HL7 Europe Imaging Study Report
0.1.0-ballot - ci-build 150

HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/tree/master and changes regularly. See the Directory of published versions

Resource Profile: EncounterEu - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the EncounterEu resource profile.

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

0. Encounter
Definition

An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient. Encounter is primarily used to record information about the actual activities that occurred, where Appointment is used to record planned activities.

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

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

ShortA set of rules under which this content was created
Comments

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

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

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

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

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Encounter.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

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

    Additional notes that apply to this resource or element.

    ShortAdditional notes that apply to this resource or element.
    Comments

    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

    Control0..1
    TypeExtension(Note) (Extension Type: Annotation)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Encounter.extension:legalStatus
    Slice NamelegalStatus
    Definition

    Legal status/situation at admission. This extension may be used for representing the basis on which the patient is staying in a healthcare organisation. This can be either voluntary or involuntary. A patient can also receive healthcare based on a forensic status. (voluntary, involuntary, admission by legal authority).

    ShortEncounter: Legal Status
    Control0..1
    TypeExtension(Encounter: Legal Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Encounter.modifierExtension
    Definition

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

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

    ShortExtensions that cannot be ignored
    Comments

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

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

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

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

    The current state of the encounter (not the state of the patient within the encounter - that is subjectState).

    Shortplanned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
    Comments

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

    Control1..1
    BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|5.0.0
    (required to http://hl7.org/fhir/ValueSet/encounter-status|5.0.0)

    Current state of the encounter.

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

    Indicates the urgency of the encounter.

    ShortIndicates the urgency of the encounter
    Control0..1
    BindingThe codes SHOULD be taken from For example codes, see x_EncounterAdmissionUrgencyhttp://terminology.hl7.org/ValueSet/v3-ActPriority
    (preferred to http://terminology.hl7.org/ValueSet/v3-xEncounterAdmissionUrgency)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Encounter.type
    Definition

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

    ShortSpecific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
    Comments

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

    Control0..*
    BindingThe codes SHOULD be taken from For example codes, see ActEncounterCodehttp://hl7.org/fhir/ValueSet/encounter-type
    (preferred to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Encounter.partOf
    Definition

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

    ShortAnother Encounter this encounter is part of
    Comments

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

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

    Control0..1
    TypeReference(EU Encounter, Encounter)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Encounter.serviceProvider
    Definition

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

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

    The list of people responsible for providing the service.

    ShortList of participants involved in the encounter
    Comments

    Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
    enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
    SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ type
    • 26. Encounter.participant.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      Role of participant in encounter.

      ShortRole of participant in encounter
      Comments

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

      Control0..*
      This element is affected by the following invariants: enc-1, enc-2
      BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

      Role of participant in encounter.

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

      Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

      ShortThe individual, device, or service participating in the encounter
      Comments

      For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

      Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

      The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

      If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

      Control0..1
      This element is affected by the following invariants: enc-1, enc-2
      TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Encounter.participant:admitter
      Slice Nameadmitter
      Definition

      The list of people responsible for providing the service.

      ShortList of participants involved in the encounter
      Comments

      Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
      enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
      34. Encounter.participant:admitter.modifierExtension
      Definition

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      Role of participant in encounter.

      ShortRole of participant in encounter
      Comments

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

      Control10..*
      This element is affected by the following invariants: enc-1, enc-2
      BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
      (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

      Role of participant in encounter.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ coding
      • 38. Encounter.participant:admitter.type:participantCode
        Slice NameparticipantCode
        Definition

        Role of participant in encounter.

        ShortRole of participant in encounter
        Comments

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

        Control10..1*
        This element is affected by the following invariants: enc-1, enc-2
        BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
            "code" : "ADM"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Encounter.participant:admitter.actor
        Definition

        Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

        ShortThe individual, device, or service participating in the encounter
        Comments

        For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

        Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

        The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

        If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

        Control0..1
        This element is affected by the following invariants: enc-1, enc-2
        TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Encounter.participant:discharger
        Slice Namedischarger
        Definition

        The list of people responsible for providing the service.

        ShortList of participants involved in the encounter
        Comments

        Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
        enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
        44. Encounter.participant:discharger.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        Role of participant in encounter.

        ShortRole of participant in encounter
        Comments

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

        Control10..*
        This element is affected by the following invariants: enc-1, enc-2
        BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ coding
        • 48. Encounter.participant:discharger.type:participantCode
          Slice NameparticipantCode
          Definition

          Role of participant in encounter.

          ShortRole of participant in encounter
          Comments

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

          Control10..1*
          This element is affected by the following invariants: enc-1, enc-2
          BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

          Role of participant in encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code" : "DIS"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Encounter.participant:discharger.actor
          Definition

          Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

          ShortThe individual, device, or service participating in the encounter
          Comments

          For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

          Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

          The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

          If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

          Control0..1
          This element is affected by the following invariants: enc-1, enc-2
          TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Encounter.participant:referrer
          Slice Namereferrer
          Definition

          The list of people responsible for providing the service.

          ShortList of participants involved in the encounter
          Comments

          Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
          enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
          54. Encounter.participant:referrer.modifierExtension
          Definition

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

          Role of participant in encounter.

          ShortRole of participant in encounter
          Comments

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

          Control10..*
          This element is affected by the following invariants: enc-1, enc-2
          BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

          Role of participant in encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ coding
          • 58. Encounter.participant:referrer.type:participantCode
            Slice NameparticipantCode
            Definition

            Role of participant in encounter.

            ShortRole of participant in encounter
            Comments

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

            Control10..1*
            This element is affected by the following invariants: enc-1, enc-2
            BindingUnless not suitable, these codes SHALL be taken from ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
            (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

            Role of participant in encounter.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                "code" : "REF"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Encounter.participant:referrer.actor
            Definition

            Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

            ShortThe individual, device, or service participating in the encounter
            Comments

            For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

            Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

            The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

            If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

            Control0..1
            This element is affected by the following invariants: enc-1, enc-2
            TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

            0. Encounter
            2. Encounter.extension
            SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 4. Encounter.extension:note
              Slice Namenote
              Control0..1
              TypeExtension(Note) (Extension Type: Annotation)
              6. Encounter.extension:legalStatus
              Slice NamelegalStatus
              Control0..1
              TypeExtension(Encounter: Legal Status) (Extension Type: CodeableConcept)
              8. Encounter.priority
              BindingThe codes SHOULD be taken from x_EncounterAdmissionUrgency
              (preferred to http://terminology.hl7.org/ValueSet/v3-xEncounterAdmissionUrgency)
              10. Encounter.type
              BindingThe codes SHOULD be taken from ActEncounterCode
              (preferred to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)
              12. Encounter.partOf
              TypeReference(EU Encounter)
              14. Encounter.serviceProvider
              TypeReference(Organization (EU base))
              16. Encounter.participant
              SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ type
              • 18. Encounter.participant:admitter
                Slice Nameadmitter
                Control0..*
                20. Encounter.participant:admitter.type
                Control1..?
                SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ coding
                • 22. Encounter.participant:admitter.type:participantCode
                  Slice NameparticipantCode
                  Control1..1
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                      "code" : "ADM"
                    }]
                  }
                  24. Encounter.participant:discharger
                  Slice Namedischarger
                  Control0..*
                  26. Encounter.participant:discharger.type
                  Control1..?
                  SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ coding
                  • 28. Encounter.participant:discharger.type:participantCode
                    Slice NameparticipantCode
                    Control1..1
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                        "code" : "DIS"
                      }]
                    }
                    30. Encounter.participant:referrer
                    Slice Namereferrer
                    Control0..*
                    32. Encounter.participant:referrer.type
                    Control1..?
                    SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ coding
                    • 34. Encounter.participant:referrer.type:participantCode
                      Slice NameparticipantCode
                      Control1..1
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                          "code" : "REF"
                        }]
                      }

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

                      0. Encounter
                      Definition

                      An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient. Encounter is primarily used to record information about the actual activities that occurred, where Appointment is used to record planned activities.

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

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

                      ShortLogical id of this artifact
                      Comments

                      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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

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

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

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

                      ShortA set of rules under which this content was created
                      Comments

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

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

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      Comments

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

                      Control0..1
                      BindingThe codes SHALL be taken from AllLanguages
                      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                      IETF language tag for a human language

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

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

                      ShortText summary of the resource, for human interpretation
                      Comments

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

                      Control0..1
                      This element is affected by the following invariants: dom-6
                      TypeNarrative
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. Encounter.contained
                      Definition

                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                      ShortContained, inline Resources
                      Comments

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

                      Control0..*
                      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                      TypeResource
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. Encounter.extension
                      Definition

                      An Extension

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

                        Additional notes that apply to this resource or element.

                        ShortAdditional notes that apply to this resource or element.
                        Comments

                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                        Control0..1
                        TypeExtension(Note) (Extension Type: Annotation)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        18. Encounter.extension:legalStatus
                        Slice NamelegalStatus
                        Definition

                        Legal status/situation at admission. This extension may be used for representing the basis on which the patient is staying in a healthcare organisation. This can be either voluntary or involuntary. A patient can also receive healthcare based on a forensic status. (voluntary, involuntary, admission by legal authority).

                        ShortEncounter: Legal Status
                        Control0..1
                        TypeExtension(Encounter: Legal Status) (Extension Type: CodeableConcept)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        20. Encounter.modifierExtension
                        Definition

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

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

                        ShortExtensions that cannot be ignored
                        Comments

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

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

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

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

                        Identifier(s) by which this encounter is known.

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

                        The current state of the encounter (not the state of the patient within the encounter - that is subjectState).

                        Shortplanned | in-progress | on-hold | discharged | completed | cancelled | discontinued | entered-in-error | unknown
                        Comments

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

                        Control1..1
                        BindingThe codes SHALL be taken from EncounterStatus
                        (required to http://hl7.org/fhir/ValueSet/encounter-status|5.0.0)

                        Current state of the encounter.

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

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

                        ShortClassification of patient encounter context - e.g. Inpatient, outpatient
                        Control0..*
                        BindingThe codes SHOULD be taken from Encounter class
                        (preferred to http://terminology.hl7.org/ValueSet/encounter-class)

                        Classification of the encounter.

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

                        Indicates the urgency of the encounter.

                        ShortIndicates the urgency of the encounter
                        Control0..1
                        BindingThe codes SHOULD be taken from x_EncounterAdmissionUrgency
                        (preferred to http://terminology.hl7.org/ValueSet/v3-xEncounterAdmissionUrgency)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. Encounter.type
                        Definition

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

                        ShortSpecific type of encounter (e.g. e-mail consultation, surgical day-care, ...)
                        Comments

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

                        Control0..*
                        BindingThe codes SHOULD be taken from ActEncounterCode
                        (preferred to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        32. Encounter.serviceType
                        Definition

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

                        ShortSpecific type of service
                        Control0..*
                        BindingFor example codes, see ServiceType
                        (example to http://hl7.org/fhir/ValueSet/service-type)

                        Broad categorization of the service that is to be provided.

                        TypeCodeableReference(HealthcareService)
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        34. Encounter.subject
                        Definition

                        The patient or group related to this encounter. In some use-cases the patient MAY not be present, such as a case meeting about a patient between several practitioners or a careteam.

                        ShortThe patient or group related to this encounter
                        Comments

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

                        Control0..1
                        TypeReference(Patient, Group)
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Alternate Namespatient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        36. Encounter.subjectStatus
                        Definition

                        The subjectStatus value can be used to track the patient's status within the encounter. It details whether the patient has arrived or departed, has been triaged or is currently in a waiting status.

                        ShortThe current status of the subject in relation to the Encounter
                        Comments

                        Different use-cases are likely to have different permitted transitions between states, such as an Emergency department could use arrived when the patient first presents, then triaged once has been assessed by a nurse, then receiving-care once treatment begins, however other sectors may use a different set of these values, or their own custom set in place of this example valueset provided.

                        Control0..1
                        BindingFor example codes, see EncounterSubjectStatus
                        (example to http://hl7.org/fhir/ValueSet/encounter-subject-status)

                        Current status of the subject within the encounter.

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

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

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

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

                        ShortThe request that initiated this encounter
                        Control0..*
                        TypeReference(CarePlan, DeviceRequest, MedicationRequest, ServiceRequest)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate NamesincomingReferral
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. Encounter.careTeam
                        Definition

                        The group(s) of individuals, organizations that are allocated to participate in this encounter. The participants backbone will record the actuals of when these individuals participated during the encounter.

                        ShortThe group(s) that are allocated to participate in this encounter
                        Control0..*
                        TypeReference(CareTeam)
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        44. Encounter.partOf
                        Definition

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

                        ShortAnother Encounter this encounter is part of
                        Comments

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

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

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

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

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

                        The list of people responsible for providing the service.

                        ShortList of participants involved in the encounter
                        Comments

                        Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

                        Control0..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
                        enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
                        SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ type
                        • 50. Encounter.participant.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          52. Encounter.participant.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

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

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

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

                          Role of participant in encounter.

                          ShortRole of participant in encounter
                          Comments

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

                          Control0..*
                          This element is affected by the following invariants: enc-1, enc-2
                          BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                          Role of participant in encounter.

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

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

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

                          Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

                          ShortThe individual, device, or service participating in the encounter
                          Comments

                          For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

                          Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

                          The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

                          If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

                          Control0..1
                          This element is affected by the following invariants: enc-1, enc-2
                          TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          62. Encounter.participant:admitter
                          Slice Nameadmitter
                          Definition

                          The list of people responsible for providing the service.

                          ShortList of participants involved in the encounter
                          Comments

                          Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
                          enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
                          64. Encounter.participant:admitter.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          66. Encounter.participant:admitter.extension
                          Definition

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

                          ShortAdditional content defined by implementations
                          Comments

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

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

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

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

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

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

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

                          Role of participant in encounter.

                          ShortRole of participant in encounter
                          Comments

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

                          Control1..*
                          This element is affected by the following invariants: enc-1, enc-2
                          BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                          Role of participant in encounter.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ coding
                          • 72. Encounter.participant:admitter.type:participantCode
                            Slice NameparticipantCode
                            Definition

                            Role of participant in encounter.

                            ShortRole of participant in encounter
                            Comments

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

                            Control1..1
                            This element is affected by the following invariants: enc-1, enc-2
                            BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                            (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                            Role of participant in encounter.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                "code" : "ADM"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            74. Encounter.participant:admitter.period
                            Definition

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

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

                            Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

                            ShortThe individual, device, or service participating in the encounter
                            Comments

                            For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

                            Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

                            The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

                            If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

                            Control0..1
                            This element is affected by the following invariants: enc-1, enc-2
                            TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            78. Encounter.participant:discharger
                            Slice Namedischarger
                            Definition

                            The list of people responsible for providing the service.

                            ShortList of participants involved in the encounter
                            Comments

                            Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
                            enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
                            80. Encounter.participant:discharger.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            82. Encounter.participant:discharger.extension
                            Definition

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

                            ShortAdditional content defined by implementations
                            Comments

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

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

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

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            Role of participant in encounter.

                            ShortRole of participant in encounter
                            Comments

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

                            Control1..*
                            This element is affected by the following invariants: enc-1, enc-2
                            BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                            (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                            Role of participant in encounter.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ coding
                            • 88. Encounter.participant:discharger.type:participantCode
                              Slice NameparticipantCode
                              Definition

                              Role of participant in encounter.

                              ShortRole of participant in encounter
                              Comments

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

                              Control1..1
                              This element is affected by the following invariants: enc-1, enc-2
                              BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                              (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                              Role of participant in encounter.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summarytrue
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                  "code" : "DIS"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              90. Encounter.participant:discharger.period
                              Definition

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

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

                              Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

                              ShortThe individual, device, or service participating in the encounter
                              Comments

                              For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

                              Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

                              The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

                              If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

                              Control0..1
                              This element is affected by the following invariants: enc-1, enc-2
                              TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
                              Is Modifierfalse
                              Must Supportfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              94. Encounter.participant:referrer
                              Slice Namereferrer
                              Definition

                              The list of people responsible for providing the service.

                              ShortList of participants involved in the encounter
                              Comments

                              Any Patient or Group present in the participation.actor must also be the subject, though the subject may be absent from the participation.actor for cases where the patient (or group) is not present, such as during a case review conference.

                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supportfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              enc-1: A type must be provided when no explicit actor is specified (actor.exists() or type.exists())
                              enc-2: A type cannot be provided for a patient or group participant (actor.exists(resolve() is Patient or resolve() is Group) implies type.exists().not())
                              96. Encounter.participant:referrer.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              98. Encounter.participant:referrer.extension
                              Definition

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

                              ShortAdditional content defined by implementations
                              Comments

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

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

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

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

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

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

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

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

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

                              Role of participant in encounter.

                              ShortRole of participant in encounter
                              Comments

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

                              Control1..*
                              This element is affected by the following invariants: enc-1, enc-2
                              BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                              (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                              Role of participant in encounter.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Encounter.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ coding
                              • 104. Encounter.participant:referrer.type:participantCode
                                Slice NameparticipantCode
                                Definition

                                Role of participant in encounter.

                                ShortRole of participant in encounter
                                Comments

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

                                Control1..1
                                This element is affected by the following invariants: enc-1, enc-2
                                BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

                                Role of participant in encounter.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                                    "code" : "REF"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                106. Encounter.participant:referrer.period
                                Definition

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

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

                                Person involved in the encounter, the patient/group is also included here to indicate that the patient was actually participating in the encounter. Not including the patient here covers use cases such as a case meeting between practitioners about a patient - non contact times.

                                ShortThe individual, device, or service participating in the encounter
                                Comments

                                For planning purposes, Appointments may include a CareTeam participant to indicate that one specific person from the CareTeam will be assigned, but that assignment might not happen until the Encounter begins. Hence CareTeam is not included in Encounter.participant, as the specific individual should be assigned and represented as a Practitioner or other person resource.

                                Similarly, Location can be included in Appointment.participant to assist with planning. However, the patient location is tracked on the Encounter in the Encounter.location property to allow for additional metadata and history to be recorded.

                                The role of the participant can be used to declare what the actor will be doing in the scope of this encounter participation.

                                If the individual is not specified during planning, then it is expected that the individual will be filled in at a later stage prior to the encounter commencing.

                                Control0..1
                                This element is affected by the following invariants: enc-1, enc-2
                                TypeReference(Patient, Group, RelatedPerson, Practitioner, PractitionerRole, Device, HealthcareService)
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                110. Encounter.appointment
                                Definition

                                The appointment that scheduled this encounter.

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

                                Connection details of a virtual service (e.g. conference call).

                                ShortConnection details of a virtual service (e.g. conference call)
                                Comments

                                There are two types of virtual meetings that often exist:

                                • a persistent, virtual meeting room that can only be used for a single purpose at a time,
                                • and a dynamic virtual meeting room that is generated on demand for a specific purpose.

                                Implementers may consider using Location.virtualService for persistent meeting rooms.

                                If each participant would have a different meeting link, an extension using the VirtualServiceContactDetail can be applied to the Encounter.participant BackboneElement.

                                Control0..*
                                TypeVirtualServiceDetail
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                114. Encounter.actualPeriod
                                Definition

                                The actual start and end time of the encounter.

                                ShortThe actual start and end time of the encounter
                                Comments

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

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

                                The planned start date/time (or admission date) of the encounter.

                                ShortThe planned start date/time (or admission date) of the encounter
                                Control0..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                118. Encounter.plannedEndDate
                                Definition

                                The planned end date/time (or discharge date) of the encounter.

                                ShortThe planned end date/time (or discharge date) of the encounter
                                Control0..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                120. Encounter.length
                                Definition

                                Actual quantity of time the encounter lasted. This excludes the time during leaves of absence.

                                When missing it is the time in between the start and end values.

                                ShortActual quantity of time the encounter lasted (less time absent)
                                Comments

                                If the precision on these values is low (e.g. to the day only) then this may be considered was an all day (or multi-day) encounter, unless the duration is included, where that amount of time occurred sometime during the interval.

                                May differ from the time in Encounter.period due to leave of absence(s).

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

                                The list of medical reasons that are expected to be addressed during the episode of care.

                                ShortThe list of medical reasons that are expected to be addressed during the episode of care
                                Comments

                                The reason communicates what medical problem the patient has that should be addressed during the episode of care. This reason could be patient reported complaint, a clinical indication that was determined in a previous encounter or episode of care, or some planned care such as an immunization recommendation. In the case where you have a primary reason, but are expecting to also address other problems, you can list the primary reason with a use code of 'Chief Complaint', while the other problems being addressed would have a use code of 'Reason for Visit'.

                                Examples:

                                • pregnancy would use HealthcareService or a coding as the reason
                                • patient home monitoring could use Condition as the reason
                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                124. Encounter.reason.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                126. Encounter.reason.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                What the reason value should be used as e.g. Chief Complaint, Health Concern, Health Maintenance (including screening).

                                ShortWhat the reason value should be used for/as
                                Control0..*
                                BindingFor example codes, see EncounterReasonUse
                                (example to http://hl7.org/fhir/ValueSet/encounter-reason-use)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                132. Encounter.reason.value
                                Definition

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

                                ShortReason the encounter takes place (core or reference)
                                Control0..*
                                BindingThe codes SHOULD be taken from EncounterReasonCodes
                                (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

                                Reason why the encounter takes place.

                                TypeCodeableReference(Condition, DiagnosticReport, Observation, ImmunizationRecommendation, Procedure)
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Alternate NamesIndication, Admission diagnosis
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                134. Encounter.diagnosis
                                Definition

                                The list of diagnosis relevant to this encounter.

                                ShortThe list of diagnosis relevant to this encounter
                                Comments

                                Also note that for the purpose of billing, the diagnoses are recorded in the account where they can be ranked appropriately for how the invoicing/claiming documentation needs to be prepared.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                136. Encounter.diagnosis.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                138. Encounter.diagnosis.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                The coded diagnosis or a reference to a Condition (with other resources referenced in the evidence.detail), the use property will indicate the purpose of this specific diagnosis.

                                ShortThe diagnosis relevant to the encounter
                                Control0..*
                                BindingFor example codes, see ConditionProblemDiagnosisCodes
                                (example to http://hl7.org/fhir/ValueSet/condition-code)
                                TypeCodeableReference(Condition)
                                Is Modifierfalse
                                Must Supportfalse
                                Summarytrue
                                Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                144. Encounter.diagnosis.use
                                Definition

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

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

                                The type of diagnosis this condition represents.

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

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

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

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

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

                                Diet preferences reported by the patient.

                                ShortDiet preferences reported by the patient
                                Comments

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

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

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

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

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

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

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

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

                                Special arrangements.

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

                                Special courtesies that may be provided to the patient during the encounter (VIP, board member, professional courtesy).

                                ShortSpecial courtesies (VIP, board member)
                                Comments

                                Although the specialCourtesy property can contain values like VIP, the purpose of this field is intended to be used for flagging additional benefits that might occur for the patient during the encounter.

                                It could include things like the patient is to have a private room, special room features, receive a friendly visit from hospital adminisitration, or should be briefed on treatment by senior staff during the stay.

                                It is not specifically intended to be used for securing the specific record - that is the purpose of the security meta tag, and where appropriate, both fields could be used.

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

                                Special courtesies.

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

                                Details about the stay during which a healthcare service is provided.

                                This does not describe the event of admitting the patient, but rather any information that is relevant from the time of admittance until the time of discharge.

                                ShortDetails about the admission to a healthcare service
                                Comments

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

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

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

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                158. Encounter.admission.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                Pre-admission identifier.

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

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

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

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

                                ShortFrom where patient was admitted (physician referral, transfer)
                                Control0..1
                                BindingThe codes SHOULD be taken from AdmitSource
                                (preferred to http://hl7.org/fhir/ValueSet/encounter-admit-source)

                                From where the patient was admitted.

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

                                Indicates that this encounter is directly related to a prior admission, often because the conditions addressed in the prior admission were not fully addressed.

                                ShortIndicates that the patient is being re-admitted
                                Control0..1
                                BindingFor example codes, see hl7VS-re-admissionIndicator
                                (example to http://terminology.hl7.org/ValueSet/v2-0092)

                                The reason for re-admission of this admission encounter.

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

                                Location/organization to which the patient is discharged.

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

                                Category or kind of location after discharge.

                                ShortCategory or kind of location after discharge
                                Control0..1
                                BindingFor example codes, see DischargeDisposition
                                (example to http://hl7.org/fhir/ValueSet/encounter-discharge-disposition)

                                Discharge Disposition.

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

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

                                ShortList of locations where the patient has been
                                Comments

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

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

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                178. Encounter.location.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                The location where the encounter takes place.

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

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

                                Shortplanned | active | reserved | completed
                                Comments

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

                                Control0..1
                                BindingThe codes SHALL be taken from EncounterLocationStatus
                                (required to http://hl7.org/fhir/ValueSet/encounter-location-status|5.0.0)

                                The status of the location.

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

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

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

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

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

                                Control0..1
                                BindingFor example codes, see LocationForm
                                (example to http://hl7.org/fhir/ValueSet/location-form)

                                Physical form of the location.

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

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

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