeOfAttendance
        Slice NameOutcomeOfAttendance
        Definition

        This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

        ShortAn extension to support the outcome of an Outpatient attendance.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Outcome Of Attendance) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Encounter.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. Encounter.identifier
        Definition

        Identifier(s) by which this encounter is known.

        ShortIdentifier(s) by which this encounter is known.
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Encounter.status
        Definition

        planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

        ShortThe status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknownplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
        Comments

        Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

        Control1..1
        BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

        Current state of the encounter.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Encounter.class
        Definition

        Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

        ShortConcepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.Classification of patient encounter
        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
        (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

        Classification of the encounter.

        TypeCoding
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Encounter.type
        Definition

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

        ShortSpecific type of encounter
        Comments

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

        Control0..*
        BindingThe codes SHOULD be taken from For example codes, see UK Core Encounter Typehttp://hl7.org/fhir/ValueSet/encounter-type
        (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType)

        A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record).


        The type of encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Encounter.serviceType
        Definition

        Broad categorization of the service that is to be provided (e.g. cardiology).

        ShortSpecific type of service
        Control0..1
        BindingThe codes SHOULD be taken from For example codes, see UK Core Care Setting Typehttp://hl7.org/fhir/ValueSet/service-type
        (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType)

        Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.


        Broad categorization of the service that is to be provided.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Encounter.subject
        Definition

        The patient or group present at the encounter.

        ShortThe patient or group present at the encounter.
        Comments

        While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

        Control0..1
        TypeReference(Patient, Group)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Encounter.participant
        Definition

        The list of people responsible for providing the service.

        ShortThe list of people responsible for providing the service.List of participants involved in the encounter
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Encounter.participant.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. Encounter.reasonCode
        Definition

        Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

        ShortReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.Coded reason the encounter takes place
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..*
        BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

        Reason why the encounter takes place.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Encounter.reasonReference
        Definition

        Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

        ShortReason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation.Reason the encounter takes place (reference)
        Comments

        For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

        Control0..*
        TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

        0. Encounter
        Definition

        An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.

        ShortAn interaction during which services are provided to the patient
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Alternate NamesVisit
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. Encounter.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

        Control0..1
        Typeid
        Is Modifierfalse
        Summarytrue
        4. Encounter.meta
        Definition

        The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Encounter.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Encounter.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Encounter.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Encounter.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. Encounter.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. Encounter.extension:dischargeMethod
          Slice NamedischargeMethod
          Definition

          This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital.

          ShortAn extension to support the method of discharge from a hospital.
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Discharge Method) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. Encounter.extension:emergencyCareDischargeStatus
          Slice NameemergencyCareDischargeStatus
          Definition

          This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department.

          ShortAn extension to support the status of an individual on discharge from an Emergency Care Department.
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Emergency Care Discharge Status) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          20. Encounter.extension:legalStatus
          Slice NamelegalStatus
          Definition

          Information relating to a patient's legal status on admission or discharge.

          ShortInformation relating to a patient's legal status on admission or discharge.
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Legal Status) (Complex Extension)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          22. Encounter.extension:OutcomeOfAttendance
          Slice NameOutcomeOfAttendance
          Definition

          This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance.

          ShortAn extension to support the outcome of an Outpatient attendance.
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Extension UK Core Outcome Of Attendance) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          24. Encounter.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. Encounter.identifier
          Definition

          Identifier(s) by which this encounter is known.

          ShortIdentifier(s) by which this encounter is known.
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Encounter.status
          Definition

          planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

          ShortThe status of this encounter: planned | arrived | triaged | in-progress | onleave | finished | cancelled | entered-in-error | unknown
          Comments

          Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).

          Control1..1
          BindingThe codes SHALL be taken from EncounterStatus
          (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

          Current state of the encounter.

          Typecode
          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Encounter.statusHistory
          Definition

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

          ShortList of past encounter statuses
          Comments

          The current status is always found in the current version of the resource, not the status history.

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

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

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

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          36. Encounter.statusHistory.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          38. Encounter.statusHistory.status
          Definition

          planned | arrived | triaged | in-progress | onleave | finished | cancelled +.

          Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
          Control1..1
          BindingThe codes SHALL be taken from EncounterStatus
          (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

          Current state of the encounter.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Encounter.statusHistory.period
          Definition

          The time that the episode was in the specified status.

          ShortThe time that the episode was in the specified status
          Control1..1
          TypePeriod
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Encounter.class
          Definition

          Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

          ShortConcepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
          (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

          Classification of the encounter.

          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Encounter.classHistory
          Definition

          The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.

          ShortList of past encounter classes
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Encounter.classHistory.id
          Definition

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

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

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          50. Encounter.classHistory.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          52. Encounter.classHistory.class
          Definition

          inpatient | outpatient | ambulatory | emergency +.

          Shortinpatient | outpatient | ambulatory | emergency +
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
          (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

          Classification of the encounter.

          TypeCoding
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Encounter.classHistory.period
          Definition

          The time that the episode was in the specified class.

          ShortThe time that the episode was in the specified class
          Control1..1
          TypePeriod
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. Encounter.type
          Definition

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

          ShortSpecific type of encounter
          Comments

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

          Control0..*
          BindingThe codes SHOULD be taken from UK Core Encounter Type
          (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterType)

          A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record).

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Encounter.serviceType
          Definition

          Broad categorization of the service that is to be provided (e.g. cardiology).

          ShortSpecific type of service
          Control0..1
          BindingThe codes SHOULD be taken from UK Core Care Setting Type
          (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-CareSettingType)

          Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Encounter.priority
          Definition

          Indicates the urgency of the encounter.

          ShortIndicates the urgency of the encounter
          Control0..1
          BindingFor example codes, see ActPriority
          (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

          Indicates the urgency of the encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Encounter.subject
          Definition

          The patient or group present at the encounter.

          ShortThe patient or group present at the encounter.
          Comments

          While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

          Control0..1
          TypeReference(Patient, Group)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Alternate Namespatient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Encounter.episodeOfCare
          Definition

          Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).

          ShortEpisode(s) of care that this encounter should be recorded against
          Control0..*
          TypeReference(EpisodeOfCare)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. Encounter.basedOn
          Definition

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

          ShortThe ServiceRequest that initiated this encounter
          Control0..*
          TypeReference(ServiceRequest)
          Is Modifierfalse
          Summaryfalse
          Alternate NamesincomingReferral
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Encounter.participant
          Definition

          The list of people responsible for providing the service.

          ShortThe list of people responsible for providing the service.
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Encounter.participant.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          72. Encounter.participant.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          74. Encounter.participant.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          76. Encounter.participant.type
          Definition

          Role of participant in encounter.

          ShortRole of participant in encounter
          Comments

          The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from ParticipantType
          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

          Role of participant in encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. Encounter.participant.period
          Definition

          The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.

          ShortPeriod of time during the encounter that the participant participated
          Control0..1
          TypePeriod
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Encounter.participant.individual
          Definition

          Persons involved in the encounter other than the patient.

          ShortPersons involved in the encounter other than the patient
          Control0..1
          TypeReference(Practitioner, PractitionerRole, RelatedPerson)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Encounter.appointment
          Definition

          The appointment that scheduled this encounter.

          ShortThe appointment that scheduled this encounter
          Control0..*
          TypeReference(Appointment)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. Encounter.period
          Definition

          The start and end time of the encounter.

          ShortThe start and end time of the encounter
          Comments

          If not (yet) known, the end of the Period may be omitted.

          Control0..1
          TypePeriod
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. Encounter.length
          Definition

          Quantity of time the encounter lasted. This excludes the time during leaves of absence.

          ShortQuantity of time the encounter lasted (less time absent)
          Comments

          May differ from the time the Encounter.period lasted because of leave of absence.

          Control0..1
          TypeDuration
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. Encounter.reasonCode
          Definition

          Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

          ShortReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control0..*
          BindingThe codes SHOULD be taken from EncounterReasonCodes
          (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

          Reason why the encounter takes place.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Alternate NamesIndication, Admission diagnosis
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. Encounter.reasonReference
          Definition

          Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.

          ShortReason the encounter takes place, expressed as a reference to a Condition, Procedure, Observation, or ImmunizationRecommendation.
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control0..*
          TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
          Is Modifierfalse
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          Summarytrue
          Alternate NamesIndication, Admission diagnosis
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. Encounter.diagnosis
          Definition

          The list of diagnosis relevant to this encounter.

          ShortThe list of diagnosis relevant to this encounter
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. Encounter.diagnosis.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          96. Encounter.diagnosis.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          98. Encounter.diagnosis.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          100. Encounter.diagnosis.condition
          Definition

          Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

          ShortThe diagnosis or procedure relevant to the encounter
          Comments

          For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

          Control1..1
          TypeReference(Condition, Procedure)
          Is Modifierfalse
          Summarytrue
          Alternate NamesAdmission diagnosis, discharge diagnosis, indication
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          102. Encounter.diagnosis.use
          Definition

          Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).

          ShortRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
          Control0..1
          BindingThe codes SHOULD be taken from DiagnosisRole
          (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role)

          The type of diagnosis this condition represents.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          104. Encounter.diagnosis.rank
          Definition

          Ranking of the diagnosis (for each role type).

          ShortRanking of the diagnosis (for each role type)
          Control0..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. Encounter.account
          Definition

          The set of accounts that may be used for billing for this Encounter.

          ShortThe set of accounts that may be used for billing for this Encounter
          Comments

          The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

          Control0..*
          TypeReference(Account)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. Encounter.hospitalization
          Definition

          Details about the admission to a healthcare service.

          ShortDetails about the admission to a healthcare service
          Comments

          An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

          The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

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

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

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          112. Encounter.hospitalization.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Encounter.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 114. Encounter.hospitalization.extension:admissionMethod
            Slice NameadmissionMethod
            Definition

            This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital.

            ShortAn extension to support the method by which an individual was admitted into hospital.
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension UK Core Admission Method) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            116. Encounter.hospitalization.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            118. Encounter.hospitalization.preAdmissionIdentifier
            Definition

            Pre-admission identifier.

            ShortPre-admission identifier
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Encounter.hospitalization.origin
            Definition

            The location/organization from which the patient came before admission.

            ShortThe location/organization from which the patient came before admission
            Control0..1
            TypeReference(Location, Organization)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. Encounter.hospitalization.admitSource
            Definition

            From where patient was admitted (physician referral, transfer).

            ShortFrom where patient was admitted (physician referral, transfer)
            Control0..1
            BindingThe codes SHOULD be taken from UK Core Source Of Admission
            (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-SourceOfAdmission)

            The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            124. Encounter.hospitalization.reAdmission
            Definition

            Whether this hospitalization is a readmission and why if known.

            ShortThe type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
            Control0..1
            BindingFor example codes, see hl7VS-re-admissionIndicator
            (example to http://terminology.hl7.org/ValueSet/v2-0092)

            The reason for re-admission of this hospitalization encounter.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Encounter.hospitalization.dietPreference
            Definition

            Diet preferences reported by the patient.

            ShortDiet preferences reported by the patient
            Comments

            For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

            Control0..*
            BindingFor example codes, see Diet
            (example to http://hl7.org/fhir/ValueSet/encounter-diet)

            Medical, cultural or ethical food preferences to help with catering requirements.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. Encounter.hospitalization.specialCourtesy
            Definition

            Special courtesies (VIP, board member).

            ShortSpecial courtesies (VIP, board member)
            Control0..*
            BindingThe codes SHOULD be taken from SpecialCourtesy
            (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy)

            Special courtesies.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            130. Encounter.hospitalization.specialArrangement
            Definition

            Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.

            ShortWheelchair, translator, stretcher, etc.
            Control0..*
            BindingThe codes SHOULD be taken from SpecialArrangements
            (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements)

            Special arrangements.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. Encounter.hospitalization.destination
            Definition

            Location/organization to which the patient is discharged.

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

            Category or kind of location after discharge.

            ShortCategory or kind of location after discharge
            Control0..1
            BindingThe codes SHOULD be taken from UK Core Discharge Destination
            (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-DischargeDestination)

            The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Encounter.location
            Definition

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

            ShortList of locations where the patient has been
            Comments

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

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

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            140. Encounter.location.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            142. Encounter.location.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            144. Encounter.location.location
            Definition

            The location where the encounter takes place.

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

            The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.

            Shortplanned | active | reserved | completed
            Comments

            When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

            Control0..1
            BindingThe codes SHALL be taken from EncounterLocationStatus
            (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

            The status of the location.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Encounter.location.physicalType
            Definition

            This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.

            ShortThe physical type of the location (usually the level in the location hierachy - bed room ward etc.)
            Comments

            This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.

            There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.

            Control0..1
            BindingThe codes SHOULD be taken from UK Core Encounter Location Type
            (preferred to https://fhir.hl7.org.uk/ValueSet/UKCore-EncounterLocationType)

            A set of codes that define the physical type of location where an encounter takes place.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Encounter.location.period
            Definition

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

            ShortTime period during which the patient was present at the location
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            152. Encounter.serviceProvider
            Definition

            The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.

            ShortThe organization (facility) responsible for this encounter
            Control0..1
            TypeReference(Organization)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            154. Encounter.partOf
            Definition

            Another Encounter of which this encounter is a part of (administratively or in time).

            ShortAnother Encounter this encounter is part of
            Comments

            This is also used for associating a child's encounter back to the mother's encounter.

            Refer to the Notes section in the Patient resource for further details.

            Control0..1
            TypeReference(Encounter)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))