Scope and Usage

The Finnish Core Encounter profile is intended to encapsulate the most common and basic data model of encounters in Finnish healthcare systems. The profile also defines encounter's relation to the Kanta registry. As such the profile should be usable in most Finnish contexts.

Relation to Finnish palvelutapahtuma

Kanta is the Finnish national central registry of health and social welfare information. It has a specification for Palvelutapahtuma, this is typically translated as service-event or encompassing encounter.

The scope of palvelutapahtuma is described in Kanta documentation (in Finnish). It's scope is not always the same as the encounter's. Encounter and palvelutapahtuma will overlap as concepts (depending on implementation). Some encounters clearly align with palvelutapahtuma while others don't. Palvelutapahtuma may contain multiple encounters. For example a series of treatments is considered to be a singular palvelutapahtuma, but systems most likely want to express each visit as a separate encounter (see kanta doc for the description of hoitosarja, there are other examples too).

For deeper techical details, see (in Finnish):

• Kanta CDA R2 Header version 4.66 or later.
  • Descriptions of palvelutapahtuma
• Kanta HL7 V3 Medical Records specification.
  • Shows the role of palvelutapahtuma when making requests to Kanta

Why does an encounter need this information?

Kanta HL7 V3 Medical Records specification requires that both queries and archivals transmit palvelutapahtuma's OID identifier on each request. A client application that is integrated to a patient administration system (one that masters the data of encounters) often needs to create and query Kanta Medical records. Encounter is the best "vessel" we have to transmit this information.

For example a laboratory information system may have it's own Kanta Medical Records capabilities and will archive lab results directly to Kanta. It receives encounter id in SMART App Launch context. Laboratory system can resolve palvelutapahtuma's OID identifier by fetching the encounter resource.

How to communicate the palvelutapahtuma via the Encounter resource

This method is applicable for resources that have a direct link to Encounter.

An Encounter that is a palvelutapahtuma SHALL have an identifier with use=official and the value of that identifier SHALL be the OID of a palvelutapahtuma.

Other levels of encounter that are not a palvelutapahtuma, MUST NOT contain an identifier with use=official.

The resource referring to the Encounter, may link to the palvelutapahtuma Encounter directly, or to a lower level Encounter (some systems call these prosessitapahtuma). In this case, the lower level Encounters SHALL have a chain of .partOf links eventually leading to the palvelutapahtuma Encounter.

How to communicate the palvelutapahtuma without an Encounter resource

When the resource does not have a direct link to Encounter or if the chaining of Encounter resources is considered too complex, the ServiceEvent extension can be used instead.

Organizational responsibility

The unit responsible for the encounter SHOULD be communicated using the serviceProvider property.

For instance, there's a detailed example with explanations for how to fetch patients in a ward.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	Σ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
subject	Σ	0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
appointment	Σ	0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
reasonReference	Σ	0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
subject		0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare		0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
participant
individual		0..1	Reference(FI Base Practitioner(2.0.0-ci) | FI Base PractitionerRole(2.0.0-ci) | RelatedPerson)	Persons involved in the encounter other than the patient
appointment		0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
reasonReference		0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis
condition		1..1	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci))	The diagnosis or procedure relevant to the encounter
hospitalization
origin		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	The location/organization from which the patient came before admission
destination		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	Location/organization to which the patient is discharged
location
location		1..1	Reference(FI Base Location(2.0.0-ci))	Location the encounter takes place
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!Σ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	Σ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	Σ	0..*	CodeableConcept	Specific type of encounter Binding: EncounterType (example): The type of encounter.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	Σ	0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	Σ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period		0..1	Period	Period of time during the encounter that the participant participated
individual	Σ	0..1	Reference(FI Base Practitioner(2.0.0-ci) | FI Base PractitionerRole(2.0.0-ci) | RelatedPerson)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	Σ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci))	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	Location/organization to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location		0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location		1..1	Reference(FI Base Location(2.0.0-ci))	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5
Encounter.type	Base	example	Encounter type	📍4.0.1	FHIR Std.
Encounter.serviceType	Base	example	Service type	📍4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📦3.0.0	THO v6.5
Encounter.participant.​type	Base	extensible	Participant type	📍4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📍4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	preferred	Admit source	📍4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	example	hl7VS-re-admissionIndicator	📦2.0.0	THO v6.5
Encounter.hospitalization.​dietPreference	Base	example	Diet	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📍4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	example	Discharge disposition	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	example	Location type	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	Σ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
subject	Σ	0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
appointment	Σ	0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
reasonReference	Σ	0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from Encounter

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
subject		0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare		0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
participant
individual		0..1	Reference(FI Base Practitioner(2.0.0-ci) | FI Base PractitionerRole(2.0.0-ci) | RelatedPerson)	Persons involved in the encounter other than the patient
appointment		0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
reasonReference		0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis
condition		1..1	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci))	The diagnosis or procedure relevant to the encounter
hospitalization
origin		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	The location/organization from which the patient came before admission
destination		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	Location/organization to which the patient is discharged
location
location		1..1	Reference(FI Base Location(2.0.0-ci))	Location the encounter takes place
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	Encounter	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier(s) by which this encounter is known
status	?!Σ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	Σ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	Σ	0..*	CodeableConcept	Specific type of encounter Binding: EncounterType (example): The type of encounter.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	Σ	0..1	Reference(FI Base Patient(2.0.0-ci) | Group)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(FI Base EpisodeOfCare(2.0.0-ci))	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	Σ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period		0..1	Period	Period of time during the encounter that the participant participated
individual	Σ	0..1	Reference(FI Base Practitioner(2.0.0-ci) | FI Base PractitionerRole(2.0.0-ci) | RelatedPerson)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(FI Base Appointment(2.0.0-ci))	The appointment that scheduled this encounter
period		0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	Σ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci) | FI Base Observation(2.0.0-ci) | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(FI Base Condition(2.0.0-ci) | Fi Base Procedure(2.0.0-ci))	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization		0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(FI Base Location(2.0.0-ci) | FI Base Organization(2.0.0-ci))	Location/organization to which the patient is discharged
dischargeDisposition		0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location		0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location		1..1	Reference(FI Base Location(2.0.0-ci))	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(FI Base Organization(2.0.0-ci))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(FI Base Encounter(2.0.0-ci))	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Encounter.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Encounter.status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.statusHistory.​status	Base	required	EncounterStatus	📍4.0.1	FHIR Std.
Encounter.class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5
Encounter.classHistory.​class	Base	extensible	ActEncounterCode	📦3.0.0	THO v6.5
Encounter.type	Base	example	Encounter type	📍4.0.1	FHIR Std.
Encounter.serviceType	Base	example	Service type	📍4.0.1	FHIR Std.
Encounter.priority	Base	example	ActPriority	📦3.0.0	THO v6.5
Encounter.participant.​type	Base	extensible	Participant type	📍4.0.1	FHIR Std.
Encounter.reasonCode	Base	preferred	Encounter Reason Codes	📍4.0.1	FHIR Std.
Encounter.diagnosis.​use	Base	preferred	DiagnosisRole	📍4.0.1	FHIR Std.
Encounter.hospitalization.​admitSource	Base	preferred	Admit source	📍4.0.1	FHIR Std.
Encounter.hospitalization.​reAdmission	Base	example	hl7VS-re-admissionIndicator	📦2.0.0	THO v6.5
Encounter.hospitalization.​dietPreference	Base	example	Diet	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialCourtesy	Base	preferred	Special courtesy	📍4.0.1	FHIR Std.
Encounter.hospitalization.​specialArrangement	Base	preferred	Special arrangements	📍4.0.1	FHIR Std.
Encounter.hospitalization.​dischargeDisposition	Base	example	Discharge disposition	📍4.0.1	FHIR Std.
Encounter.location.status	Base	required	EncounterLocationStatus	📍4.0.1	FHIR Std.
Encounter.location.physicalType	Base	example	Location type	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from Encounter

Summary

Structures

This structure refers to these other structures:

• FI Base Patient (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-patient)
• FI Base EpisodeOfCare (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-episode-of-care)
• FI Base Practitioner (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-practitioner)
• FI Base PractitionerRole (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-practitioner-role)
• FI Base Appointment (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-appointment)
• FI Base Condition (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-condition)
• Fi Base Procedure (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-procedure)
• FI Base Observation (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-observation)
• FI Base Location (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-location)
• FI Base Organization (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-organization)
• FI Base Encounter (https://hl7.fi/fhir/finnish-base-profiles/StructureDefinition/fi-base-encounter)