Status: Active: Approved (STU)

Introduction

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

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

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

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

In addition as Must Support:

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

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

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

This structure is derived from CareConnect-Encounter-1

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:encounterTransport		0..0
extension:outcomeOfAttendance		0..0
extension:emergencyCareDischargeStatus		0..0
Slices for identifier		0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:localIdentifier	S	0..1	Identifier	Identifier(s) by which this encounter is known
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	S	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
classHistory		0..0
type		0..0
priority		0..0
subject	S	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
episodeOfCare		0..0
incomingReferral		0..0
participant		0..0
appointment		0..0
period	S	1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
reason		0..0
diagnosis		0..0
account		0..0
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
extension:admissionMethod	S	0..1	Extension-CareConnect-AdmissionMethod-1	An extension to the Encounter resource to record how a Patient was admitted to hospital.
extension:dischargeMethod	S	0..1	Extension-CareConnect-DischargeMethod-1	An extension to the Encounter resource to record the method of discharge from hospital.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
location		0..0
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
class	SΣ	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
id		0..0	string	xml:id (or equivalent in JSON)
extension		0..0	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
userSelected		0..0	boolean	If this coding was chosen directly by the user
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
admissionMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record how a Patient was admitted to hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1 Binding: NHS Data Model and Dictionary Admission Method (required): The method of admission to a Hospital Provider Spell.
dischargeMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record the method of discharge from hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DischargeMethod-1 Binding: NHS Data Model and Dictionary Discharge Method (required): The method of discharge from a Hospital Provider Spell.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (extensible)
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.meta.security	extensible	All Security Labels
Encounter.meta.tag	example	Common Tags
Encounter.meta.tag:Source	example	Common Tags
Encounter.meta.tag:Provenance	example	Common Tags
Encounter.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier:localIdentifier.use	required	IdentifierUse
Encounter.status	required	EncounterStatus
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type.coding:snomedCT	extensible	Care Connect Encounter Type
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.dietPreference	extensible	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Encounter.hospitalization.extension:admissionMethod, Encounter.hospitalization.extension:dischargeMethod	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
id		0..0	string	xml:id (or equivalent in JSON)
extension		0..0	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
userSelected		0..0	boolean	If this coding was chosen directly by the user
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
admissionMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record how a Patient was admitted to hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1 Binding: NHS Data Model and Dictionary Admission Method (required): The method of admission to a Hospital Provider Spell.
dischargeMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record the method of discharge from hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DischargeMethod-1 Binding: NHS Data Model and Dictionary Discharge Method (required): The method of discharge from a Hospital Provider Spell.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 Re-Admission Indicator (example): The reason for re-admission of this hospitalization encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (extensible)
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.meta.security	extensible	All Security Labels
Encounter.meta.tag	example	Common Tags
Encounter.meta.tag:Source	example	Common Tags
Encounter.meta.tag:Provenance	example	Common Tags
Encounter.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.identifier:localIdentifier.use	required	IdentifierUse
Encounter.identifier:localIdentifier.type	extensible	Identifier Type Codes
Encounter.status	required	EncounterStatus
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type.coding:snomedCT	extensible	Care Connect Encounter Type
Encounter.participant.type	extensible	ParticipantType
Encounter.diagnosis.role	preferred	DiagnosisRole
Encounter.hospitalization.preAdmissionIdentifier.use	required	IdentifierUse
Encounter.hospitalization.preAdmissionIdentifier.type	extensible	Identifier Type Codes
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.reAdmission	example	v2 Re-Admission Indicator
Encounter.hospitalization.dietPreference	extensible	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes
Encounter.location.status	required	EncounterLocationStatus

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Encounter.hospitalization.extension:admissionMethod, Encounter.hospitalization.extension:dischargeMethod	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from CareConnect-Encounter-1

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	S	0..1	id	Logical id of this artifact
meta
versionId	S	0..1	id	Version specific identifier
lastUpdated	S	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	S	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security		0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers
Slices for tag		0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system
tag:Source	S	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	S	1..1	code	The Data Provider Id of the system supplying the data
display	S	1..1	string	Name of the system supplying the data
tag:Provenance	S	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data
system		1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	S	1..1	code	The ODS Code of the organisation responsible for the data
display	S	1..1	string	Name of the organisation supplying the data
implicitRules		0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation)
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
extension:encounterTransport		0..0
extension:outcomeOfAttendance		0..0
extension:emergencyCareDischargeStatus		0..0
Slices for identifier		0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:localIdentifier	S	0..1	Identifier	Identifier(s) by which this encounter is known
system	S	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	S	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique
period		0..0
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
classHistory		0..0
type		0..0
priority		0..0
subject	S	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
episodeOfCare		0..0
incomingReferral		0..0
participant		0..0
appointment		0..0
period	S	1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Starting time with inclusive boundary
end	S	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
reason		0..0
diagnosis		0..0
account		0..0
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
extension:admissionMethod	S	0..1	Extension-CareConnect-AdmissionMethod-1	An extension to the Encounter resource to record how a Patient was admitted to hospital.
extension:dischargeMethod	S	0..1	Extension-CareConnect-DischargeMethod-1	An extension to the Encounter resource to record the method of discharge from hospital.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference		1..1	string	Reference to a resource (could be Contained)
identifier		0..1	Identifier	If relevant could include an id
display		1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
coding
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
display		1..1	string	Representation defined by the system
location		0..0
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
partOf		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
class	SΣ	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
id		0..0	string	xml:id (or equivalent in JSON)
extension		0..0	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
userSelected		0..0	boolean	If this coding was chosen directly by the user
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
admissionMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record how a Patient was admitted to hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1 Binding: NHS Data Model and Dictionary Admission Method (required): The method of admission to a Hospital Provider Spell.
dischargeMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record the method of discharge from hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DischargeMethod-1 Binding: NHS Data Model and Dictionary Discharge Method (required): The method of discharge from a Hospital Provider Spell.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (extensible)
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.meta.security	extensible	All Security Labels
Encounter.meta.tag	example	Common Tags
Encounter.meta.tag:Source	example	Common Tags
Encounter.meta.tag:Provenance	example	Common Tags
Encounter.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier:localIdentifier.use	required	IdentifierUse
Encounter.status	required	EncounterStatus
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type.coding:snomedCT	extensible	Care Connect Encounter Type
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.dietPreference	extensible	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Encounter.hospitalization.extension:admissionMethod, Encounter.hospitalization.extension:dischargeMethod	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	CareConnect-Encounter-1	An interaction during which services are provided to the patient
id	SΣ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
versionId	SΣ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	MANDATORY except in Contained Resources. When the resource version last changed.
profile	SΣ	0..*	uri	Profiles this resource claims to conform to. Should list (i) this profile (ii) underlying CareConnect profile
security	Σ	0..*	Coding	DISCOURAGED - may not be honoured by Data Consumers Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
Slices for tag	Σ	0..*	Coding	Tags applied to this resource Slice: Unordered, Open by value:system Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
tag:Source	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The Data Provider Id (and display text) of the system supplying the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Source
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The Data Provider Id of the system supplying the data
display	SΣ	1..1	string	Name of the system supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
tag:Provenance	SΣ	0..1	Coding	MANDATORY except in Contained Resources. The ODS Code (and display text) of the organisation responsible for the data Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: https://yhcr.nhs.uk/Provenance
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	The ODS Code of the organisation responsible for the data
display	SΣ	1..1	string	Name of the organisation supplying the data
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
implicitRules	?!Σ	0..1	uri	DISCOURAGED - may not be honoured by Data Consumers
language		0..1	code	English is assumed (not currently a multi-lingual implementation) Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	DISCOURAGED - the preferred approach is to offer structured data fields which a Data Consumer can then render and present in a manner most suited to its users
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known Slice: Unordered, Open by value:system
identifier:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
identifier:localIdentifier	SΣ	0..1	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Fixed Value: https://fhir.yhcr.nhs.uk/Id/local-encounter-identifier
value	SΣ	1..1	string	The Local encounter Identifier. Please prefix with ODS code plus period (XXX.) to ensure unique Example General: 123456
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of the encounter Binding: InterweaveEncounterClass (required) Fixed Value: As shown
id		0..0	string	xml:id (or equivalent in JSON)
extension		0..0	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.yhcr.nhs.uk/CodeSystem/Interweave-EncounterClass-1
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: GROUPING
display		1..1	string	Representation defined by the system Fixed Value: Grouping of related Encounters
userSelected		0..0	boolean	If this coding was chosen directly by the user
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
subject	SΣ	1..1	Reference(CareConnectPatient1)	The patient (NOT group) present at the encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	DISCOURAGED: This duplicates information that is already available via the Period
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
admissionMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record how a Patient was admitted to hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-AdmissionMethod-1 Binding: NHS Data Model and Dictionary Admission Method (required): The method of admission to a Hospital Provider Spell.
dischargeMethod	S	0..1	CodeableConcept	An extension to the Encounter resource to record the method of discharge from hospital. URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-DischargeMethod-1 Binding: NHS Data Model and Dictionary Discharge Method (required): The method of discharge from a Hospital Provider Spell.
medicallySafeForDischarge	S	0..1	(Complex)	Medically Safe for Discharge URL: https://fhir.yhcr.nhs.uk/StructureDefinition/Extension-Interweave-MedicallySafeForDischarge
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(CareConnect-Organization-1)	Organization that issued id (may be just text)
origin		0..1	Reference(CareConnect-Location-1)	The location from which the patient came before admission. Useful to provide if possible, in particular to reference a 'site' if transfered from another institution.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: Interweave Admission Source codes (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 Re-Admission Indicator (example): The reason for re-admission of this hospitalization encounter.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:snomedCT	Σ	0..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
snomedCTDescriptionID		0..*	(Complex)	The SNOMED CT Description ID for the display URL: https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
dietPreference		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: Diet (extensible)
specialCourtesy		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialCourtesy (preferred): Special courtesies
specialArrangement		0..*	CodeableConcept	DISCOURAGED: Relevant for managing the patient's stay, but less so for regional sharing Binding: SpecialArrangements (preferred): Special arrangements
destination	S	0..1	Reference(CareConnect-Location-1)	Location to which the patient is discharged. Important to provide if known to support discharge planning, and/or to reference a 'site' if transfered to another institution.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Reference to a resource (could be Contained)
identifier	Σ	0..1	Identifier	If relevant could include an id
display	Σ	1..1	string	Description of the referenced resource
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: Interweave Discharge Destination codes (required)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	1..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceProvider		0..1	Reference(CareConnect-Organization-1)	DISCOURAGED: This is instead covered via the provenance tags
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.meta.security	extensible	All Security Labels
Encounter.meta.tag	example	Common Tags
Encounter.meta.tag:Source	example	Common Tags
Encounter.meta.tag:Provenance	example	Common Tags
Encounter.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.identifier:localIdentifier.use	required	IdentifierUse
Encounter.identifier:localIdentifier.type	extensible	Identifier Type Codes
Encounter.status	required	EncounterStatus
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	required	Fixed Value: GROUPING("Grouping of related Encounters")
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type.coding:snomedCT	extensible	Care Connect Encounter Type
Encounter.participant.type	extensible	ParticipantType
Encounter.diagnosis.role	preferred	DiagnosisRole
Encounter.hospitalization.preAdmissionIdentifier.use	required	IdentifierUse
Encounter.hospitalization.preAdmissionIdentifier.type	extensible	Identifier Type Codes
Encounter.hospitalization.admitSource	required	Interweave Admission Source codes
Encounter.hospitalization.reAdmission	example	v2 Re-Admission Indicator
Encounter.hospitalization.dietPreference	extensible	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	required	Interweave Discharge Destination codes
Encounter.location.status	required	EncounterLocationStatus

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
ext-1	error	Encounter.hospitalization.extension:admissionMethod, Encounter.hospitalization.extension:dischargeMethod	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from CareConnect-Encounter-1

Summary

Mandatory: 9 elements (16 nested mandatory elements)
Must-Support: 26 elements
Fixed Value: 4 elements
Prohibited: 16 elements

Structures

This structure refers to these other structures:

• CareConnectPatient1 (https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1)

Extensions

This structure refers to these extensions:

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

Slices

This structure defines the following Slices:

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