RIVO-Noord Zorgviewer Implementation Guide
1.15.0 - sprint58 Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide - Local Development build (v1.15.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Encounter - Detailed Descriptions

Draft as of 2025-05-12

Definitions for the Encounter resource profile.

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

0. Encounter
Definition

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

ShortEncounterAn interaction during which services are provided to the patient
Control0..*
Alternate NamesVisit, Contact
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. 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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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 No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
6. Encounter.status
Definition

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

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

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

This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.

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

Current state of the encounter

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. Encounter.class
Definition

The type of contact.


inpatient | outpatient | ambulatory | emergency +.

ShortContactTypeinpatient | outpatient | ambulatory | emergency +
Control10..1
BindingUnless not suitable, these codes SHALL be taken from ContactTypeCodelijsthttp://hl7.org/fhir/ValueSet/v3-ActEncounterCode
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.1--20171231000000)

ContactTypeCodelijst


Classification of the encounter

TypeCoding
Summarytrue
Alternate NamesContactType
10. Encounter.subject
Definition

The patient ro group present at the encounter.

ShortThe patient ro group present at the encounter
Comments

While the encounter is always about the patient, the patient may 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).

Control10..1
TypeReference(nl-core-patient, Patient, Group)
Summarytrue
Alternate Namespatient

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

0. Encounter

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

0. Encounter
Definition

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

ShortEncounter
Control0..*
Alternate NamesVisit, Contact
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
2. Encounter.id
Definition

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

ShortLogical id of this artifact
Comments

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

Control0..1
Typeid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. Encounter.meta
Definition

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

ShortMetadata about the resource
Control0..1
TypeMeta
Summarytrue
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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
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
BindingUnless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
All LanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Encounter.text
Definition

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

ShortText summary of the resource, for human interpretation
Comments

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

Control0..1
This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
12. Encounter.contained
Definition

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

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

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

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

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
Alternate Namesextensions, user content
16. 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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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 No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
18. 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
Summarytrue
20. Encounter.status
Definition

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

Shortplanned | arrived | triaged | in-progress | onleave | finished | cancelled +
Comments

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

This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.

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

Current state of the encounter

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
22. Encounter.statusHistory
Definition

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

ShortList of past encounter statuses
Comments

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

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

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

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
26. Encounter.statusHistory.extension
Definition

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

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
Alternate Namesextensions, user content
28. Encounter.statusHistory.modifierExtension
Definition

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

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 No Modifier Reason provideed in previous versions of FHIR
Summarytrue
Alternate Namesextensions, user content, modifiers
30. Encounter.statusHistory.status
Definition

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

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

Current state of the encounter

Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. Encounter.statusHistory.period
Definition

The time that the episode was in the specified status.

ShortThe time that the episode was in the specified status
Control1..1
TypePeriod
34. Encounter.class
Definition

The type of contact.

ShortContactType
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ContactTypeCodelijst
(extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.1--20171231000000)

ContactTypeCodelijst

TypeCoding
Summarytrue
Alternate NamesContactType
36. Encounter.classHistory
Definition

The class history permits the tracking of the encounters transitions without needing to go through the resource history.

This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.

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

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

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
40. Encounter.classHistory.extension
Definition

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

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
Alternate Namesextensions, user content
42. Encounter.classHistory.modifierExtension
Definition

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

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 No Modifier Reason provideed in previous versions of FHIR
Summarytrue
Alternate Namesextensions, user content, modifiers
44. Encounter.classHistory.class
Definition

inpatient | outpatient | ambulatory | emergency +.

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

Classification of the encounter

TypeCoding
46. Encounter.classHistory.period
Definition

The time that the episode was in the specified class.

ShortThe time that the episode was in the specified class
Control1..1
TypePeriod
48. Encounter.type
Definition

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

ShortSpecific type of encounter
Comments

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

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

The type of encounter

TypeCodeableConcept
Summarytrue
50. Encounter.priority
Definition

Indicates the urgency of the encounter.

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

Indicates the urgency of the encounter.

TypeCodeableConcept
52. Encounter.subject
Definition

The patient ro group present at the encounter.

ShortThe patient ro group present at the encounter
Comments

While the encounter is always about the patient, the patient may 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).

Control1..1
TypeReference(nl-core-patient)
Summarytrue
Alternate Namespatient
54. 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(nl-core-episodeofcare)
Summarytrue
56. Encounter.incomingReferral
Definition

The referral request this encounter satisfies (incoming referral).

ShortThe ReferralRequest that initiated this encounter
Control0..*
TypeReference(ReferralRequest)
58. Encounter.participant
Definition

The list of people responsible for providing the service.

ShortList of participants involved in the encounter
Control0..*
TypeBackboneElement
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
60. 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.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
62. Encounter.participant.extension
Definition

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

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
Alternate Namesextensions, user content
64. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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 No Modifier Reason provideed in previous versions of FHIR
Summarytrue
Alternate Namesextensions, user content, modifiers
66. Encounter.participant.type
Definition

Role of participant in encounter.

ShortRole of participant in encounter
Comments

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

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

Role of participant in encounter

TypeCodeableConcept
Summarytrue
68. Encounter.participant.type.id
Definition

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

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
70. Encounter.participant.type.extension
Definition

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

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
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on Encounter.participant.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 72. Encounter.participant.type.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Summarytrue
    Requirements

    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

    SlicingThis element introduces a set of slices on Encounter.participant.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 74. Encounter.participant.type.coding:healthProfessionalRole
      Slice NamehealthProfessionalRole
      Definition

      The role the healthcare provider fulfils in the healthcare process. For healthcare providers, this could be for example main practitioner, referrer or general practitioner.

      ShortHealthProfessionalRole
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..*
      BindingThe codes SHALL be taken from ZorgverlenerRolCodelijst
      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20171231000000)
      TypeCoding
      Summarytrue
      Requirements

      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

      Alternate NamesZorgverlenerRol
      76. Encounter.participant.type.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

      78. Encounter.participant.period
      Definition

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

      ShortPeriod of time during the encounter that the participant participated
      Control0..1
      TypePeriod
      80. Encounter.participant.individual
      Definition

      The healthcare provider with whom the contact took place. The specialty and role of the healthcare provider can be entered in the HealthcareProvider information model as well.

      ShortContactWith
      Control0..1
      TypeReference(nl-core-relatedperson, nl-core-practitioner)
      Summarytrue
      Alternate NamesContactMet
      82. Encounter.participant.individual.id
      Definition

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

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      84. Encounter.participant.individual.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      SlicingThis element introduces a set of slices on Encounter.participant.individual.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 86. Encounter.participant.individual.extension:practitionerRole
        Slice NamepractitionerRole
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control0..1
        TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
        88. Encounter.participant.individual.reference
        Definition

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortLiteral reference, Relative, internal or absolute URL
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control0..1
        This element is affected by the following invariants: ref-1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        90. Encounter.participant.individual.identifier
        Definition

        An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Summarytrue
        92. Encounter.participant.individual.display
        Definition

        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        94. Encounter.appointment
        Definition

        The appointment that scheduled this encounter.

        ShortThe appointment that scheduled this encounter
        Control0..1
        TypeReference(Appointment)
        Summarytrue
        96. Encounter.period
        Definition

        The start and end time of the encounter.

        ShortThe start and end time of the encounter
        Comments

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

        Control0..1
        TypePeriod
        98. Encounter.period.id
        Definition

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

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        100. Encounter.period.extension
        Definition

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

        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
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Encounter.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 102. Encounter.period.start
          Definition

          The date and time at which the contact took place.

          ShortStartDateTime
          Comments

          If the low element is missing, the meaning is that the low boundary is not known.

          Control1..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesBeginDatumTijd
          104. Encounter.period.end
          Definition

          The date and time at which the contact ended. If the contact takes place over a period of time, this indicates the end of the period, in the case of an admission, for example.

          If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

          ShortEndDateTime
          Comments

          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesEindDatumTijd
          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
          106. Encounter.length
          Definition

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

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

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

          Control0..1
          TypeDuration
          108. Encounter.reason
          Definition

          A deviating result which serves as the reason for the contact.

          ShortDeviatingResult
          Comments

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

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

          Reason why the encounter takes place.

          TypeCodeableConcept
          Summarytrue
          Alternate NamesIndication, Admission diagnosis, AfwijkendeUitslag
          110. 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.

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          112. Encounter.reason.extension
          Definition

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

          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
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Encounter.reason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 114. Encounter.reason.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Summarytrue
            Requirements

            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

            116. Encounter.reason.text
            Definition

            A deviating result which serves as the reason for the contact.

            ShortDeviatingResult
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Alternate NamesAfwijkendeUitslag
            118. Encounter.diagnosis
            Definition

            The list of diagnosis relevant to this encounter.

            ShortThe list of diagnosis relevant to this encounter
            Control0..*
            TypeBackboneElement
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            120. 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.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            122. Encounter.diagnosis.extension
            Definition

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

            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
            Alternate Namesextensions, user content
            124. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            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 No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            126. Encounter.diagnosis.condition
            Definition

            The problem that led to the contact or the procedure carried out during the contact.

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

            ShortContactReason
            Comments

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

            Control1..1
            TypeReference(HCIM Procedure, HCIM Problem)
            Alternate NamesAdmission diagnosis, discharge diagnosis, indication, Probleem, Procedure
            128. Encounter.diagnosis.role
            Definition

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

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

            The type of diagnosis this condition represents

            TypeCodeableConcept
            130. Encounter.diagnosis.rank
            Definition

            Ranking of the diagnosis (for each role type).

            ShortRanking of the diagnosis (for each role type)
            Control0..1
            TypepositiveInt
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            132. 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)
            134. Encounter.hospitalization
            Definition

            Details about the admission to a healthcare service.

            ShortDetails about the admission to a healthcare service
            Comments

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

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

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

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

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            138. Encounter.hospitalization.extension
            Definition

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

            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
            Alternate Namesextensions, user content
            140. Encounter.hospitalization.modifierExtension
            Definition

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

            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 No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            142. Encounter.hospitalization.preAdmissionIdentifier
            Definition

            Pre-admission identifier.

            ShortPre-admission identifier
            Control0..1
            TypeIdentifier
            144. Encounter.hospitalization.origin
            Definition

            The location from which the patient came before admission.

            ShortThe location from which the patient came before admission
            Control0..1
            TypeReference(Location)
            146. Encounter.hospitalization.admitSource
            Definition

            Location from which the patient came before the encounter. In most cases this will only be used when the patient is admitted.

            ShortOrigin
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from HerkomstCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.2--20171231000000)

            HerkomstCodelijst

            TypeCodeableConcept
            Alternate NamesHerkomst
            148. Encounter.hospitalization.reAdmission
            Definition

            Whether this hospitalization is a readmission and why if known.

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

            The reason for re-admission of this hospitalization encounter.

            TypeCodeableConcept
            150. Encounter.hospitalization.dietPreference
            Definition

            Diet preferences reported by the patient.

            ShortDiet preferences reported by the patient
            Comments

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

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

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

            TypeCodeableConcept
            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.

            152. Encounter.hospitalization.specialCourtesy
            Definition

            Special courtesies (VIP, board member).

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

            Special courtesies

            TypeCodeableConcept
            154. Encounter.hospitalization.specialArrangement
            Definition

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

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

            Special arrangements

            TypeCodeableConcept
            156. Encounter.hospitalization.destination
            Definition

            Location to which the patient is discharged.

            ShortLocation to which the patient is discharged
            Control0..1
            TypeReference(Location)
            158. Encounter.hospitalization.dischargeDisposition
            Definition

            Location to which the patient will go after the encounter. In most cases this will only be used when the patient is discharged.

            ShortDestination
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from BestemmingCodelijst
            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.3--20171231000000)

            BestemmingCodelijst

            TypeCodeableConcept
            Alternate NamesBestemming
            160. 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
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            162. 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.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            164. Encounter.location.extension
            Definition

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

            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
            Alternate Namesextensions, user content
            166. 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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            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 No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            168. Encounter.location.location
            Definition

            The location where the encounter takes place.

            ShortLocation the encounter takes place
            Control1..1
            TypeReference(Location)
            170. Encounter.location.status
            Definition

            The status of the participants' presence at the specified location during the period specified. If the participant is 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)

            The status of the location.

            Typecode
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            172. 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
            174. Encounter.serviceProvider
            Definition

            The physical location at which the contact took place.

            ShortLocation
            Control0..1
            TypeReference(nl-core-organization)
            Alternate NamesLocatie
            176. Encounter.partOf
            Definition

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

            ShortAnother Encounter this encounter is part of
            Comments

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

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

            Control0..1
            TypeReference(Encounter)