Scope and usage

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

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

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

Status and class

A status and class shall be included MedComCoreEncounter.

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

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

EpisodeOfCare identifier

The element Encounter.episodeOfCare may be included in MedComCoreEncounter.

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

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

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

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

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required)
subject	S	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	S	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier		1..1	Lpr3Identifier	An identifier intended for computation
account		0..0
serviceProvider	S	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	MedComCoreEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-encounter-class

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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 patient encounter Binding: MedComCoreEncounterClassCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier		1..1	Lpr3Identifier	An identifier intended for computation
serviceProvider	S	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	MedComCoreEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-encounter-class

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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

Terminology Bindings

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

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
status	S	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class	S	1..1	Coding	Classification of patient encounter Binding: MedComCoreEncounterClassCodes (required)
subject	S	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	S	0..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	S	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier		1..1	Lpr3Identifier	An identifier intended for computation
account		0..0
serviceProvider	S	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	MedComCoreEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-encounter-class

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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 patient encounter Binding: MedComCoreEncounterClassCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	The patient or group present at the encounter
Slices for episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against Slice: Unordered, Open by value:identifier.system
episodeOfCare:All Slices				Content/Rules for all slices
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
episodeOfCare:lpr3identifier	SΣ	0..1	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
identifier		1..1	Lpr3Identifier	An identifier intended for computation
serviceProvider	S	0..1	Reference(MedComCoreOrganization) {b}	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	required	MedComCoreEncounterClass http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-encounter-class

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

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

Terminology Bindings

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

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Encounter

Summary

Mandatory: 1 element(1 nested mandatory element)
Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

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

Slices

This structure defines the following Slices:

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