<aside> 💡 The encounter resource records an interaction between the patient and the health care provider for the process of providing health care service or assessing the health care status of the patient.
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A patient encounter is further characterized by the setting in which it takes place. Amongst them are ambulatory, emergency, home health, inpatient and virtual encounters. An Encounter encompasses the lifecycle from pre-admission, the actual encounter (for ambulatory encounters), and admission, stay and discharge (for inpatient encounters). During the encounter the patient may move from practitioner to practitioner and location to location.
Because of the broad scope of Encounter, not all elements will be relevant in all settings. For this reason, admission/discharge related information is kept in a separate Hospitalization component within Encounter. The class element is used to distinguish between these settings, which will guide further validation and application of business rules.
There is also substantial variance from organization to organization (and between jurisdictions and countries) on which business events translate to the start of a new Encounter, or what level of aggregation is used for Encounter. For example, each single visit of a practitioner during a hospitalization may lead to a new instance of Encounter, but depending on local practice and the systems involved, it may well be that this is aggregated to a single instance for a whole hospitalization. Even more aggregation may occur where jurisdictions introduce groups of Encounters for financial or other reasons. Encounters can be aggregated or grouped under other Encounters using the partOf element.
Encounter instances may exist before the actual encounter takes place to convey pre-admission information, including using Encounters elements to reflect the planned start date or planned encounter locations. In this case the status element is set to 'planned'.
The Hospitalization component is intended to store the extended information relating to a hospitalization event. It is always expected to be the same period as the encounter itself. Where the period is different, another encounter instance should be used to capture this information as a partOf this encounter instance.
The Procedure and encounter have references to each other, and these should be to different procedures; one for the procedure that was performed during the encounter (stored in Procedure.encounter), and another for cases where an encounter is a result of another procedure (stored in Encounter.indication) such as a follow-up encounter to resolve complications from an earlier procedure.
{
"resourceType" : "Encounter",
"identifier" : [{ Identifier }], // Identifier(s) by which this encounter is known
"status" : "<code>", // R! planned | arrived | triaged | in-progress | onleave | finished | cancelled +
"type" : [{ CodeableConcept }], // Specific type of encounter
"subject" : { Reference(Patient|Group) }, // The patient or group present at the encounter
"basedOn" : [{ Reference(ServiceRequest) }], // The ServiceRequest that initiated this encounter
"participant" : [{ // List of participants involved in the encounter
"type" : [{ CodeableConcept }], // Role of participant in encounter
"period" : { Period }, // Period of time during the encounter that the participant participated
"individual" : { Reference(Practitioner|PractitionerRole|RelatedPerson) } // Persons involved in the encounter other than the patient
}],
"period" : { Period }, // The start and end time of the encounter
"length" : { Duration }, // Quantity of time the encounter lasted (less time absent)
"reasonCode" : [{ CodeableConcept }], // Coded reason the encounter takes place
"reasonReference" : [{ Reference(Condition|Procedure|Observation|
ImmunizationRecommendation) }], // Reason the encounter takes place (reference)
"diagnosis" : [{ // The list of diagnosis relevant to this encounter
"condition" : { Reference(Condition|Procedure) }, // R! The diagnosis or procedure relevant to the encounter
"use" : { CodeableConcept } // Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
}],
"location" : [{ // List of locations where the patient has been
"location" : { Reference(Location) }, // R! Location the encounter takes place
"status" : "<code>", // planned | active | reserved | completed
"physicalType" : { CodeableConcept }, // The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
"period" : { Period } // Time period during which the patient was present at the location
}],
"serviceProvider" : { Reference(Organization) }, // The organization (facility) responsible for this encounter
}
"resourceType": "Encounter",
"identifier": [
{
"use": "temp",
"value": "Encounter_Roel_20130404"
}
],
"status": "finished",
"type": [
{
"coding": [
{
"system": "<http://snomed.info/sct>",
"code": "11429006",
"display": "Consultation"
}
]
}
],
"subject": {
"reference": "Patient/f201"
},
"participant": [
{
"individual": {
"reference": "Practitioner/f201"
}
}
],
"reasonCode": [
{
"text": "The patient had fever peaks over the last couple of days. He is worried about these peaks."
}
],
"serviceProvider": {
"reference": "Organization/f201"
},
"period":
[
"start": "2020-10-23",
"end": "2020-10-24"
]
}
This resource is being referred to by the Observation resource