CA Core+ v1.1.0 DFT-preBallot
1.1.0-DFT-preBallot 
DFT-preBallot - The specification is a DFT-preBallot version of CA Core+ for collecting community feedback. For a full list of available versions, see the Directory of published versions
Encounter (CA-Core)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Encounter
Examples
Description
This profile applies constraints to the Encounter resource for CA Core+ to support representation of care events and encounters in the pan-Canadian context.
References to this resource
AllergyIntoleranceCACore, CommunicationCACore, ConditionCACore, DiagnosticReportCACore, ObservationAlcoholUseCACore, ObservationCACore, ObservationLaboratoryPathologyResultCACore, ObservationResultsRadiologyCACore, ObservationSocialHistoryCACore, ObservationTobaccoUseCACore, ServiceRequestCACore
CFMM: 2
Resource Content
| EncounterCACore (Encounter) | C | Encounter | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| status | SO Σ ?! | 1..1 | codeBinding |
| statusHistory | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| status | 1..1 | codeBinding | |
| period | 1..1 | Period | |
| class | Σ | 1..1 | CodingBinding |
| classHistory | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| class | 1..1 | CodingBinding | |
| period | 1..1 | Period | |
| type | Σ | 0..* | CodeableConcept |
| serviceType | Σ | 0..1 | CodeableConcept |
| priority | 0..1 | CodeableConcept | |
| subject | O Σ | 0..1 | Reference(PatientCACore | Group) |
| episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) |
| basedOn | 0..* | Reference(ServiceRequest) | |
| participant | Σ | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 0..* | CodeableConceptBinding |
| period | 0..1 | Period | |
| individual | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | RelatedPerson) |
| appointment | Σ | 0..* | Reference(Appointment) |
| period | 0..1 | Period | |
| length | 0..1 | Duration | |
| reasonCode | Σ | 0..* | CodeableConceptBinding |
| reasonReference | Σ | 0..* | Reference(ConditionCACore | ObservationCACore | ImmunizationRecommendation | Procedure) |
| diagnosis | Σ | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| condition | Σ | 1..1 | Reference(Condition | Procedure) |
| use | 0..1 | CodeableConceptBinding | |
| rank | 0..1 | positiveInt | |
| account | 0..* | Reference(Account) | |
| hospitalization | 0..1 | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| preAdmissionIdentifier | 0..1 | Identifier | |
| origin | 0..1 | Reference(LocationCACore | OrganizationCACore) | |
| admitSource | 0..1 | CodeableConceptBinding | |
| reAdmission | 0..1 | CodeableConcept | |
| dietPreference | 0..* | CodeableConcept | |
| specialCourtesy | 0..* | CodeableConceptBinding | |
| specialArrangement | 0..* | CodeableConceptBinding | |
| destination | 0..1 | Reference(LocationCACore | OrganizationCACore) | |
| dischargeDisposition | 0..1 | CodeableConcept | |
| location | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| location | 1..1 | Reference(LocationCACore) | |
| status | 0..1 | codeBinding | |
| physicalType | 0..1 | CodeableConcept | |
| period | 0..1 | Period | |
| serviceProvider | 0..1 | Reference(OrganizationCACore) | |
| partOf | 0..1 | Reference(Encounter) |
| EncounterCACore (Encounter) | C | Encounter | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| status | SO Σ ?! | 1..1 | codeBinding |
| statusHistory | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| status | 1..1 | codeBinding | |
| period | 1..1 | Period | |
| class | Σ | 1..1 | CodingBinding |
| classHistory | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| class | 1..1 | CodingBinding | |
| period | 1..1 | Period | |
| type | Σ | 0..* | CodeableConcept |
| serviceType | Σ | 0..1 | CodeableConcept |
| priority | 0..1 | CodeableConcept | |
| subject | O Σ | 0..1 | Reference(PatientCACore | Group) |
| episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) |
| basedOn | 0..* | Reference(ServiceRequest) | |
| participant | Σ | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 0..* | CodeableConceptBinding |
| period | 0..1 | Period | |
| individual | Σ | 0..1 | Reference(PractitionerCACore | PractitionerRoleCACore | RelatedPerson) |
| appointment | Σ | 0..* | Reference(Appointment) |
| period | 0..1 | Period | |
| length | 0..1 | Duration | |
| reasonCode | Σ | 0..* | CodeableConceptBinding |
| reasonReference | Σ | 0..* | Reference(ConditionCACore | ObservationCACore | ImmunizationRecommendation | Procedure) |
| diagnosis | Σ | 0..* | BackboneElement |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| condition | Σ | 1..1 | Reference(Condition | Procedure) |
| use | 0..1 | CodeableConceptBinding | |
| rank | 0..1 | positiveInt | |
| account | 0..* | Reference(Account) | |
| hospitalization | 0..1 | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| preAdmissionIdentifier | 0..1 | Identifier | |
| origin | 0..1 | Reference(LocationCACore | OrganizationCACore) | |
| admitSource | 0..1 | CodeableConceptBinding | |
| reAdmission | 0..1 | CodeableConcept | |
| dietPreference | 0..* | CodeableConcept | |
| specialCourtesy | 0..* | CodeableConceptBinding | |
| specialArrangement | 0..* | CodeableConceptBinding | |
| destination | 0..1 | Reference(LocationCACore | OrganizationCACore) | |
| dischargeDisposition | 0..1 | CodeableConcept | |
| location | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| location | 1..1 | Reference(LocationCACore) | |
| status | 0..1 | codeBinding | |
| physicalType | 0..1 | CodeableConcept | |
| period | 0..1 | Period | |
| serviceProvider | 0..1 | Reference(OrganizationCACore) | |
| partOf | 0..1 | Reference(Encounter) |
</extension>
</telecom>
</telecom>
</contact>
<description value="This profile applies constraints to the Encounter resource for CA Core+ to support representation of care events and encounters in the pan-Canadian context." />
</jurisdiction>
<copyright value="Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
</mapping>
<definition value="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." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<definition value="planned | arrived | triaged | in-progress | onleave | finished | cancelled +." />
<comment value="Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes)." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</extension>
</binding>
</mapping>
</mapping>
<map value="No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16" />
</mapping>
</mapping>
</element>
</extension>
<definition value="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." />
<comment value="The current status is always found in the current version of the resource, not the status history." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="planned | arrived | triaged | in-progress | onleave | finished | cancelled +." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<definition value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation)." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Broad categorization of the service that is to be provided (e.g. cardiology)." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<comment value="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)." />
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The request this encounter satisfies (e.g. incoming referral or procedure request)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<comment value="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." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Quantity of time the encounter lasted. This excludes the time during leaves of absence." />
<comment value="May differ from the time the Encounter.period lasted because of leave of absence." />
</base>
</type>
</constraint>
</mapping>
<map value="(PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes" />
</mapping>
</mapping>
</element>
<definition value="Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis." />
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
<map value="EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )" />
</mapping>
</mapping>
</element>
<definition value="Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis." />
<comment value="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)." />
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/observation-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
<map value="EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )" />
</mapping>
</mapping>
</element>
</extension>
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="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." />
<comment value="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)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
<map value="Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively." />
</mapping>
</mapping>
</element>
<short value="Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)" />
<definition value="Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)." />
</base>
</type>
</constraint>
</extension>
</extension>
</binding>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
<comment value="The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules." />
</base>
</type>
</constraint>
</mapping>
</element>
<comment value="An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.\n\nThe duration recorded in the period of this encounter covers the entire scope of this hospitalization record." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</constraint>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
<short value="The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission" />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
<comment value="For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive)." />
<requirements value="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." />
</base>
</type>
</constraint>
</extension>
<description value="Medical, cultural or ethical food preferences to help with catering requirements." />
</binding>
</mapping>
<map value=".outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]" />
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
<definition value="Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
<comment value="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"." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="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." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
<short value="The physical type of the location (usually the level in the location hierachy - bed room ward etc.)" />
<definition value="This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query." />
<comment value="This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.\n\nThere may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario." />
</base>
</type>
</constraint>
</extension>
</binding>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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." />
</base>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Another Encounter of which this encounter is a part of (administratively or in time)." />
<comment value="This is also used for associating a child's encounter back to the mother's encounter.\n\nRefer to the Notes section in the Patient resource for further details." />
</base>
</extension>
</type>
</constraint>
</mapping>
</mapping>
</element>
</snapshot>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
</element>
</extension>
</extension>
</extension>
</extension>
</extension>
</extension>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core" />
</type>
</mapping>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/observation-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core" />
</type>
</element>
<targetProfile value="http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core" />
</type>
</element>
</differential>
</StructureDefinition>
{
],
{
{
},
{
}
]
}
],
"description": "This profile applies constraints to the Encounter resource for CA Core+ to support representation of care events and encounters in the pan-Canadian context.",
],
"copyright": "Copyright © 2025+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
}
],
{
"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.",
"Visit"
],
},
{
},
{
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
}
],
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
"comment": "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.",
},
],
{
}
],
"isModifierReason": "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",
},
{
"comment": "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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"comment": "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.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"comment": "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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes).",
},
],
{
}
],
"isModifierReason": "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",
{
}
],
},
{
},
{
},
{
"map": "No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16"
},
{
}
]
},
{
{
}
],
"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.",
"comment": "The current status is always found in the current version of the resource, not the status history.",
},
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
},
],
{
}
],
]
},
{
"definition": "Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.",
},
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
{
}
],
"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.",
},
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
},
],
{
}
],
]
},
{
"definition": "Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).",
},
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
"comment": "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).",
"patient"
],
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"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).",
},
{
}
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "The request this encounter satisfies (e.g. incoming referral or procedure request).",
"incomingReferral"
],
},
{
}
],
{
}
],
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"comment": "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.",
},
],
{
}
],
{
}
],
},
{
},
{
},
{
}
]
},
{
"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.",
},
],
{
}
],
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "Quantity of time the encounter lasted. This excludes the time during leaves of absence.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.",
"comment": "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).",
"Indication",
"Admission diagnosis"
],
},
],
{
}
],
{
}
],
},
{
},
{
},
{
"map": "EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )"
},
{
}
]
},
{
"definition": "Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.",
"comment": "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).",
"Indication",
"Admission diagnosis"
],
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/observation-ca-core",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/Procedure"
]
}
],
{
}
],
{
},
{
},
{
"map": "EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )"
},
{
}
]
},
{
{
}
],
},
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"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.",
"comment": "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).",
"Admission diagnosis",
"discharge diagnosis",
"indication"
],
},
{
"http://hl7.org/fhir/StructureDefinition/Condition",
"http://hl7.org/fhir/StructureDefinition/Procedure"
]
}
],
{
}
],
{
},
{
},
{
"map": "Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively."
},
{
}
]
},
{
"short": "Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)",
"definition": "Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).",
},
],
{
}
],
{
},
{
}
],
},
]
},
{
},
],
{
}
],
]
},
{
"comment": "The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.",
},
],
{
}
],
]
},
{
"comment": "An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.\n\nThe duration recorded in the period of this encounter covers the entire scope of this hospitalization record.",
},
],
{
}
],
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
],
{
}
],
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
"short": "The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission",
},
],
{
}
],
{
}
],
},
]
},
{
"comment": "For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).",
"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.",
},
],
{
}
],
{
}
],
},
{
},
{
}
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
"definition": "Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.",
},
],
{
}
],
{
}
],
},
{
},
{
}
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
],
{
}
],
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
"comment": "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\".",
},
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "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.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core"
]
}
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"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.",
"comment": "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.",
},
],
{
}
],
{
}
],
},
]
},
{
"short": "The physical type of the location (usually the level in the location hierachy - bed room ward etc.)",
"definition": "This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.",
"comment": "This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.\n\nThere may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.",
},
],
{
}
],
{
}
],
}
},
{
},
],
{
}
],
]
},
{
"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.",
},
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Another Encounter of which this encounter is a part of (administratively or in time).",
"comment": "This is also used for associating a child's encounter back to the mother's encounter.\n\nRefer to the Notes section in the Patient resource for further details.",
},
{
{
}
],
"http://hl7.org/fhir/StructureDefinition/Encounter"
]
}
],
{
}
],
{
},
{
}
]
}
]
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
},
{
{
{
},
{
}
],
},
{
{
},
{
}
],
}
],
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/patient-ca-core",
"http://hl7.org/fhir/StructureDefinition/Group"
]
}
],
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitioner-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/practitionerRole-ca-core",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/condition-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/observation-ca-core",
"http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation",
"http://hl7.org/fhir/StructureDefinition/Procedure"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core",
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/location-ca-core"
]
}
]
},
{
{
"http://fhir.infoway-inforoute.ca/cacore/StructureDefinition/organization-ca-core"
]
}
]
}
]
}
}
Terminology bindings
Additional Terminology Bindings
These bindings may be used in lieu of the primary bindings in the table above.
Mappings to CACDI
The following tables list how the data elements from CA Core+ map to CACDI. For more information visit Mapping Logic.
| FHIR Profile Element | CACDI Element(s) |
|---|---|
| Encounter.subject | Patient |