Purpose

The SHINNY Encounter resource is profiled off of the USCore Encounter, which sets minimum expectations for the Encounter resource to record, search, and fetch basic encounter information for an individual patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Usage

The Encounter profile is required for all screening, assessment and referral bundles.

Location References

The Location reference within the Encounter profile is required for all screenings.

Note that the meta.profile used for the location is the SDOH Clinical Care profile and when this profile is used the location.name is required for all locations.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
Slices for type	SΣ	1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
type:23918007	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG
Encounter.type:405672008	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.type:23918007	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard

Constraints

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

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	S	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	S	1..1	SHINNYMeta	Metadata about the resource
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for type		1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008		0..1	CodeableConcept	Specific type of encounter
coding
code		1..1	code	Symbol in syntax defined by the system Required Pattern: 405672008
type:23918007		0..1	CodeableConcept	Specific type of encounter
coding
code		1..1	code	Symbol in syntax defined by the system Required Pattern: 23918007
serviceType	S	0..1	CodeableConcept	Specific type of service
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter
subject		1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
participant
individual		1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	S	0..*	Reference(Appointment)	The appointment that scheduled this encounter
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
condition	S	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
location		0..1	BackboneElement	List of locations where the patient has been
status	S	0..1	code	planned | active | reserved | completed
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
Slices for type	SΣ	1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: 405672008
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
type:23918007	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: 23918007
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG
Encounter.type:405672008	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.type:23918007	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

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

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
Slices for type	SΣ	1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
type:23918007	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..1	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG
Encounter.type:405672008	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.type:23918007	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard

Constraints

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

Differential View

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	S	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	S	1..1	SHINNYMeta	Metadata about the resource
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
Slices for type		1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008		0..1	CodeableConcept	Specific type of encounter
coding
code		1..1	code	Symbol in syntax defined by the system Required Pattern: 405672008
type:23918007		0..1	CodeableConcept	Specific type of encounter
coding
code		1..1	code	Symbol in syntax defined by the system Required Pattern: 23918007
serviceType	S	0..1	CodeableConcept	Specific type of service
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter
subject		1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	S	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
participant
individual		1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	S	0..*	Reference(Appointment)	The appointment that scheduled this encounter
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
condition	S	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
location		0..1	BackboneElement	List of locations where the patient has been
status	S	0..1	code	planned | active | reserved | completed
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	SΣ	1..1	id	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
meta	SΣ	1..1	SHINNYMeta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	S	0..1	code	Language of the resource content Binding: SHINNYLanguageVS (preferred)
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
Slices for type	SΣ	1..1	CodeableConcept	Specific type of encounter Slice: Unordered, Open by value:coding.code Binding: SHINNYEncounterTypeVS (extensible)
type:405672008	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: 405672008
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
type:23918007	SΣ	0..1	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Required Pattern: 23918007
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority	S	0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(SHINNY Patient Profile)	The patient or group present at the encounter
episodeOfCare	SΣ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id	S	0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(SHINNY SDOHCC Condition Profile)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..1	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(SHINNY Encounter Profile)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.language	preferred	SHINNYLanguageVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYLanguageVS From this IG
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 From the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	SHINNYEncounterTypeVS http://shinny.org/us/ny/hrsn/ValueSet/SHINNYEncounterTypeVS From this IG
Encounter.type:405672008	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.type:23918007	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type From the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type From the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason From the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role From the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source From the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet From the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy From the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements From the FHIR Standard
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition http://hl7.org/fhir/ValueSet/encounter-discharge-disposition From the FHIR Standard
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 From the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type From the FHIR Standard

Constraints

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

This structure is derived from USCoreEncounterProfile

Summary

Mandatory: 2 elements(3 nested mandatory elements)
Must-Support: 11 elements

Structures

This structure refers to these other structures:

• SHINNYMeta (http://shinny.org/us/ny/hrsn/StructureDefinition/SHINNYMeta)
• SHINNY Patient Profile (http://shinny.org/us/ny/hrsn/StructureDefinition/shinny-patient)
• SHINNY SDOHCC Condition Profile (http://shinny.org/us/ny/hrsn/StructureDefinition/SHINNY-SDOHCC-Condition)
• SHINNY Encounter Profile (http://shinny.org/us/ny/hrsn/StructureDefinition/shinny-encounter)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Encounter.type