Advance Care Planning (PZP)
1.0.0-rc1 - trial-use

This page is part of the Advance Care Planning (PZP) (v1.0.0-rc1: Release 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Resource Profile: ACPEncounter - Detailed Descriptions

Draft as of 2025-10-30

Definitions for the ACP-Encounter resource profile.

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

0. Encounter
Definition

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

ShortEncounterAn interaction during which services are provided to the patient
Control0..*
Is Modifierfalse
Alternate NamesVisit, Contact, nl-core-Encounter
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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 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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-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
This element is affected by the following invariants: ele-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()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
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 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..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
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())
ele-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.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Encounter.status
    Definition

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

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

    This element is implictly mapped to the zib concepts NL-CM:15.1.3 (StartDateTime) and NL-CM:15.1.4 (EndDateTime). Unless the status is explicitly recorded, the following guidance applies:

    • When StartDateTime is in the future, .status will usually be set to planned.
    • When StartDateTime is in the past and EndDateTime is present and in the future, .status will usually be set to in-progress.
    • When EndDateTime is present and in the past, .status will usually be set to finished.
    • When EndDateTime is not present, this means it was a point-in-time encounter and .status will usually be set to finished.
    • When a system is unable to infer the status from the StartDateTime and EndDateTime, .status will be set to unknown.

    The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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


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

    Control1..1
    This element is affected by the following invariants: ele-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()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Encounter.class
    Definition

    The type of contact.


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

    ShortContactTypeClassification of patient encounter
    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.

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode (3.0.0)http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
    (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)

    Use ConceptMap ContactTypeCodeLijst-to-ActEncounterCode to translate terminology from the functional model to profile terminology in ValueSet ActEncounterCode.


    Classification of the encounter.

    TypeCoding
    Is Modifierfalse
    Summarytrue
    Alternate NamesContactType
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. 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..1
    This element is affected by the following invariants: ele-1
    TypeReference(Patient, Patient, Group)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:populate-if-knownACP Actor Provider
      SHALL:no-errorACP Actor Consulter
      Summarytrue
      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Encounter.participant
      Definition

      The list of people responsible for providing the service.

      ShortList of participants involved in the encounter
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeBackboneElement
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ individual.resolve()
      • 14. Encounter.participant.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

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

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

        The list of people responsible for providing the service.

        ShortList of participants involved in the encounter
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Is Modifierfalse
        Obligations
          ObligationsActor
          SHALL:populate-if-knownACP Actor Provider
          SHALL:no-errorACP Actor Consulter
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. Encounter.participant:healthProfessional.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

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

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

          The role the health professional fulfils in the healthcare process. For health professionals, this could be for example attender, referrer or performer.


          Role of participant in encounter.

          ShortHealthProfessionalRoleRole of participant in encounter
          Comments

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

          Control0..1*
          This element is affected by the following invariants: ele-1
          BindingUnless not suitable, these codes SHALL be taken from ZorgverlenerRolCodelijst (2020-09-01T00:00:00)http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1
          (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20200901000000|2020-09-01T00:00:00)

          Role of participant in encounter.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Alternate NamesZorgverlenerRol
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Encounter.participant:healthProfessional.individual
          Definition

          The health professional with whom the contact took or will take place. The specialty and role of the health professional can be entered in the HealthProfessional information model.


          Persons involved in the encounter other than the patient.

          ShortContactWithPersons involved in the encounter other than the patient
          Comments

          Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

          In rare circumstances, there is only a Practitioner instance, in which case it is that instance which can be referenced on the Encounter.participant element (due to open slicing). Since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeReference(HealthProfessional PractitionerRole, Practitioner, PractitionerRole, RelatedPerson)
          Is Modifierfalse
          Summarytrue
          Alternate NamesContactMet
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Encounter.participant:contactPerson
          Slice NamecontactPerson
          Definition

          The list of people responsible for providing the service.

          ShortList of participants involved in the encounter
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:populate-if-knownACP Actor Provider
            SHALL:no-errorACP Actor Consulter
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Encounter.participant:contactPerson.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

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

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

            Persons involved in the encounter other than the patient.

            ShortPersons involved in the encounter other than the patient
            Comments

            References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeReference(ContactPerson, Practitioner, PractitionerRole, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. 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..*
            This element is affected by the following invariants: ele-1
            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()))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Encounter.reasonCode. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • exists @ coding
            • 32. Encounter.reasonCode:deviatingResult
              Slice NamedeviatingResult
              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..*
              This element is affected by the following invariants: ele-1
              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()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. Encounter.reasonCode:deviatingResult.extension:commentContactReason
              Slice NamecommentContactReason
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ext Comment) (Extension Type: string)
              Obligations
                ObligationsActor
                SHALL:populate-if-knownACP Actor Provider
                SHALL:no-errorACP Actor Consulter
                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())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                36. Encounter.reasonCode:deviatingResult.extension:commentContactReason.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Comment
                38. Encounter.reasonCode:deviatingResult.extension:commentContactReason.value[x]
                Definition

                Explanation of the reason for the contact


                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortCommentContactReasonValue of extension
                Control0..1
                This element is affected by the following invariants: ele-1
                Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Alternate NamesToelichtingRedenContact
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Encounter.reasonCode:deviatingResult.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..0*
                This element is affected by the following invariants: ele-1
                TypeCoding
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. 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..*
                This element is affected by the following invariants: ele-1
                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()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Encounter.reasonReference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 44. Encounter.reasonReference.extension:commentContactReason
                  Slice NamecommentContactReason
                  Definition

                  Optional Extension Element - found in all resources.

                  ShortOptional Extensions Element
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(ext Comment) (Extension Type: string)
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownACP Actor Provider
                    SHALL:no-errorACP Actor Consulter
                    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())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    46. Encounter.reasonReference.extension:commentContactReason.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Comment
                    48. Encounter.reasonReference.extension:commentContactReason.value[x]
                    Definition

                    Explanation of the reason for the contact


                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortCommentContactReasonValue of extension
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Alternate NamesToelichtingRedenContact
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. Encounter.reasonReference.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: ele-1, ref-1
                    Typestring
                    Is Modifierfalse
                    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()))
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    52. Encounter.reasonReference:problem
                    Slice Nameproblem
                    Definition

                    The problem that is the reason for the contact.


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

                    ShortProblemReason 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..*
                    This element is affected by the following invariants: ele-1
                    TypeReference(nl core Problem, Condition, Procedure, Observation, ImmunizationRecommendation)
                    Is Modifierfalse
                    Summarytrue
                    Alternate NamesIndication, Admission diagnosis, Probleem
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    54. Encounter.reasonReference:procedure
                    Slice Nameprocedure
                    Definition

                    The procedure carried out or will be carried out during the contact.


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

                    ShortProcedureReason 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..*
                    This element is affected by the following invariants: ele-1
                    TypeReference(nl core Procedure event, Condition, Procedure, Observation, ImmunizationRecommendation)
                    Is Modifierfalse
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownACP Actor Provider
                      SHALL:no-errorACP Actor Consulter
                      Summarytrue
                      Alternate NamesIndication, Admission diagnosis, Verrichting
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      56. 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..1*
                      This element is affected by the following invariants: ele-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      58. Encounter.location.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

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

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

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

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

                      The physical location at which the contact took or will take place.


                      The location where the encounter takes place.

                      ShortLocationLocation the encounter takes place
                      Comments

                      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeReference(Location, nl core HealthcareProvider)
                      Is Modifierfalse
                      Alternate NamesLocatie
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                      0. Encounter
                      2. Encounter.class
                      4. Encounter.subject
                      TypeReference(Patient)
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownACP Actor Provider
                        SHALL:no-errorACP Actor Consulter
                        6. Encounter.participant
                        8. Encounter.participant:healthProfessional
                        Slice NamehealthProfessional
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownACP Actor Provider
                          SHALL:no-errorACP Actor Consulter
                          10. Encounter.participant:healthProfessional.individual
                          TypeReference(HealthProfessional PractitionerRole)
                          12. Encounter.participant:contactPerson
                          Slice NamecontactPerson
                          Control0..*
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownACP Actor Provider
                            SHALL:no-errorACP Actor Consulter
                            14. Encounter.participant:contactPerson.individual
                            TypeReference(ContactPerson)
                            16. Encounter.period
                            18. Encounter.period.start
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownACP Actor Provider
                              SHALL:no-errorACP Actor Consulter
                              20. Encounter.reasonCode:deviatingResult
                              Slice NamedeviatingResult
                              22. Encounter.reasonCode:deviatingResult.extension:commentContactReason
                              Slice NamecommentContactReason
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownACP Actor Provider
                                SHALL:no-errorACP Actor Consulter
                                24. Encounter.reasonCode:deviatingResult.extension:commentContactReason.value[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                26. Encounter.reasonReference
                                28. Encounter.reasonReference.extension:commentContactReason
                                Slice NamecommentContactReason
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownACP Actor Provider
                                  SHALL:no-errorACP Actor Consulter
                                  30. Encounter.reasonReference.extension:commentContactReason.value[x]
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  32. Encounter.reasonReference:procedure
                                  Slice Nameprocedure
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownACP Actor Provider
                                    SHALL:no-errorACP Actor Consulter

                                    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.

                                    ShortEncounter
                                    Control0..*
                                    Alternate NamesVisit, Contact, nl-core-Encounter
                                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.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 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-6: A resource should have narrative for robust management (text.`div`.exists())
                                    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.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
                                    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
                                    This element is affected by the following invariants: ele-1
                                    TypeMeta
                                    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
                                    This element is affected by the following invariants: ele-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
                                    This element is affected by the following invariants: ele-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
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    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..1
                                    This element is affected by the following invariants: ele-1
                                    TypeNarrative
                                    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
                                    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. 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.

                                    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..*
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension
                                    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
                                    • 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 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..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                      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())
                                      SlicingThis element introduces a set of slices on Encounter.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 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..*
                                        This element is affected by the following invariants: ele-1
                                        TypeIdentifier
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        20. Encounter.status
                                        Definition

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

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

                                        This element is implictly mapped to the zib concepts NL-CM:15.1.3 (StartDateTime) and NL-CM:15.1.4 (EndDateTime). Unless the status is explicitly recorded, the following guidance applies:

                                        • When StartDateTime is in the future, .status will usually be set to planned.
                                        • When StartDateTime is in the past and EndDateTime is present and in the future, .status will usually be set to in-progress.
                                        • When EndDateTime is present and in the past, .status will usually be set to finished.
                                        • When EndDateTime is not present, this means it was a point-in-time encounter and .status will usually be set to finished.
                                        • When a system is unable to infer the status from the StartDateTime and EndDateTime, .status will be set to unknown.

                                        The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

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

                                        Control1..1
                                        This element is affected by the following invariants: ele-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()))
                                        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..*
                                        This element is affected by the following invariants: ele-1
                                        TypeBackboneElement
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (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.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        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. 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.

                                        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..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension
                                        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.statusHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

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

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

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

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

                                          Note that FHIR strings SHALL NOT exceed 1MB in size

                                          Control1..1
                                          This element is affected by the following invariants: ele-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
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          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
                                          Comments

                                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                          Period is not used for a duration (a measure of elapsed time). See Duration.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          TypePeriod
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                          34. Encounter.class
                                          Definition

                                          The type of contact.

                                          ShortContactType
                                          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.

                                          Control1..1
                                          This element is affected by the following invariants: ele-1
                                          BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode (3.0.0)
                                          (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)

                                          Use ConceptMap ContactTypeCodeLijst-to-ActEncounterCode to translate terminology from the functional model to profile terminology in ValueSet ActEncounterCode.

                                          TypeCoding
                                          Summarytrue
                                          Alternate NamesContactType
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          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 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..*
                                          This element is affected by the following invariants: ele-1
                                          TypeBackboneElement
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (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.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          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. 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.

                                          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..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension
                                          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.classHistory.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

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

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

                                            inpatient | outpatient | ambulatory | emergency +.

                                            Shortinpatient | outpatient | ambulatory | emergency +
                                            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.

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            BindingUnless not suitable, these codes SHALL be taken from ActEncounterCode (3.0.0)
                                            (extensible to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)

                                            Classification of the encounter.

                                            TypeCoding
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            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
                                            Comments

                                            A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                            Period is not used for a duration (a measure of elapsed time). See Duration.

                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypePeriod
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                            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..*
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see EncounterType
                                            (example to http://hl7.org/fhir/ValueSet/encounter-type|4.0.1)

                                            The type of encounter.

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

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

                                            ShortSpecific type of service
                                            Comments

                                            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            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
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            52. Encounter.priority
                                            Definition

                                            Indicates the urgency of the encounter.

                                            ShortIndicates the urgency of the encounter
                                            Comments

                                            Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            BindingFor example codes, see ActPriority (3.0.0)
                                            (example to http://terminology.hl7.org/ValueSet/v3-ActPriority|3.0.0)

                                            Indicates the urgency of the encounter.

                                            TypeCodeableConcept
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            54. 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..1
                                            This element is affected by the following invariants: ele-1
                                            TypeReference(Patient)
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownACP Actor Provider
                                              SHALL:no-errorACP Actor Consulter
                                              Summarytrue
                                              Alternate Namespatient
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              56. 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
                                              Comments

                                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(EpisodeOfCare)
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              58. Encounter.basedOn
                                              Definition

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

                                              ShortThe ServiceRequest that initiated this encounter
                                              Comments

                                              References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeReference(ServiceRequest)
                                              Alternate NamesincomingReferral
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                              60. Encounter.participant
                                              Definition

                                              The list of people responsible for providing the service.

                                              ShortList of participants involved in the encounter
                                              Control0..*
                                              This element is affected by the following invariants: ele-1
                                              TypeBackboneElement
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Encounter.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ individual.resolve()
                                              • 62. Encounter.participant.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                64. Encounter.participant.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                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..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension
                                                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.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 66. Encounter.participant.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

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

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

                                                  Role of participant in encounter.

                                                  ShortRole of participant in encounter
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                                  (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

                                                  Role of participant in encounter.

                                                  TypeCodeableConcept
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  70. 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
                                                  Comments

                                                  A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                  Period is not used for a duration (a measure of elapsed time). See Duration.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypePeriod
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                  72. Encounter.participant.individual
                                                  Definition

                                                  Persons involved in the encounter other than the patient.

                                                  ShortPersons involved in the encounter other than the patient
                                                  Comments

                                                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  TypeReference(Practitioner, PractitionerRole, RelatedPerson)
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                  74. Encounter.participant:healthProfessional
                                                  Slice NamehealthProfessional
                                                  Definition

                                                  The list of people responsible for providing the service.

                                                  ShortList of participants involved in the encounter
                                                  Control0..*
                                                  This element is affected by the following invariants: ele-1
                                                  TypeBackboneElement
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populate-if-knownACP Actor Provider
                                                    SHALL:no-errorACP Actor Consulter
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    76. Encounter.participant:healthProfessional.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    78. Encounter.participant:healthProfessional.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                    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..*
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension
                                                    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.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 80. Encounter.participant:healthProfessional.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

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

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

                                                      The role the health professional fulfils in the healthcare process. For health professionals, this could be for example attender, referrer or performer.

                                                      ShortHealthProfessionalRole
                                                      Comments

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

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      BindingUnless not suitable, these codes SHALL be taken from ZorgverlenerRolCodelijst (2020-09-01T00:00:00)
                                                      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.17.1.5--20200901000000|2020-09-01T00:00:00)

                                                      Role of participant in encounter.

                                                      TypeCodeableConcept
                                                      Summarytrue
                                                      Alternate NamesZorgverlenerRol
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      84. Encounter.participant:healthProfessional.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
                                                      Comments

                                                      A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                      Period is not used for a duration (a measure of elapsed time). See Duration.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypePeriod
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                      86. Encounter.participant:healthProfessional.individual
                                                      Definition

                                                      The health professional with whom the contact took or will take place. The specialty and role of the health professional can be entered in the HealthProfessional information model.

                                                      ShortContactWith
                                                      Comments

                                                      Each occurrence of the zib HealthProfessional is normally represented by two FHIR resources: a PractitionerRole resource (instance of nl-core-HealthProfessional-PractitionerRole) and a Practitioner resource (instance of nl-core-HealthProfessional-Practitioner). The Practitioner resource is referenced from the PractitionerRole instance. For this reason, sending systems should fill the reference to the PractitionerRole instance here, and not the Practitioner resource. Receiving systems can then retrieve the reference to the Practitioner resource from that PractitionerRole instance.

                                                      In rare circumstances, there is only a Practitioner instance, in which case it is that instance which can be referenced on the Encounter.participant element (due to open slicing). Since this should be the exception, the nl-core-HealthProfessional-Practitioner profile is not explicitly mentioned as a target profile.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeReference(HealthProfessional PractitionerRole)
                                                      Summarytrue
                                                      Alternate NamesContactMet
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                      88. Encounter.participant:contactPerson
                                                      Slice NamecontactPerson
                                                      Definition

                                                      The list of people responsible for providing the service.

                                                      ShortList of participants involved in the encounter
                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeBackboneElement
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populate-if-knownACP Actor Provider
                                                        SHALL:no-errorACP Actor Consulter
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        90. Encounter.participant:contactPerson.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        Typestring
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        92. Encounter.participant:contactPerson.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                        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..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        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.participant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 94. Encounter.participant:contactPerson.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

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

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

                                                          Role of participant in encounter.

                                                          ShortRole of participant in encounter
                                                          Comments

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

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          BindingUnless not suitable, these codes SHALL be taken from ParticipantType
                                                          (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|4.0.1)

                                                          Role of participant in encounter.

                                                          TypeCodeableConcept
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          98. Encounter.participant:contactPerson.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
                                                          Comments

                                                          A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                          Period is not used for a duration (a measure of elapsed time). See Duration.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypePeriod
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                          100. Encounter.participant:contactPerson.individual
                                                          Definition

                                                          Persons involved in the encounter other than the patient.

                                                          ShortPersons involved in the encounter other than the patient
                                                          Comments

                                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(ContactPerson)
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                          102. Encounter.appointment
                                                          Definition

                                                          The appointment that scheduled this encounter.

                                                          ShortThe appointment that scheduled this encounter
                                                          Comments

                                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(Appointment)
                                                          Summarytrue
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                          104. 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
                                                          This element is affected by the following invariants: ele-1
                                                          TypePeriod
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                          106. 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.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          Typestring
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          108. Encounter.period.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                          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..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension
                                                          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.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 110. Encounter.period.start
                                                            Definition

                                                            The date and time at which the contact took or will take place.

                                                            ShortStartDateTime
                                                            Comments

                                                            If only a single moment in time is known for the encounter rather than a period, both period.start and period.end are populated with this value (populating just period.start would indicate an ongoing period).

                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1, per-1
                                                            TypedateTime
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populate-if-knownACP Actor Provider
                                                              SHALL:no-errorACP Actor Consulter
                                                              Summarytrue
                                                              Alternate NamesBeginDatumTijd
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              112. Encounter.period.end
                                                              Definition

                                                              The date and time at which the contact ended or will end. 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.

                                                              ShortEndDateTime
                                                              Comments

                                                              If only a single moment in time is known for the encounter rather than a period, both period.start and period.end are populated with this value (populating just period.start would indicate an ongoing period).

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1, 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
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              114. 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
                                                              This element is affected by the following invariants: ele-1
                                                              TypeDuration
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                              drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. (code.exists() implies ((system = %ucum) and value.exists()))
                                                              116. 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..*
                                                              This element is affected by the following invariants: ele-1
                                                              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
                                                              Summarytrue
                                                              Alternate NamesIndication, Admission diagnosis
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on Encounter.reasonCode. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • exists @ coding
                                                              • 118. Encounter.reasonCode:deviatingResult
                                                                Slice NamedeviatingResult
                                                                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..*
                                                                This element is affected by the following invariants: ele-1
                                                                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
                                                                Summarytrue
                                                                Alternate NamesIndication, Admission diagnosis
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                120. Encounter.reasonCode:deviatingResult.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                122. Encounter.reasonCode:deviatingResult.extension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                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..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension
                                                                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.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 124. Encounter.reasonCode:deviatingResult.extension:commentContactReason
                                                                  Slice NamecommentContactReason
                                                                  Definition

                                                                  Optional Extension Element - found in all resources.

                                                                  ShortOptional Extensions Element
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension(ext Comment) (Extension Type: string)
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populate-if-knownACP Actor Provider
                                                                    SHALL:no-errorACP Actor Consulter
                                                                    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())
                                                                    126. Encounter.reasonCode:deviatingResult.extension:commentContactReason.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    Typestring
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    128. Encounter.reasonCode:deviatingResult.extension:commentContactReason.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                    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..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension
                                                                    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.reasonCode.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 130. Encounter.reasonCode:deviatingResult.extension:commentContactReason.url
                                                                      Definition

                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                      Shortidentifies the meaning of the extension
                                                                      Comments

                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                      Control1..1
                                                                      Typeuri
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Comment
                                                                      132. Encounter.reasonCode:deviatingResult.extension:commentContactReason.value[x]
                                                                      Definition

                                                                      Explanation of the reason for the contact

                                                                      ShortCommentContactReason
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typestring
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Alternate NamesToelichtingRedenContact
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      134. Encounter.reasonCode:deviatingResult.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..0
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeCoding
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      136. Encounter.reasonCode:deviatingResult.text
                                                                      Definition

                                                                      A deviating result or other textual explanation which serves as the reason for the contact.

                                                                      ShortDeviatingResult
                                                                      Comments

                                                                      Note that this definition is wider than the zib concept DeviatingResult (NL-CM:15.1.12); although the zib concept deals only with deviating results as reason for the encounter, this element could be populated with any reason for the encounter, including but not limited to deviating results. Implementers should be aware of the usage context of this profile to understand if this element is limited to a deviating result.

                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-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
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      138. 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..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
                                                                      Summarytrue
                                                                      Alternate NamesIndication, Admission diagnosis
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                      SlicingThis element introduces a set of slices on Encounter.reasonReference. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • profile @ resolve()
                                                                      • 140. Encounter.reasonReference.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        142. Encounter.reasonReference.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                        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..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        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.reasonReference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 144. Encounter.reasonReference.extension:commentContactReason
                                                                          Slice NamecommentContactReason
                                                                          Definition

                                                                          Optional Extension Element - found in all resources.

                                                                          ShortOptional Extensions Element
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension(ext Comment) (Extension Type: string)
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:populate-if-knownACP Actor Provider
                                                                            SHALL:no-errorACP Actor Consulter
                                                                            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())
                                                                            146. Encounter.reasonReference.extension:commentContactReason.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            148. Encounter.reasonReference.extension:commentContactReason.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                            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..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            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.reasonReference.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 150. Encounter.reasonReference.extension:commentContactReason.url
                                                                              Definition

                                                                              Source of the definition for the extension code - a logical name or a URL.

                                                                              Shortidentifies the meaning of the extension
                                                                              Comments

                                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                              Control1..1
                                                                              Typeuri
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/ext-Comment
                                                                              152. Encounter.reasonReference.extension:commentContactReason.value[x]
                                                                              Definition

                                                                              Explanation of the reason for the contact

                                                                              ShortCommentContactReason
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Alternate NamesToelichtingRedenContact
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              154. Encounter.reasonReference.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: ele-1, ref-1
                                                                              Typestring
                                                                              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()))
                                                                              156. Encounter.reasonReference.type
                                                                              Definition

                                                                              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                                              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                                              ShortType the reference refers to (e.g. "Patient")
                                                                              Comments

                                                                              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                                              (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                                                                              Aa resource (or, for logical models, the URI of the logical model).

                                                                              Typeuri
                                                                              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()))
                                                                              158. Encounter.reasonReference.identifier
                                                                              Definition

                                                                              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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.

                                                                              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeIdentifier
                                                                              Summarytrue
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              160. Encounter.reasonReference.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
                                                                              This element is affected by the following invariants: ele-1
                                                                              Typestring
                                                                              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()))
                                                                              162. Encounter.reasonReference:problem
                                                                              Slice Nameproblem
                                                                              Definition

                                                                              The problem that is the reason for the contact.

                                                                              ShortProblem
                                                                              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..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeReference(nl core Problem)
                                                                              Summarytrue
                                                                              Alternate NamesIndication, Admission diagnosis, Probleem
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                              164. Encounter.reasonReference:procedure
                                                                              Slice Nameprocedure
                                                                              Definition

                                                                              The procedure carried out or will be carried out during the contact.

                                                                              ShortProcedure
                                                                              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..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeReference(nl core Procedure event)
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:populate-if-knownACP Actor Provider
                                                                                SHALL:no-errorACP Actor Consulter
                                                                                Summarytrue
                                                                                Alternate NamesIndication, Admission diagnosis, Verrichting
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                166. Encounter.diagnosis
                                                                                Definition

                                                                                The list of diagnosis relevant to this encounter.

                                                                                ShortThe list of diagnosis relevant to this encounter
                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeBackboneElement
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                168. Encounter.diagnosis.id
                                                                                Definition

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

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                170. Encounter.diagnosis.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                                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..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                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.diagnosis.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 172. Encounter.diagnosis.modifierExtension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

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

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

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

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

                                                                                  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.

                                                                                  ShortThe diagnosis or procedure relevant to the encounter
                                                                                  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
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeReference(Condition, Procedure)
                                                                                  Summarytrue
                                                                                  Alternate NamesAdmission diagnosis, discharge diagnosis, indication
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                  176. Encounter.diagnosis.use
                                                                                  Definition

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

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

                                                                                  Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingThe codes SHOULD be taken from DiagnosisRole
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/diagnosis-role|4.0.1)

                                                                                  The type of diagnosis this condition represents.

                                                                                  TypeCodeableConcept
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  178. Encounter.diagnosis.rank
                                                                                  Definition

                                                                                  Ranking of the diagnosis (for each role type).

                                                                                  ShortRanking of the diagnosis (for each role type)
                                                                                  Comments

                                                                                  32 bit number; for values larger than this, use decimal

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypepositiveInt
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  180. 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..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeReference(Account)
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                  182. 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
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeBackboneElement
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  184. 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.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  186. Encounter.hospitalization.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                                  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..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  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.hospitalization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 188. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

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

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

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

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

                                                                                    Pre-admission identifier.

                                                                                    ShortPre-admission identifier
                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeIdentifier
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    192. Encounter.hospitalization.origin
                                                                                    Definition

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

                                                                                    ShortThe location/organization from which the patient came before admission
                                                                                    Comments

                                                                                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Location, Organization)
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                    194. Encounter.hospitalization.admitSource
                                                                                    Definition

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

                                                                                    ShortOrigin
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from HerkomstCodelijst (2020-09-01T00:00:00)
                                                                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.2--20200901000000|2020-09-01T00:00:00)

                                                                                    From where the patient was admitted.

                                                                                    TypeCodeableConcept
                                                                                    Alternate NamesHerkomst
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    196. 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
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingFor example codes, see Hl7VSReAdmissionIndicator (2.0.0)
                                                                                    (example to http://terminology.hl7.org/ValueSet/v2-0092|2.0.0)

                                                                                    The reason for re-admission of this hospitalization encounter.

                                                                                    TypeCodeableConcept
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    198. 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..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingFor example codes, see Diet
                                                                                    (example to http://hl7.org/fhir/ValueSet/encounter-diet|4.0.1)

                                                                                    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.

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

                                                                                    Special courtesies (VIP, board member).

                                                                                    ShortSpecial courtesies (VIP, board member)
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHOULD be taken from SpecialCourtesy
                                                                                    (preferred to http://hl7.org/fhir/ValueSet/encounter-special-courtesy|4.0.1)

                                                                                    Special courtesies.

                                                                                    TypeCodeableConcept
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    202. 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.
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHOULD be taken from SpecialArrangements
                                                                                    (preferred to http://hl7.org/fhir/ValueSet/encounter-special-arrangements|4.0.1)

                                                                                    Special arrangements.

                                                                                    TypeCodeableConcept
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    204. Encounter.hospitalization.destination
                                                                                    Definition

                                                                                    Location/organization to which the patient is discharged.

                                                                                    ShortLocation/organization to which the patient is discharged
                                                                                    Comments

                                                                                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeReference(Location, Organization)
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                    206. 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
                                                                                    Comments

                                                                                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from BestemmingCodelijst (2020-09-01T00:00:00)
                                                                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.15.1.3--20200901000000|2020-09-01T00:00:00)

                                                                                    Discharge Disposition.

                                                                                    TypeCodeableConcept
                                                                                    Alternate NamesBestemming
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    208. 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..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeBackboneElement
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    210. Encounter.location.id
                                                                                    Definition

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

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    212. Encounter.location.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

                                                                                    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..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    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.location.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 214. Encounter.location.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

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

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

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

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

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

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

                                                                                      The physical location at which the contact took or will take place.

                                                                                      ShortLocation
                                                                                      Comments

                                                                                      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeReference(Location, nl core HealthcareProvider)
                                                                                      Alternate NamesLocatie
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                      218. Encounter.location.status
                                                                                      Definition

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

                                                                                      Shortplanned | active | reserved | completed
                                                                                      Comments

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

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingThe codes SHALL be taken from EncounterLocationStatus
                                                                                      (required to http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1)

                                                                                      The status of the location.

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

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

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

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

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

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingFor example codes, see LocationType
                                                                                      (example to http://hl7.org/fhir/ValueSet/location-physical-type|4.0.1)

                                                                                      Physical form of the location.

                                                                                      TypeCodeableConcept
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      222. 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
                                                                                      Comments

                                                                                      A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").

                                                                                      Period is not used for a duration (a measure of elapsed time). See Duration.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypePeriod
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      per-1: If present, start SHALL have a lower value than end (start.hasValue().not() or end.hasValue().not() or (start <= end))
                                                                                      224. 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.

                                                                                      ShortThe organization (facility) responsible for this encounter
                                                                                      Comments

                                                                                      References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeReference(Organization)
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                                                                                      226. 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
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeReference(Encounter)
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))