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Resource Profile: Encounter: Outpatient

This StructureDefinition contains the maps for VistA file VISIT (9000010) to us-core-encounter.

Usages:

• Refer to this Profile: Debt Portal ChargeItem[charges], Diagnostic Report Note: Cytopathology DiagnosticReport, Diagnostic Report Note: Electron Microscopy DiagnosticReport, Diagnostic Report Note: Surgical Pathology DiagnosticReport... Show 5 more, Immunization Immunization, Procedure: Outpatient, Procedure: Radiology, Procedure: Surgery Procedure and Smoking Status Observation
• CapabilityStatements using this Profile: AMPL GUI, Lighthouse Clinical Health API, Lung Cancer Screening and Lighthouse Patient Health API

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile(5.0.1)	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
extension		0..0
url		1..1	uri	"http://va.gov/fhir/StructureDefinition/resource-serviceConnection"
value[x]	SC	0..1	Coding	Value of extension Binding: VSResourceServiceConnection (required) Constraints: eo-19-2035, eo-19-2036
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣC	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Constraints: eo-19-430, eo-19-431, eo-19-432
class	SΣ	1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
text	SΣ	0..1	string	Plain text representation of the concept
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
code	SΣ	0..1	code	Symbol in syntax defined by the system
subject	SΣ	1..1	Reference(Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
period	S	0..1	Period	The start and end time of the encounter
start	SΣC	0..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
code	SΣ	0..1	code	Symbol in syntax defined by the system
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile(5.0.1) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
Slices for location	S	0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
location:va-stop	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
location:va-loc	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.extension:resource-serviceConnection.value[x]	required	VSResourceServiceConnection http://va.gov/fhir/ValueSet/VSResourceServiceConnection From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition(a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter			USCoreEncounterProfile(5.0.1)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
value[x]	SC	0..1	Coding	Value of extension Constraints: eo-19-2035, eo-19-2036
identifier
system		1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value		1..1	string	The value that is unique
status	C	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Constraints: eo-19-430, eo-19-431, eo-19-432
class		1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
type		1..*	CodeableConcept	Specific type of encounter
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	S	0..1	code	Symbol in syntax defined by the system
display	S	0..1	string	Representation defined by the system
text	S	0..1	string	Plain text representation of the concept
serviceType
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
code	S	0..1	code	Symbol in syntax defined by the system
subject		1..1	Reference(Patient)	The patient or group present at the encounter
participant
type		0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period		0..1	Period	Period of time during the encounter that the participant participated
individual		0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
period
start	S	0..1	dateTime	Starting time with inclusive boundary
end	S	0..1	dateTime	End time with inclusive boundary, if not ongoing
reasonCode
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
code	S	0..1	code	Symbol in syntax defined by the system
diagnosis
condition	S	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
Slices for location		0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:va-stop		0..1	BackboneElement	List of locations where the patient has been
location		1..1	Reference(Location)	Location the encounter takes place
location:va-loc		0..1	BackboneElement	List of locations where the patient has been
location		1..1	Reference(Location)	Location the encounter takes place
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile(5.0.1)	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://va.gov/fhir/StructureDefinition/resource-serviceConnection"
value[x]	SC	0..1	Coding	Value of extension Binding: VSResourceServiceConnection (required) Constraints: eo-19-2035, eo-19-2036
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣC	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Constraints: eo-19-430, eo-19-431, eo-19-432
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile(5.0.1) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
Slices for location	S	0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
location:va-stop	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
location:va-loc	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.extension:resource-serviceConnection.value[x]	required	VSResourceServiceConnection http://va.gov/fhir/ValueSet/VSResourceServiceConnection From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition(a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard
Encounter.location:va-stop.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location:va-stop.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard
Encounter.location:va-loc.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location:va-loc.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 12 elements

Structures

This structure refers to these other structures:

• Patient (http://va.gov/fhir/StructureDefinition/Patient)
• Practitioner (http://va.gov/fhir/StructureDefinition/Practitioner)
• Condition: Encounter Diagnosis (http://va.gov/fhir/StructureDefinition/ConditionEncounterDiagnosis)
• Location (http://va.gov/fhir/StructureDefinition/Location)
• Organization (http://va.gov/fhir/StructureDefinition/Organization)

Extensions

This structure refers to these extensions:

• http://va.gov/fhir/StructureDefinition/resource-serviceConnection

Slices

This structure defines the following Slices:

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

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile(5.0.1)	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
extension		0..0
url		1..1	uri	"http://va.gov/fhir/StructureDefinition/resource-serviceConnection"
value[x]	SC	0..1	Coding	Value of extension Binding: VSResourceServiceConnection (required) Constraints: eo-19-2035, eo-19-2036
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣC	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Constraints: eo-19-430, eo-19-431, eo-19-432
class	SΣ	1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
text	SΣ	0..1	string	Plain text representation of the concept
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
code	SΣ	0..1	code	Symbol in syntax defined by the system
subject	SΣ	1..1	Reference(Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
period	S	0..1	Period	The start and end time of the encounter
start	SΣC	0..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
coding	Σ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
code	SΣ	0..1	code	Symbol in syntax defined by the system
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile(5.0.1) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
Slices for location	S	0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
location:va-stop	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
location:va-loc	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.extension:resource-serviceConnection.value[x]	required	VSResourceServiceConnection http://va.gov/fhir/ValueSet/VSResourceServiceConnection From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition(a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter			USCoreEncounterProfile(5.0.1)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
value[x]	SC	0..1	Coding	Value of extension Constraints: eo-19-2035, eo-19-2036
identifier
system		1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value		1..1	string	The value that is unique
status	C	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Constraints: eo-19-430, eo-19-431, eo-19-432
class		1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
type		1..*	CodeableConcept	Specific type of encounter
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	S	0..1	code	Symbol in syntax defined by the system
display	S	0..1	string	Representation defined by the system
text	S	0..1	string	Plain text representation of the concept
serviceType
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
code	S	0..1	code	Symbol in syntax defined by the system
subject		1..1	Reference(Patient)	The patient or group present at the encounter
participant
type		0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period		0..1	Period	Period of time during the encounter that the participant participated
individual		0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
period
start	S	0..1	dateTime	Starting time with inclusive boundary
end	S	0..1	dateTime	End time with inclusive boundary, if not ongoing
reasonCode
coding
system	S	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
code	S	0..1	code	Symbol in syntax defined by the system
diagnosis
condition	S	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
Slices for location		0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:va-stop		0..1	BackboneElement	List of locations where the patient has been
location		1..1	Reference(Location)	Location the encounter takes place
location:va-loc		0..1	BackboneElement	List of locations where the patient has been
location		1..1	Reference(Location)	Location the encounter takes place
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile(5.0.1)	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:resource-serviceConnection		0..1	(Complex)	Extension URL: http://va.gov/fhir/StructureDefinition/resource-serviceConnection
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://va.gov/fhir/StructureDefinition/resource-serviceConnection"
value[x]	SC	0..1	Coding	Value of extension Binding: VSResourceServiceConnection (required) Constraints: eo-19-2035, eo-19-2036
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Required Pattern: http://va.gov/identifiers/$Sta3n/9000010-15001
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣC	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Constraints: eo-19-430, eo-19-431, eo-19-432
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: encounterClass FHIR (required): see mapping VF_encounterClass
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://va.gov/terminology/VistADefinedTerms/9000010-.07
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: encounterParticipationType FHIR (required): see mapping VF_encounterParticipationType
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(Practitioner)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	Starting time with inclusive boundary
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: urn:see-termmap-in-mapParameter
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile S | US Core Condition Encounter Diagnosis Profile S | US Core Procedure Profile(5.0.1) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition: Encounter Diagnosis)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
Slices for location	S	0..*	BackboneElement	List of locations where the patient has been Slice: Unordered, Open by value:$this
location:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
location:va-stop	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
location:va-loc	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.extension:resource-serviceConnection.value[x]	required	VSResourceServiceConnection http://va.gov/fhir/ValueSet/VSResourceServiceConnection From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	required	EncounterClass http://va.gov/fhir/ValueSet/encounterClass From this IG
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	required	EncounterParticipationType http://va.gov/fhir/ValueSet/encounterParticipationType From this IG
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition(a valid code from http://www.nubc.org/patient-discharge) http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard
Encounter.location:va-stop.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location:va-stop.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard
Encounter.location:va-loc.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location:va-loc.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
eo-19-430	best practice	Encounter.status	If (9000010-.01) is null or > now then fixed value #planned : true
eo-19-431	best practice	Encounter.status	If (9000010-.01) is not null, < now, .18 null then fixed value #in-progress : true
eo-19-432	best practice	Encounter.status	If (9000010-.18) is not null, < now then fixed value #finished : true
eo-19-2035	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#SC "Service Connected" : true
eo-19-2036	best practice	Encounter.extension:resource-serviceConnection.value[x]	If (409.68-.1 > 409.1-.01) is Not SERVICE CONNECTED then fixed value http://va.gov/fhir/vistaDefinedTerms/409.1#NSC "Not Service Connected" : true
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 12 elements

Structures

This structure refers to these other structures:

• Patient (http://va.gov/fhir/StructureDefinition/Patient)
• Practitioner (http://va.gov/fhir/StructureDefinition/Practitioner)
• Condition: Encounter Diagnosis (http://va.gov/fhir/StructureDefinition/ConditionEncounterDiagnosis)
• Location (http://va.gov/fhir/StructureDefinition/Location)
• Organization (http://va.gov/fhir/StructureDefinition/Organization)

Extensions

This structure refers to these extensions:

• http://va.gov/fhir/StructureDefinition/resource-serviceConnection

Slices

This structure defines the following Slices:

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