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Resource Profile: Episode - Detailed Descriptions

Draft as of 2025-09-13

Definitions for the lmdi-encounter resource profile.

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

0. Encounter
2. Encounter.text
Control0..0
4. Encounter.extension
SlicingThis element introduces a set of slices on Encounter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Encounter.extension:nprEpisodeIdentifier
    Slice NamenprEpisodeIdentifier
    Definition

    En eller flere unike identifikatorer (string og/eller UUID) som identifiserer episoden entydig i helseinstitusjonens systemer. Brukes ved rapportering til Norsk pasientregister (NPR). Kan inneholde både string-basert og UUID-basert identifikator samtidig.

    ShortUnik identifikator(er) for episoden, som brukes ved rapportering til NPR
    Control0..1
    TypeExtension(NPR Episode Identifier) (Complex Extension)
    Must Supporttrue
    8. Encounter.statusHistory
    Control0..0
    10. Encounter.classHistory
    Control0..0
    12. Encounter.type
    Control0..0
    14. Encounter.serviceType
    Control0..0
    16. Encounter.priority
    Control0..0
    18. Encounter.subject
    Control0..0
    20. Encounter.episodeOfCare
    Control0..0
    22. Encounter.basedOn
    Control0..0
    24. Encounter.participant
    Control0..0
    26. Encounter.appointment
    Control0..0
    28. Encounter.period
    Control0..0
    30. Encounter.length
    Control0..0
    32. Encounter.reasonCode
    Control0..0
    34. Encounter.reasonReference
    Control0..0
    36. Encounter.diagnosis
    Control0..0
    38. Encounter.account
    Control0..0
    40. Encounter.hospitalization
    Control0..0
    42. Encounter.location
    Control0..0
    44. Encounter.serviceProvider
    ShortSted for episoden
    TypeReference(Organisasjon)
    46. Encounter.partOf
    Control0..0

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

    0. Encounter
    Definition

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

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

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

    ShortA set of rules under which this content was created
    Comments

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

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

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

    ShortText summary of the resource, for human interpretation
    Comments

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

    Control0..01
    TypeNarrative
    Is Modifierfalse
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. Encounter.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

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

      En eller flere unike identifikatorer (string og/eller UUID) som identifiserer episoden entydig i helseinstitusjonens systemer. Brukes ved rapportering til Norsk pasientregister (NPR). Kan inneholde både string-basert og UUID-basert identifikator samtidig.

      ShortUnik identifikator(er) for episoden, som brukes ved rapportering til NPR
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(NPR Episode Identifier) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      npr-episode-at-least-one: Minst én NPR episode identifikator (string eller UUID) må oppgis (extension('stringIdentifier').exists() or extension('uuidIdentifier').exists())
      10. Encounter.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.

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

      ShortExtensions that cannot be ignored
      Comments

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

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

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

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. 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 determine the appropriate transitions that may occur between statuses (and also classes).

      Control1..1
      BindingThe codes SHALL be taken from EncounterStatushttp://hl7.org/fhir/ValueSet/encounter-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

      Current state of the encounter.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. 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..0*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      19. Encounter.class
      Definition

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

      ShortClassification of patient encounter
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from ActEncounterCodehttp://terminology.hl7.org/ValueSet/v3-ActEncounterCode
      (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

      Classification of the encounter.

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      21. 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 transitions 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 kind of discharge from emergency to inpatient.

      ShortList of past encounter classes
      Control0..0*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. 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..0*
      BindingFor example codes, see EncounterTypehttp://hl7.org/fhir/ValueSet/encounter-type|4.0.1
      (example to http://hl7.org/fhir/ValueSet/encounter-type|4.0.1)

      The type of encounter.

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

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

      ShortSpecific type of service
      Control0..01
      BindingFor example codes, see ServiceTypehttp://hl7.org/fhir/ValueSet/service-type|4.0.1
      (example to http://hl7.org/fhir/ValueSet/service-type|4.0.1)

      Broad categorization of the service that is to be provided.

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

      Indicates the urgency of the encounter.

      ShortIndicates the urgency of the encounter
      Control0..01
      BindingFor example codes, see ActPriorityhttp://terminology.hl7.org/ValueSet/v3-ActPriority
      (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

      Indicates the urgency of the encounter.

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

      The patient or group present at the encounter.

      ShortThe patient or group present at the encounter
      Comments

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

      Control0..01
      TypeReference(Patient, Group)
      Is Modifierfalse
      Summarytrue
      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. 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..0*
      TypeReference(EpisodeOfCare)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Encounter.basedOn
      Definition

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

      ShortThe ServiceRequest that initiated this encounter
      Control0..0*
      TypeReference(ServiceRequest)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesincomingReferral
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Encounter.participant
      Definition

      The list of people responsible for providing the service.

      ShortList of participants involved in the encounter
      Control0..0*
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      41. Encounter.appointment
      Definition

      The appointment that scheduled this encounter.

      ShortThe appointment that scheduled this encounter
      Control0..0*
      TypeReference(Appointment)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      43. 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..01
      TypePeriod
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      45. 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..01
      TypeDuration
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      47. Encounter.reasonCode
      Definition

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

      ShortCoded reason the encounter takes place
      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..0*
      BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason|4.0.1
      (preferred to http://hl7.org/fhir/ValueSet/encounter-reason|4.0.1)

      Reason why the encounter takes place.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Alternate NamesIndication, Admission diagnosis
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      49. Encounter.reasonReference
      Definition

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

      ShortReason the encounter takes place (reference)
      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..0*
      TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
      Is Modifierfalse
      Summarytrue
      Alternate NamesIndication, Admission diagnosis
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      51. Encounter.diagnosis
      Definition

      The list of diagnosis relevant to this encounter.

      ShortThe list of diagnosis relevant to this encounter
      Control0..0*
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      55. 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..0*
      TypeReference(Account)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      57. 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..01
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. 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..0*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. Encounter.serviceProvider
      Definition

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

      ShortSted for episodenThe organization (facility) responsible for this encounter
      Control0..1
      TypeReference(Organisasjon, Organization)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. 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..01
      TypeReference(Encounter)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

      0. Encounter
      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.

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

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

      ShortLogical id of this artifact
      Comments

      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
      Is Modifierfalse
      Summarytrue
      4. Encounter.meta
      Definition

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

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

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

      ShortA set of rules under which this content was created
      Comments

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

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

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

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

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

      A human language.

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

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

      ShortText summary of the resource, for human interpretation
      Comments

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

      Control0..0
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Encounter.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

      An Extension

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

        En eller flere unike identifikatorer (string og/eller UUID) som identifiserer episoden entydig i helseinstitusjonens systemer. Brukes ved rapportering til Norsk pasientregister (NPR). Kan inneholde både string-basert og UUID-basert identifikator samtidig.

        ShortUnik identifikator(er) for episoden, som brukes ved rapportering til NPR
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(NPR Episode Identifier) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        npr-episode-at-least-one: Minst én NPR episode identifikator (string eller UUID) må oppgis (extension('stringIdentifier').exists() or extension('uuidIdentifier').exists())
        18. Encounter.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

        Identifier(s) by which this encounter is known.

        ShortIdentifier(s) by which this encounter is known
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. 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 determine the appropriate transitions that may occur between statuses (and also classes).

        Control1..1
        BindingThe codes SHALL be taken from EncounterStatus
        (required to http://hl7.org/fhir/ValueSet/encounter-status|4.0.1)

        Current state of the encounter.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. 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..0
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        31. Encounter.class
        Definition

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

        ShortClassification of patient encounter
        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode
        (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode)

        Classification of the encounter.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        33. 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 transitions 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 kind of discharge from emergency to inpatient.

        ShortList of past encounter classes
        Control0..0
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. 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..0
        BindingFor example codes, see EncounterType
        (example to http://hl7.org/fhir/ValueSet/encounter-type|4.0.1)

        The type of encounter.

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

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

        ShortSpecific type of service
        Control0..0
        BindingFor example codes, see ServiceType
        (example to http://hl7.org/fhir/ValueSet/service-type|4.0.1)

        Broad categorization of the service that is to be provided.

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

        Indicates the urgency of the encounter.

        ShortIndicates the urgency of the encounter
        Control0..0
        BindingFor example codes, see ActPriority
        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

        Indicates the urgency of the encounter.

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

        The patient or group present at the encounter.

        ShortThe patient or group present at the encounter
        Comments

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

        Control0..0
        TypeReference(Patient, Group)
        Is Modifierfalse
        Summarytrue
        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. 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..0
        TypeReference(EpisodeOfCare)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Encounter.basedOn
        Definition

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

        ShortThe ServiceRequest that initiated this encounter
        Control0..0
        TypeReference(ServiceRequest)
        Is Modifierfalse
        Summaryfalse
        Alternate NamesincomingReferral
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Encounter.participant
        Definition

        The list of people responsible for providing the service.

        ShortList of participants involved in the encounter
        Control0..0
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Encounter.appointment
        Definition

        The appointment that scheduled this encounter.

        ShortThe appointment that scheduled this encounter
        Control0..0
        TypeReference(Appointment)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. 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..0
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. 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..0
        TypeDuration
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Encounter.reasonCode
        Definition

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

        ShortCoded reason the encounter takes place
        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..0
        BindingThe codes SHOULD be taken from EncounterReasonCodes
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason|4.0.1)

        Reason why the encounter takes place.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Encounter.reasonReference
        Definition

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

        ShortReason the encounter takes place (reference)
        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..0
        TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
        Is Modifierfalse
        Summarytrue
        Alternate NamesIndication, Admission diagnosis
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Encounter.diagnosis
        Definition

        The list of diagnosis relevant to this encounter.

        ShortThe list of diagnosis relevant to this encounter
        Control0..0
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. 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..0
        TypeReference(Account)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. 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..0
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. 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..0
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        103. Encounter.serviceProvider
        Definition

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

        ShortSted for episoden
        Control0..1
        TypeReference(Organisasjon)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        105. 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..0
        TypeReference(Encounter)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))